Annoying oximetry report

I checked yesterday night's oximetry report (CMS 50E). I don't want to be too sceptical on this, but it made me worry. As shown below, my SPO2 first dropped below 70, but the pulse was normal. So it is possible that might be just an artifact.

But at the second event, SPO2 goes down to 50, which is FATAL. The corresponding pulse rate at that moment goes up to 150 This makes me think it was a real event and I was Goddamn choking I checked the details and saw that the desaturation lasted for nearly 10 minutes, moving between 75 and 50. (Unfortunately my data card has been corrupted and I can't see what really happened on the CPAP side at that moment.)


What's your idea of this view? BTW, I'm also thinking of trying the CPAP mode in the S9. I was titrated at 4-12 and my whole APAP stats until now show that in the 95th percentile, my pressure was at about 10.5. So what should be the CPAP constant pressure in this case?

I'd get a new SD card ASAP.

Note that the summary reports 4.4% artefacts, and no time spent at SPO2 lower than 75. I think you can relax, you're looking at artifacts.

O.

I would narrow the range on your APAP, so it could do it's job. 9CM to 12 CM would be nice. Also make sure your leak rate is low and correct. (harder to do with Resmed.) Also consider mouthbreathing as you are using a nasal mask. The time you spent at low O2 levels wasn't long, or fatal. I almost got that low my second night of checking mine, mine is closer to 88 as my normal night reading, 93 in the day. Jim

resistance wrote: But at the second event, SPO2 goes down to 50, which is FATAL. The corresponding pulse rate at that moment goes up to 150 This makes me think it was a real event and I was Goddamn choking

Well, you're not dead if you are writing this. Given that and the probability of a finger twisting in your sleep and making all sorts of strange measurements - I would be aware of it but not take it very seriously. But I would get a new data card or reformat the existing one.

If your O2 went down to 50%, it would be like someone smothering you with a pillow - and then some. Unless you were totally stoned out on hypnotics, you would remember choking to that extent.

These home oximeters are really not substantial unless you have machine data to back up "events" - even an oximeter plugged into your S9 is going to be sub-standard and only mean something if you have breathing problems recorded. When I use a CMS 50E I have to tape it totally to my finger and wrap tape around the finger and hand to stabilize it enough or it goes all over the place. So unless you really have someone smothering you with a pillow take this as a warning that you need a new SD card! Other than those two events, you look incredibly O2 stable the rest of the night.

jonquiljo wrote:

resistance wrote: But at the second event, SPO2 goes down to 50, which is FATAL. The corresponding pulse rate at that moment goes up to 150 This makes me think it was a real event and I was Goddamn choking

Well, you're not dead if you are writing this. Given that and the probability of a finger twisting in your sleep and making all sorts of strange measurements - I would be aware of it but not take it very seriously. But I would get a new data card or reformat the existing one.

If your O2 went down to 50%, it would be like someone smothering you with a pillow - and then some. Unless you were totally stoned out on hypnotics, you would remember choking to that extent.

These home oximeters are really not substantial unless you have machine data to back up "events" - even an oximeter plugged into your S9 is going to be sub-standard and only mean something if you have breathing problems recorded. When I use a CMS 50E I have to tape it totally to my finger and wrap tape around the finger and hand to stabilize it enough or it goes all over the place. So unless you really have someone smothering you with a pillow take this as a warning that you need a new SD card! Other than those two events, you look incredibly O2 stable the rest of the night.

Where are you getting your SD Card INFO, he only posted the pulse Ox readings, the Pulse Ox doesn't have a sd card. Jim

Goofproof wrote: Where are you getting your SD Card INFO, he only posted the pulse Ox readings, the Pulse Ox doesn't have a sd card. Jim

No, I meant his SD card in his S9 Elite. I have a CMS 50E and I know it does not have an SD card. I meant that he'd be best getting machine data before he jumps to any conclusions. BTW - isn't there just a simple reformat that is available for corrupted data cards for these machines? I vaguely remember seeing a way to do that somewhere.

100% Garbage data.

Calist wrote:100% Garbage data.

No ... maybe 90%. The 10% of usefulness here is shown that most of the time he sleeps fine with no desaturations. The two artifacts are problematic, but would not be in question if he had machine data to correlate with the oximeter.

The 10% usefulness would be a lot higher if this were the case - but not 100% The more witnesses to the "crime" the better.

jonquiljo wrote:

Calist wrote:100% Garbage data.

No ... maybe 90%. The 10% of usefulness here is shown that most of the time he sleeps fine with no desaturations. The two artifacts are problematic, but would not be in question if he had machine data to correlate with the oximeter.

The 10% usefulness would be a lot higher if this were the case - but not 100% The more witnesses to the "crime" the better.

So true, but as Dr House says, "Everyone Lies". Jim

Odd's are the second destat is true. Making it 95% correct, pretty good odd's in favor for the O2 reader.

Thank you for your replies. The first one is an artifact, but the second one is accompanied by a pulse rate of 150 and I guess that's proof that supports the %50 SPO2. My doctor had told me that even %70 can be fatal if it goes on for more than a few minutes and this kind of desats may cause brain damage, strokes, heart attack and sudden death. Anyway, I monitored my SPO2 yesterday night again and everything's fine. So I hope that was just one specific event. For the CPAP device, I reformatted the SD card now, the machine can read it and hopefully it will begin recording again tonight.

Narrowing the pressure to a range like 9-12 is a good idea, thank you:) But I think my cumulative pressure data since the beginning of the therapy may be helpful to verify this range:

Pressure Data (Last 5 months):
Median: 7.5
95th percentile: 10.3
Maximum: 11.7

How shall I set it? 9-12? or 7-12, considering the median value?

7 to 12, may make the machine respond too slowly to help break a event, If you could have seen your missing data from the S9 prior to the second destat you could have made a more informed decision. I even run a closer range 14 to 15 CM, I want my apnea stopped, I run a AHI under 2, under 1 with a FF mask at a leak rate under 38 LPM. With a Nasal mask I have limited mouthbreathing, but with a AHI under 2, it's still ok. Jim

You have similar number to me and I run 8.5 or 9 to 12 (I'm still experimenting). But I still am doubtful that you had an O2 of 50% with a corresponding HR of 150. That isn't much below your theoretical maximum HR and it takes a lot to go there - and it takes a lot to stop breathing enough to go to 50%. In fact has anyone ever seen that on a sleep test - at least a sleep test of anyone alive? From you picture you look young and healthy and I wouldn't expect you to look that way if you were choking like that. I would expect minor choking as well - not a single "blaster" out of the middle of nowhere that didn't even wake you enough to remember it! The chances of that being real are highly unlikely - unless, as I said, you were so out of it that you didn't remember. I certainly would remember, and I tend to be out of it.

I tend to also get weird stuff with my CMS 50E and may invest in something a bit more substantial. If I am going to bother to measure O2, then I am going to get something that I trust. I always read my CMS 50 data skeptically and that's a bad thing to do.

Well, I say start 8-12 or 8-14 and look at your data. By tomorrow you probably will know that it couldn't have been real.

gvz wrote:Your oximeter charts appear to be Contec, not S9, so no need to get a new SD Card.

A truly bizzare comment.
Looking at oximetry without AHI data is getting half the relevant data at best. With a corrupted SD card for his flow generator the OP is not getting all the info he needs.

You may want to try to correlate the dips with the S9 detailed data for the same time period.

How is he to do that with a corrupt SD card???


Congratulations on getting the SD card functional again, resistance.

With the median at 7.5 you're speding half you time at that pressure, or beneath it. I take that a a minimum to start with.

O.

I checked the reformatted SD card now to see last night's data, but the card is empty I don't know what happened, S9 had created the folders and files yesterday. I tried to reformat it on the PC now, but the process can't be completed. It's been only 5 months but looks like it's time to buy a new SD card..

Another thing is, the last two nights while falling asleep, I've been waking up in a rush, gasping for air with high pulse. The pillows are on, but I don't feel any pressure at that moment. It's obvious that I had apneas, and the machine didn't seem to respond

Anyway, depending on your recommendations, I'm rising the pressure interval to 8-12 tonight and checking how I get on with it. My AHI was about 1-2 with the nasal mask. It went up to 3+ with the nasal pillows. On the other hand, my doctor had seen my Resmed data a few times until now and I had told him each time that I still have the complications after 5 months. I wonder why he still didn't think of rising the lower pressure limit? I'll try and see tonight. I hope all goes well.

If windows can't complete a format - yes the card is probably toast. You might want to try a "quick format" in windows. It's a lower level format, but should be easier to do and work fine.

If you have a 95% at 10.5 then starting at 4 seems way too low. You don't need to be a sleep tech to see that one. Your machine may not react quickly enough if you are sitting at 4 and have a problem. I'm not that familiar with Resmed though. It would have to raise it's pressure quite a bit to get close to 10. I know from my Respironics that it will not just jump to the roof unless it is sufficiently provoked. In other words, from 4 it takes a lot of things to happen to get it to jump to 10. Lower limit, at least for me, is important to be close to what you need.

Good luck. I see so many posts about corrupt Resmed data cards. They must use cheap ones. I've never even heard of a format failure in an SD card in a camera or other device. And they tend to write a whole lot of data in a very short time.