02 levels still dropping with super low ahi's?

[APAP user]

hi all,  new to the site.  kind of confusing....hope i'm doing this right?

i've used apap religiously since oct 2023 every night.  my ahi's are almost non existent now (under 2 or less per hour... usually under.05) but my O2 still is dropping many times into the mid '80's ?         my settings are at 9/20 and i use epr of 3?   

my main purpose of starting apap was to keep my 02 levels up at night and don't think its "cutting it"?  would love to post last nights oscar results to this board but i dont' know how to do that?  (no one ever called me a rocket scientist?!   )

any thoughts would be greatly appreciated.

thanks!

[staceyburke]

Many times the 02 reading drop because the finger probe is lose.  

If the 02 measurement is not just spike and is a duration of time then you may need additional Oxygen at night.  It is very simple to add you just need an oxygen concentrator and a long oxygen tube to set the concentrator in another room and attach the tube to the cpap.  I have had that setup for about 20 years.  This has been paid by my insurance from the beginning.

[AshSF]

There are multiple ways to raise oxygenation (in increasing order of preference)

1) Raise EPAP. More the exhalation pressure, more the stenting of the airway. This will raise O2 levels if your breathing apparatus and your brain messaging to the apparatus is ok.
2) Raise EPR. This leads to more CO2 washout and consequently raises oxygenation. Although this risks introducing CA events that may cause anxiety. EPR is equivalent to pressure support of 1,2,3cms.
3) Go to a bi-level machine (BiPAP). Here you can use a higher pressure support of 4cm to more here.
4) If your brain messaging is messed up, then you typically get to an ASV or S/T machine.
5) If you still have O2 dropping, then you need supplemental oxygen.

Please proceed thru these steps and see where the optimal place is.