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KrisCrossed wrote: ↑

Tue Nov 02, 2021 7:08 pm

but maybe the teledoc is being cautious for good reason.

I assume the caution - and the care given - are legitimate and intended to provide her the best possible outcome. But I also suspect that this assessment was made without regard for available funds. So while the best care may be something other than APAP, the result of not prescribing APAP even as an interim may well be no care.

i struggle to believe that no care is better than APAP when the OSA is not in doubt.

madcity cpap wrote: ↑

Wed Nov 03, 2021 2:32 am

T90..."is the number of minutes during a night of sleep where the patient's oxygen saturation is 90% or lower"

It seems like this should be expressed in minutes, not percentage, so I'm not sure how all that gets reconciled.

That makes sense. T90 of 11% indicates some significant problems.

To calculate minutes, just take the percentage times the number of minutes in the study.

Bradycardia can be sinus bradycardia if a result of hypoxemia. If her oxygen saturation dropped pretty low, that would be a cause. However, you didn't mention that it did.

If it was only brief (<10-15 seconds) it may also have been an erroneous reading (i.e., sensor not picking up well).

At any rate, it's high risk and should be evaluated by a physician.

southerndoc wrote: ↑

Wed Nov 03, 2021 7:21 pm

Bradycardia can be sinus bradycardia if a result of hypoxemia. If her oxygen saturation dropped pretty low, that would be a cause. However, you didn't mention that it did.

If it was only brief (<10-15 seconds) it may also have been an erroneous reading (i.e., sensor not picking up well).

At any rate, it's high risk and should be evaluated by a physician.

Thank you, again for your fresh response. When I looked over the hour by hour data from the study, I could not even find the point where the BPM of 29 was recorded. I suspect the duration was below the resolution of the chart. The second night of the study showed a low of 38bpm and I couldn't find that point either.

She apparently had another conversation with the sleep dr today to try and understand what happened. They were unconcerned with the 38bpm but thought as you do that the 29 merited follow up. She agreed to follow up with her GP on the potential bradycardia, and they went ahead with the rx for the machine.

southerndoc wrote: ↑

Tue Nov 02, 2021 3:57 pm

A HR of 29 is concerning. Heart rates that low are rarely sinus rhythms. Usually they're high-grade AV blocks requiring a pacemaker.

However, I have seen people have vagal responses where their HR gets that low. How long was her HR that low?

My Cardiologists freaked out when I hit 40 a few times, and did a leadless pacemaker implant on me. I COULD definitely tell then my pulse was that low. Turned out to be med related, and they could have just adjusted the dosage sooner, and skipped the implant. But either way, not something that should be left to a sleep clinic, that should be referred quickly to Cardiology, who would likely want to have a Holter study done.

Whats Bradycardia? I never heard of it before.

Brady = slow
Cardia = heart

"Slow heart"

Generally HR <60, but most physicians don't get concerned until <50. <40 is life threatening.

tlohse wrote: ↑

Thu Nov 04, 2021 9:29 pm

Whats Bradycardia? I never heard of it before.

Ever heard of a 'search engine'?

palerider wrote: ↑

Fri Nov 05, 2021 1:26 am

Ever heard of a 'search engine'?

You could try to be kind at least some of the time.

madcity cpap wrote: ↑

Fri Nov 05, 2021 2:28 am

palerider wrote: ↑

Fri Nov 05, 2021 1:26 am

Ever heard of a 'search engine'?

You could try to be kind at least some of the time.

so kind of you to answer the question.

zonker wrote: ↑

Fri Nov 05, 2021 11:14 am

madcity cpap wrote: ↑

Fri Nov 05, 2021 2:28 am

palerider wrote: ↑

Fri Nov 05, 2021 1:26 am

Ever heard of a 'search engine'?

You could try to be kind at least some of the time.

so kind of you to answer the question.

I certainly would answer, if southerndoc had not so graciously done so already.

When one is on a computer, it baffles some of us that said person
does not think to enter the unknown term into their browser, and READ the results.
The computer is RIGHT THERE--in front of you!
Laziness explains nothing--it is easier to type a single word into a browser,
(Or even speak the word)
and wait a few seconds for every possible answer to appear--like magic,
than to beg strangers to look it up for you.
It gets annoying.