Brief Desat events, anything to worry about?

I have been using a CMS 50-E to monitor my SpO2 levels at night. I notice that I spend nearly the whole night in the upper 90's. However, once or twice a night it dips down low. Last night it dipped down to 39 for two seconds. That is the lowest I have seen. Most nights it dips into the 70's. During my original sleep study my SpO2 level dropped to 66. These dips are usually only 10 - 15 seconds in duration. For instance last night it went:

86,79,72,63,53,43,39,39,49,57,65,72,77,82,87,87.87.87.87.87.88.89.89.89.90

and then it stayed in the 90's for 23 more seconds followed by 7 seconds of zero reading. After that it was back in the mid 90's for several more hours.

The next anomaly was a a string of 99 and 98's followed by 5 zeros and then 81,81,81,83,83,86,89,89,89,89, 90, 92, 97 and then stayed in the upper 90's for the rest of the night.

My EncorePro stats are reasonably good.

Total Events 31
Total OA 22
Total Hypop 9
Total Snores 5
Total time in Apnea 5 mins
AHI 3.8
OAI 2.7
HI 1.1
NRI 0
FLI 0
SI 0.6
Avg time in Apnea 13.6 seconds

CPAP 10.0 cm/H2O
Max Leak 63 LPM
90% Leak 39 LPM
Average Leak 32 LPM
Large Leak 0

Are these desat events an artifact of the CMS 50-E? The times don't seem to correspond to anything that Respironics is showing me. By, the way I am also supplementing with 2.0 LPM of O2. Any suggestions?

[quote="scififan"]I have been using a CMS 50-E to monitor my SpO2 levels at night. I notice that I spend nearly the whole night in the upper 90's. However, once or twice a night it dips down low. Last night it dipped down to 39 for two seconds. That is the lowest I have seen. Most nights it dips into the 70's. During my original sleep study my SpO2 level dropped to 66. These dips are usually only 10 - 15 seconds in duration. For instance last night it went:

86,79,72,63,53,43,39,39,49,57,65,72,77,82,87,87.87.87.87.87.88.89.89.89.90

and then it stayed in the 90's for 23 more seconds followed by 7 seconds of zero reading. After that it was back in the mid 90's for several more hours.

The next anomaly was a a string of 99 and 98's followed by 5 zeros and then 81,81,81,83,83,86,89,89,89,89, 90, 92, 97 and then stayed in the upper 90's for the rest of the night.

My EncorePro stats are reasonably good.

Total Events 31
Total OA 22
Total Hypop 9
Total Snores 5
Total time in Apnea 5 mins
AHI 3.8
OAI 2.7
HI 1.1
NRI 0
FLI 0
SI 0.6
Avg time in Apnea 13.6 seconds

CPAP 10.0 cm/H2O
Max Leak 63 LPM
90% Leak 39 LPM
Average Leak 32 LPM
Large Leak 0

Are these desat events an artifact of the CMS 50-E? The times don't seem to correspond to anything that Respironics is showing me. By, the way I am also supplementing with 2.0 LPM of O2. Any suggestions?

My heart rate was right at 55 during nearly that whole time. After then 7 seconds of no readings, the heart rate started back up at 70 and didn't come back down for about 30 seconds.[/img]

Any thoughts from anyone?

I don't use an oxygen sensor so I can't really answer the desats question. But looking at your graphs I would wonder if you could do something about those remaining apneas.

With the oxygen thing it almost looks to me like equipment related. Like is the sensor reading correctly all the time. I can't see it being possible to dip to zero if the equipment is reading correctly and that would make me suspicious of the 39 reading as well.

Check correlation with the times you leak, and find out if you're mouthleaking.

If you're mouth leaking you machine may not be identifying the apnea you are having, and the pressure pours out of your mouth instead of keeping your airway open. It doen't have to be a massive leak to invlidate both your therapy and your results.

O/

According to an email from Keeme a representative from the maker of the CMS 50-E, a zero indicates that the unit has come off and is not reporting anything. He said that should not affect the other readings around that time.

The leak rate did go up some around the time of the low desat event. It peaked at around 50, with the average being 32.44. Thanks for the feedback!

When leak gets over 50L/m on that machine you need to pay more attention to them,
but with that said,

While AHI is below 5 and you are effectively being treated, too many OA's exist to my liking on that Encore Report, I would bump up pressure to 10.5 and look for improvement.

Bumping up the pressure by .5 or 1 cm should help, you may notice after doing that, that your HI may climb higher, that is to be expected, after OA is cut in about half of what you show above continuing to increase the pressure will bring down the residual HI's (should they climb after the minor increase).

Any fluctuations with desats are related to OA's as opposed to the other events, so increasing pressure should reduce the number of OA's seen and help with any desat issue.

Actually the night with the worst Desat ever was when I upped the pressure to 10.0 cm. The other nights I have been at 9.5 and my OAI numbers have been better at the lower pressure.



For instance my Desat last night looked like this.

[/img]

Here is the EncorePro detail for last night



Still confused....

scififan wrote:Actually the night with the worst Desat ever was when I upped the pressure to 10.0 cm. The other nights I have been at 9.5 and my OAI numbers have been better at the lower pressure.

well then stay at the lower pressure.