Added an O2/Pulse meter to my therapy:

[Phaleronic]

Seeing some drops in O2 saturation here, is it concerning?   I don't feel bad.

[BigWing]

I too added a pulse oximeter to my armoury a few weeks ago, and it certainly shows a general drop in my oxygen if I try sleeping without my CPAP (compared with when I do use the CPAP).

Having said that, I am struggling to find much correlation between the CPAP data and the oximeter data. The only one I have found is that pulse rate and movement DO show a spike at an arousal (where the flow rate waveform has a sudden weird pattern) - the oxygen chart shows nothing particular at those events.

The other surprising finding - so far - is that the oxygen chart does vary quite a lot from night to night, though I have no idea why.....AND it strangely shows no correlation with how well I felt I slept!

[UnicornRider]

The OSCAR Report Daily view is useful to compare Pulse/Oximeter graphs to Flagged events and how the other graphs FR,TV, indicate my body's reaction to the event.

When it gets interesting is when you start accumulating several 0.00 AHI nights and still do not feel you are really any better. So the only Event Flags left to chase are Pulse Change (PC) and SpO2 Drops (SD). What I found was I still had events with distortion of Flow Rate wave shapes, so I started chasing those and adjusting to reduce or eliminate as many as I could. 

I found my pillow and soft cervical collar could make a noticeable difference.

I also find the Wellue software O2 Insight Pro report presents information in a different format, that at time is more useable than OSCAR. When I am talking to my PCP she normally likes to see the Wellue report style, the sleep clinic I see uses OSCAR in their offices, after I started bringing them in about four years ago, my pulmonologists Looks at both and convinced my PCP to look at OSCAR a little closer.

To address your question:  "Seeing some drops in O2 saturation here, is it concerning?"   It appears as though about 2300 you had a couple of drops over a ~two minute period that went down to ~86-87% SpO2'

I cannot get enough fine detail from your image to get closer than that. Your O2 Insight Report would provide  " <90% Time" which is what medical professionals would initially be interested in.

This O2 Insight Pro report enabled me to get supplemental O2 for another member of the house. 


   


What you view is all the information the PCP was interested in.

The other household members who had similar reports, because we could correct our breathing by concenscienely responding to the audible and vibratory alarms during the day, and our *PAP machines provide support at night, did not qualify for supplemental O2. They knew we were recovering from a nasty respiratory infection and did not test positive for either Covid nor the Flu. Similar to long covid we are slowly recovering our ability to remember to breath without the audible/vibratory alarms.

This recent 0.00 AHI with Pulse/Oximeter/Motion will show some features I go granular on (zoom in).

   

Let me know ways you find to utilize your Wellue devices to improve sleep.







,

[Phaleronic]

Thanks for the responses both of you   Here's a zoomed in shot of the lowest desaturation event of the night...:

[UnicornRider]

That is about 14 maybe 15 seconds below 90% SpO2, nothing to get concerned about.

I do not see anything on your Flow Rate Graph to justify it.

How do you sync time between the Pulse/Oximeter and the Dreamstation? It could be the FR distorted wave shapes that coincides with the drop, is not visible on this screen due to time shift between the two.

Here is a recent Dreamstation OSCAR Report with a Wellue Checkme O2 Max  synched fairly close, You will notice a Flagged SD & flagged CA event at ~0500 with a corresponding drop in the SpO2 Graph at that time.

   


Here is a zoomed in view.

   

How much of an offset in time do you see between the start of the CA event and the start of the visible drop in SpO2. Would you consider that the "Time Offset" between the Dreamstation and the Pulse/Oximeter? Here is a final close up view 

   

Did you notice the the difference between the "Event Types" in your Event Graph area and the "Event Types" in the OSCAR Report that I posted?

[BigWing]

I do not see anything on your Flow Rate Graph to justify it.

Neither do I, and that's the same situation I have. Last night was in fact a perfect example of the lack of correlation I mentioned: I felt I slept really well; my oximeter says I had a poor night, and even woke me with a vibration alert due to a brief drop to 89%; the CPAP machine said I had a great night with ZERO events....oh and, for what it's worth, myAir gave me a poor score due to terrible leaks!

How do you sync time between the Pulse/Oximeter and the Dreamstation?

I don't know if Phaleronic has a system for synching, but here is mine if he needs one....

I make notes after each night's sleep, and I have developed a technique which enables me to flag the times I was awake so that I can extract that information from the Flow Rate chart. I then extended that to flagging which side I was laying on, as I wondered whether different types of events were more prominent on one side or the other (the jury's still out on that).

As soon as I lay down, I do 4 short, sharp sniffs if I am on my LEFT side or 5 if I am on my RIGHT side (that's the number of letters in each word)....I never sleep supine or prone. I do the same every time I wake up - and if I turn over.

These flags are readily apparent, as shown in the attached figure. Here, I was awoken right after a hypopnea - I immediately remembered to flag that I was on my right side, but then decided to turn over so I flagged that too.

   

I also use this to synchronise my two monitoring devices, the CPAP machine and my pulse oximeter (with a nod to what they do in movies to align the video and sound, I call this my "sniffing clapperboard"). 

When I perform the first group of sniffs (and occasionally at another during the night as a further check), I also twist my arm sharply once per sniff. Oscar allows me to tweak "CPAP Clock Drift" so that I can then align the very clear resulting spikes in the CPAP's Flow Rate graph (and the Mask Pressure one, actually) with the peak in the oximeter's Movement chart. The delay varies from about 13-25 seconds. The result is shown in the attached image.

   

[UnicornRider]

That is an innovative way to check sync of time. 

For my own use, I have had identifiable drops that I can check sync with.  I do sync the Checkme O2 Max, daily with the laptop after I download the data.

You say your Oximeter say you had a bad night, could you post a Pulse/Oximeter report here.

We had four people in my house walk around with a SpO2 average in the low 80% for awhile before we figured out why everyone was so sleepy, tired, grouchy. irritable all the symptoms of sleep deprivation. Once we strapped on the Wellue and alarms started going off to remind us to breathe, most of us were able to get the SpO2 average up to the low 90% range, Not so with my mom, we had to get supplemental O2 for her. It has taken several months for three of us to get to the point where we average mid 90% with alarms.. I occasionally turn off my alarms to see how low my O2 drops, I still go down to mid 80% for short periods, my average without the alarms will be 91 to 90%. Like sleep deprivation I suspect it will take a long time at normal O2 levels to fully recover.


For some reason my second image did not post last night, so I shall try again. Maybe that image is corrupted.

   

[BigWing]

That is an innovative way to check sync of time. 

Thanks!

You say your Oximeter say you had a bad night, could you post a Pulse/Oximeter report here.

Here it is:
   

Or maybe you meant this:
   

[UnicornRider]

Congratulation on the 0.00 AHI, I remember the thrill of reaching that goal. It was quickly diminished when I realized I still needed a early afternoon nap. So now When I have a 0.00 AHI, I seek out the PC & SD Event flags and go granular (zoom in) on the Flow Rate.

Not bad on your SpO2 graph, you only touched 89% for a very short time, it would be interesting to see a three minute zoomed view of the event at ~0330 that caused the SpO2 drop and the pulse spike.

Down in the bottom left hand corner of the graphs you have a tab to select which events you would like to display in the Events Graph., if you check PC & SD your Events Graph will start flagging Pulse Change and SpO2 Drops. It makes it easy to review by going in to the Events tab on the left hand panel of the Daily view, double click on the event category you would like to review ie. Pulse Change, it will open up with the times of the event, I just click on the top time listed then use the down arrow button to scroll through them while viewing  Flow Rate for disruptions in wave shape. Makes it fast to do an initial review.

I did notice I do not have LL in my events category, Probably because I have very little tolerance for leaks. Damn leaks interfere with the machines function and blinds the machine's sensors to needed changes in flow and pressure.  You may want to review the Mask Primer to assist in overcoming those fugitive leaks. After you read down to Jeffy1958, he really puts everything up to that point in to practical application in a common sense way. He enabled me to over come leaks. I still have a few, very few nights with leaks, mostly when I am breaking in a new mask & headgear. One of the hardest concepts for me to initially overcome was the "Tighter is not always better, when it comes to mask leaks." Then one day I loosened my mask and "Poof" my leaks went away. Since that day I have not had much trouble with mask leaks. Give it a try.

https://www.apneaboard.com/wiki/index.ph...ask_Primer

Your O2 stats from your O2 Insight Pro report does not look bad at all. Our medical team SpO2 limit used to be <88%SpO2, for a time duration or % of time. Now some of them start talking <90%. Covid changed a lot of things.


  UnicornRider Nov 8 2023 not a good night.pdf (Size: 293.74 KB / Downloads: 9)

It was a very bad night, but not my worst.

Let me know how you do with the leaks.

[BigWing]

Congratulation on the 0.00 AHI, I remember the thrill of reaching that goal. 

Thank you so much for your comprehensive response, UnicornRider. I feel bad for hijacking Phaleronic's thread, but hopefully he will benefit from the extra info which is relevant to his issue.

I do normally show the flags for PC & SD but turned them off before taking that screen shot as I find them a bit distracting. I will though try your quick method of reviewing them.

It was somewhat unfortunate that I chose that particular night to post my charts, as I had just switched from my long-standing mask liner to a new one - and that clearly caused a ton of leaks. I only really realised how bad it was when I got up for the loo at ~4am - when I turned off the AirSense I spotted the big red unhappy face next to MASK! I then decided it must be the new liner so I removed it - and that eliminated the worst of the leaks for the rest of the night.

Not bad on your SpO2 graph, you only touched 89% for a very short time, it would be interesting to see a three minute zoomed view of the event at ~0330 that caused the SpO2 drop and the pulse spike.

Here you go - I guess an arousal caused it? It's interesting that you picked on the 3.30am drop to only 92%, rather than the bigger drops later - why?

   

Damn leaks interfere with the machines function and blinds the machine's sensors to needed changes in flow and pressure.

That's why I wondered if the report of zero events was valid, though it did hold up during the second part of the night after I had mostly eliminated the leaks. I decided to repeat the same conditions last night, as a check, and sure enough that yielded zero events again! This seems to be a result of changing my APAP pressure settings (to 7-12 with an EPR of 3), thanks to guidance from ever-so-helpful people like you on these forums. 

I was still skeptical though, so before getting out of bed I decided to check that the CPAP wasn't faulty by inducing some events....by sleeping supine for a little while! I'm not convinced I really got fully to sleep during the 13 minute test, but it did the job - the AirSense reported 5 x OA's and 2 x CA's!

Your O2 stats from your O2 Insight Pro report does not look bad at all. Our medical team SpO2 limit used to be <88%SpO2, for a time duration or % of time. Now some of them start talking <90%. Covid changed a lot of things.

I'm never quite sure which metric to track from my oximeter. I tend to base my ultimate decision for "sleep quality according to the oximeter" on how the two "SpO2%" charts look for the whole sleep session (while also casting an eye on the non-standard Viatom "O2 Score").