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Help on analysing SpO2 drops
#1
Help on analysing SpO2 drops
My nightly data on SpO2 drops appears to be above average and I was trying to analyze the SpO2 data with the hope of finding the root cause of my high SpO2 drop rate. Attached here is my recent screenshot ( ending ...209) of my sleep data. A quick look at the Event Flags graph shows that my SD (SpO2 drops) are far too frequent and I had 121 events in this chart. First, I would like to know what the numbers inside the brackets represent. For example, event #6 timeline shows #006: 22:20:10 (242). Also, in the left side, Details column, how do we interpret SpO2 (17.99) (Screenshot ending ...606). Second, any relationship between SpO2 drops and Pulse rate or any other parameters such as CA, OA or H. I think, those  drops below 88% may need more attention. Any suggestions, inputs, etc, in this regard, will be greatly appreciated.


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#2
RE: Help on analysing SpO2 drops
Your sp02 drops are far too frequent because your cpap therapy is not adequate. You have hypopneas (dark blue), flow limits (grey) and obstructive apneas (light blue) that a cpap in auto mode can only react to and not protect you from. If you wish to continue using auto mode, have you considered raising your minimum pressure to eliminate the obstructive apneas and enable whatever the EPR equivalent is for the Philips machine to help with hypopneas and flow limits? Have you ever tried constant pressure at say 9cmH20?
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#3
RE: Help on analysing SpO2 drops
Ok One thing that people don’t look at are flow limits chart. Flow limits are apnea just like Oa and H events but are smaller and are NOT counted in the AHI. If they are high they could be the reason for lower O2 levels. And it is controlled inother ways than raising pressure.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Help on analysing SpO2 drops
To add to staceyburke's post, it would appear that you may do better by increasing your minimum pressure to 7 to 8 cm. Philips CPAPs are slow to respond to flow limits, hypopneas and OAs. Increasing the minimum pressure above your median value is one way to play the Philips' game.

- Red
Crimson Nape
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Project Manager for OSCAR - Open Source CPAP Analysis Reporter
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#5
RE: Help on analysing SpO2 drops
Attachment (ending...209)

Adding missing attachment.


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#6
RE: Help on analysing SpO2 drops
The 22:20:10 is the time, 10:20:10 PM. The numbers in parentheses is the time in seconds of the event. 242 seconds = 4 minutes, 2 seconds.

- Red
Crimson Nape
Apnea Board Moderator
Project Manager for OSCAR - Open Source CPAP Analysis Reporter
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Help on analysing SpO2 drops
Thank you for your valuable comments and suggestions. Added again is the attachment describing Oximeter Statistics (CMS50F) and the Device settings for the past months (as prescribed by my Pulmonologist). I didn't see much change in all my Apnea Indices after my change from (6 - 12) to (5 - 15) in AutoCPAP mode. I started collecting SpO2 data since Jan 1, 2023. Maybe, I will try changing to constant EPAP at 9cmH2O and see if there is any improvements. Will update results as soon as it become available.
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#8
RE: Help on analysing SpO2 drops
On your oximetry summary data, it show a low heart rate of 20 (and several 24's) and a high of 255 (another 170) during sleep.   Do you think these are accurate?  Or do you think the sensor malfunctioned or slipped off your finger, etc.?

Since your Pulmonologist recommended this, I would definintely show them these summary statistics (with the low pulses and high pulses) and see what they recommend.  An incredibly large range from high of 255 to low of 20.
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#9
RE: Help on analysing SpO2 drops
Cheers for your great observation on my Oximeter Stats. First, I was a sports maniac (tennis) before my retirement years and now in my 70+. My cardiologist graded me as bradycardia (low resting heart rate, average 45-50 bpm) and I went through rigid cardio tests (and got a green light) including EKG, Holter monitor (14 days) and Nuclear Treadmill. Non smoker but have slight arrhythmia (not yet need pacemaker, thank God). My resting heart rate can go down to 37 bpm and hence my concern for SpO2 drops. The max pulse rate of 255 bpm in may of 2022 may be an outlier, since I start using CMS50F in Jan 1, 2023. May be the residual data in the Oximeter unit at the time of the purchase. I have to revisit those high max pulse rate incidents and I do recall cases where the finger sensor slipped of a couple of times, during my sleep. Thanks again for your in-depth study on my Spo2 and Apnea results. Much encouraging.
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#10
RE: Help on analysing SpO2 drops
I have had SA for 20 years and OSA is well treated with CPAP. But then I got an Old type Pacemaker (2lead dual chamber right ventricle only) 2 years ago, and then unfortunately developed the Pacemaker syndrome, which made my CSA level go up to ~37. Drop in nighttime oxygene levels to below 85 was one of the consequences. After being upgraded to another PM type: the CRT biventricular, the CSA has dropped dramaticallly to below 5. Wonder if any other have the same experience?
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