Anybody had problems with their CMS-60D?

Hey Bev, good luck with the overnight pulse-ox.

I find this whole topic very interesting. While it seems unlikely that one's pulse could jump up to 200+ so quickly and for such a short period, you do report that the desaturation does seem to be correlate with your tiredness, so it's hard tell if these wildly varying numbers are indeed just artifacts or if they are real.

Physiologically, is it normal or possible for a person's o2 to vary so wildly and to jump up/down in a matter of just 1 sec??

ca_hosehead makes a good point- those moments when it records very high heart rate, can you confirm that by just measuring it manually?

echo wrote:Physiologically, is it normal or possible for a person's o2 to vary so wildly and to jump up/down in a matter of just 1 sec??

Very darn good question IMHO. I admittedly haven't had time to properly search that excellent question. But I did pick up this definition in a super quick Google search that describes SpO2 drop-off rates of greater than 5% per second being dismissed as artifact:

http://pmbcii.psy.cmu.edu/core_d/Harmon ... Report.pdf

1. A desaturation event is defined by SpO2 decrease of =4% for = 5 seconds with a maximum drop-off rate of 5% / second.
2. Values include SpO2 data from all epochs between Good Night Time and Good Morning Time, including both sleep and wake.
3. These values include all available SpO2 data, without censoring for artifact.
4. SpO2 data censored for artifacts (probe slips), defined as a SpO2 drop of > 5% / second until within 5% of last non-artifact value

The above also implies that these presumably measured conditions do not clinically qualify as "desaturation events": 1) SpO2-decrease measurements under 4%, and 2) SpO2-decrease measurements lasting under 5 seconds.

I think it's entirely interesting that the medical industry now feels a need to measure SpO2 transients with much greater resolution for SDB diagnosis.

And in the fine print of the reports Bev posted from the Contec software, it gives its definition of what it considers an event, under "Analysis Parameters":

Desaturation Event: drop in spO2 by at least 4% for a minimum duration of 10 seconds.

jnk wrote:And in the fine print of the reports Bev posted from the Contec software, it gives its definition of what it considers an event, under "Analysis Parameters":

Desaturation Event: drop in spO2 by at least 4% for a minimum duration of 10 seconds.

Also a comment that the above 4% and 10-second values are Contec default settings for scoring "desaturation events". That meter will allow the user to change either of those numeric parameters so that "desaturation events" can be scored differently. (click here for CMS60D user manual download from http://healthcare.echostore.com)

-SWS wrote:I think it's entirely interesting that the medical industry now feels a need to measure SpO2 transients with much greater resolution for SDB diagnosis.

Forgot to mention that I was referring to this interesting article: http://www.sleepreviewmag.com/issues/ar ... -04_10.asp

-SWS wrote:4% and 10-second values are Contec default settings for scoring "desaturation events". That meter will allow the user to change either of those numeric parameters so that "desaturation events" can be scored differently.

Ah! VERY interesting! I didn't understand that.

Can the 1s resolution (if I'm using the right word) be changed too? If so, would that smooth out the response?

Sorry, I'm still suffering from gadget envy!

Oh, wait, I see your link to the manual now. THANKS!!

Jeff, the Contec "refresh" parameter is fixed at 1 second on that meter. Take a peek at the user manual download I just edited into my post above.

That thing makes my MD300A pulse-ox look like an ancient child's toy. The MD300A only records the one-minute averages overnight. It could easily be missing significant dips.

Say, Bev, wanna trade? j/k

I don't see where one would be able to change the parameters for desaturation. We can change the point at which the alarms will go off, but I don't think that changes how events are scored. When I feel better I can experiment with that.

I don't have a watch with a second hand so have not double checked my pulse. But there is no way that Jim's resting pulse is as high as it says. I think his radiation treatments make the thing go crazy.

I got a Respironics 920M-Plus around 2:30 today. I can't find on their website how often it records. So far, my O2 have been way up there in the normal range and my pulse has been over 100 for 2 hours. My written instructions say to use it tonight WITHOUT CPAP. Yeah, right, like that's going to happen.

Bev

OutaSync wrote:I got a Respironics 920M-Plus around 2:30 today. I can't find on their website how often it records.

According to the manual the Respironics 920M-Plus is fixed at 4 second readings:
http://global.respironics.com/UserGuide ... 0MPLUS.pdf

Page 24 of the Respironics 920M-Plus manual wrote:Patient SpO2 and pulse rate are sampled and stored every 4 seconds"

So any 1-second meter versus 4-second meter comparison should return different SpO2 data---at least regarding those very brief SpO2 transients.

OutaSync wrote:I don't see where one would be able to change the parameters for desaturation.

Bev, maybe the echostore link several posts above is sourcing the wrong file. Here's what that questionable manual states under the section called "Analysis" (Chinglish mistranslations included):

SpO2 review program can analysis the data and print analysis reports. It does some basis statistical analysis as well as SpO2 and pulse events analysis.

SpO2 desaturation event is defined as drop in SpO2 by at least N% for a minimum duration of L seconds. N and L are configurable, and is defaulted to 4 and 10.

The above N and L settings are configurable by clicking on the tools icon in the lower left corner (the wrench and screwdriver logo). But the CMS-60D statistical analysis software doesn't allow for those N and L parameters to be configurable?

Bear in mind that changing N and L wouldn't change how the meter recorded anyway. It would only change how the reporting software tallies "desaturation events" on your computer long after your sleep session is done.

OutaSync wrote:I don't see where one would be able to change the parameters for desaturation. We can change the point at which the alarms will go off, but I don't think that changes how events are scored. When I feel better I can experiment with that.

OutaSync, assuming you are talking about cms-60d: all those settings are in the analysis program after you download the data to your pc. As for recording, the only useful setting on the meter itself is the time at which you start recording -- you need to do this every time you start recording. All the others are related to display brightenss, download start, ...

Most doctors are really not going to look at the chart or detailed data at all. They look at the summary of the analysis, how many times it went below desat, and for how long. On the other hand, everybody here, (especially I !), is into detailed data, and for me raw data . I do not look at all any of that analysis summary.

This is the way I used the O2 graph data: On the computer screen, I lined up the graph with the graphs from my m-series data, adjusted the width of both so that I had a common time scale. For the cms-60d, there is only a starting point, no real time, but the elapsed time is accurate. So you hav to insure you start the recording meter and the cpap machine close to each other. Now, I looked for events such as OA, H, and looked at the O2 around that time. If I had a wild O2 down spike without any events at other places, I simply assumed it would have been a movement related. I had one two of these every night. However I could indded see slight reductions around OAs, and closely spaced repeated Hs. Even without cpap my o2 during initial sleep study never belwo below 85 or so.

I don't have a watch with a second hand so have not double checked my pulse. But there is no way that Jim's resting pulse is as high as it says. I think his radiation treatments make the thing go crazy.

If you have a running clock on your computer you can use that.

I got a Respironics 920M-Plus around 2:30 today. I can't find on their website how often it records. So far, my O2 have been way up there in the normal range and my pulse has been over 100 for 2 hours. My written instructions say to use it tonight WITHOUT CPAP. Yeah, right, like that's going to happen.Bev

Never mind the instructions about 'without cpap'. All instrument manufacturers want no other instrument nearby I remember I was doing a 24 hour blood pressure study, and the sleep study people did not want anything to do with anything else --- phobias of foreign wires and instruments So I had to reschedule my initial sleep study.

-SWS wrote:

SpO2 desaturation event is defined as drop in SpO2 by at least N% for a minimum duration of L seconds. N and L are configurable, and is defaulted to 4 and 10.

The above N and L settings are configurable by clicking on the tools icon in the lower left corner (the wrench and screwdriver logo). But the CMS-60D statistical analysis software doesn't allow for those N and L parameters to be configurable?

Bear in mind that changing N and L wouldn't change how the meter recorded anyway. It would only change how the reporting software tallies "desaturation events" on your computer long after your sleep session is done.

Ahhh I get it now: the graph will still show all those desaturation events, but the analysis and summary section won't report them as desaturations unless they fit the specified N and L criteria.

If we look at the analysis/summary info, the lowest was somewhere in the 80s, and not the 70's like in the graphs. Still, I guess 80s are low if you're awake.

Is your normal resting pulse over 100 normally? BTW are you using both pulse-ox's at the moment?? I bet you just want to club all of us don't you?!

My pulse hasn't gone much below 100 all day, sometimes going up to 134, like a minute ago when I was trying to find my big Tupperware Cake Keeper. Is that normal? Jim says he has to work hard at the gym to get his that high. My chest aches. Don't know if its fast pulse all day or GERD. I'm heading for the Prilosec.

I'm going to have to wear both of these things tonight, one on each hand. Don't mind taking one for the team

If you do indeed have fast heart rate, that's tachycardia and may or may not be an issue. I'm not a doctor so don't take anything I say as fact. A few weeks ago I did a quick search online and read that sometimes tachycardia can occur is not necessarily problematic, depending on the source of the problem. But this means they should first rule out any other serious conditions that would cause a fast heart rate. More important is whether that is normal for you. 134 seems pretty high, that's like the target heart rate you go for when doing cardio training!
http://www.mayoclinic.com/health/tachycardia/DS00929

I was getting a really fast heart rate in the 2 weeks prior to my getting diagnosed with the pneumonia (in the range of 120-130. my normal resting hr is 75 BPM). Right now I can jump up and down for 5 minutes and it doesn't budge by much (OK i confess I haven't made it a whole 5 minutes!).

There's another condition where your heart rate jumps up when you make sudden movements, like jumping up out of a chair to go into the kitchen for the salt... I can't remember what this is called.

You can use the clock on your computer, as someone suggested earlier, to manually measure your heart rate. Double click on the time/date on the bottom right -> that should bring up the clock face; after 10-15 seconds the second hand disappears - just move the mouse to get it to reappear.

Also remember the whole concept of mind-over-matter -- if you get really nervous thinking that the fast heart rate is bad, it will just make your heart beat faster and make you more worried. Try not to think about it too much, and even after double-checking it against the other monitor or a manual measurement you find that your heart rate is still high, I still would try to relax and not over-think it if I were you (for the moment anyway).

OutaSync wrote:I'm going to have to wear both of these things tonight, one on each hand. Don't mind taking one for the team

poor Bev!

Fever is also a reason for tachycardia.

O.

I don't have the download of my 24 hr pulse/oximeter test on the borrowed unit, yet, but here is the CMS-60D report from last night


and from today while at work


This unit seems to be very sensitive to movement, or else it has a loose wire somewhere. The numbers were wildly different for some of the time and nearly identical for some of the time. I understand the difference between a 1 second and a four second recording time (I think)






Everytime there is a disconnect, whether I'm moving or not, it seems to require a couple of minutes to get back on track.

What y'all think?

Bev