[CPAP] Bad O2 days with APAP?

[ikwtif]

I have been on CPAP for about 3 months now. I'm also tracking my O2 saturation with an Wellue O2 ring. What I'm noticing now is that, according to the ring, I have some "bad" days where my O2 is all over the place and supposedly even drops to 88%. I can't really find anything in the OSCAR data so I'm wondering if it's just an issue with the ring or not. 

The reason why I am posting now is because this morning I also just felt bad and the last month my heart rate has been elevated and this morning it was also very high until noon. When I started CPAP my RHR dropped significantly (probably in combination with sports/less weight), during nights I had a 52 RHR, last month I have been hovering just around or at 60 RHR. My HR while sitting on the couch before one month ago was in the 50s, now I'm high 60s again. This morning felt like one of the mornings I had before I got the CPAP device (feeling nervous with high elevated HR that wouldn't go down) and I'm wondering if it's because of these O2 levels on some days that swing consistently throughout the night. 

Does anyone has any insights? I really don't understand the difference with "regular" nights if nothing changes regarding the settings of the CPAP. 

For tonight I had this


06:58:17
Large Leak (LL) 0.14%
Clear Airway (CA) 0.00
Obstructive Apnea (OA) 0.14
Unclassified Apnea (UA) 0.00
Hypopnea (H) 0.00
SpO2 Drop (SD) 23.28
Pulse Change (PC) 36.39

Oximeter Information


Viatom 
SpO2 Desaturations: 165 (14.08%) 23.28/h
Pulse Change events: 258 (8.01%) 36.39/h
SpO2 Baseline Used: 97.00%

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[Gideon]

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[ikwtif]

I see, apologies. These were the images

O2 from this night
   


general stats
   
   

[staceyburke]

You need to post a daily chars from Oscar. I have the charts you need in my signature. 

I would say that a min of 4 is too low for an adult. Try a min of 7 and see if that helps your O2.

[ikwtif]

Apologies for not adding the proper info! 

I made 2 screenshots for 2 days, I hope it is readable enough as I had to scale a lot down.µ
I got the APAP device through the hospital, I also called them because I couldn't find the settings to change the pressure. But they mentioned that since it's automatic and had me look for a pressure setting on the device (I think they said 95% pressure) is about 7 so that changing this would not really help since the machine would just use that value for most of the time.  
I did find out that the setting for the mask was wrong, nasal (IIRC) instead of pillows. And I upped the reaction setting as well as it was on "low". 
I'll also set the minimum for 7 for tonight, I guess I just keep the max setting for now or should I increase it as well? 

Thank you for the help so far! 
 
September 20
   

September 19
   

[ikwtif]

So, I had 2 nights with the new settings 

• mask setting from nasal to pillow (had the wrong setting from the previous mask)
  
• Response setting from soft to standard 
  
• new min pressure setting from 4 to 7
  
• new max pressure setting from 9 to 11
  

The 95% pressure seems significantly higher these 2 days, I guess because of the new pressure settings? The person on the phone I talked about changing the pressure settings had my look at the 95% pressure data (which was between 7-8s) and said this would basically remain the same but it is now even higher than my previously max pressure setting (over 9) for both days with the new settings. 

Any insight is appreciated. 

First night was easy and shows good SPO2 levels
   


Second night I woke up (I think) about 3 times, half conciously, I think because I had my mouth open because I remember thinking my mouth was dry. SPO2 is also all over the place and the CPAP data shows significant leak rates (which I think confirms my mouth being open during sleep?) 

I can't really remember ever waking up before on CPAP like this (with dry mouth). I guess this might be because of the higher pressure? Or maybe just in combination with a bad sleep day? Is it strange that SPO2 is all over the place the whole night? 
   

[gainerfull]

Are you using a climate line for your cpap? If not, I'd highly recommend one and set the temperature as warm as you feel comfortable (I use 85*). I'd also recommend flushing your sinuses with a saline mix 1-2hrs before bed. In auto climate mode I'd have cold air being pumped into me all night narrowing my nasal passages resulting in bad sp02 values once obstructive events were accounted for. This may help you too.

[ikwtif]

Are you using a climate line for your cpap? If not, I'd highly recommend one and set the temperature as warm as you feel comfortable (I use 85*). I'd also recommend flushing your sinuses with a saline mix 1-2hrs before bed. In auto climate mode I'd have cold air being pumped into me all night narrowing my nasal passages resulting in bad sp02 values once obstructive events were accounted for. This may help you too.

I don't think I have. It says heating sometimes I think but haven't found a way to set temperatures. I don't find the air cold though. 
I did notice after starting CPAP that most of the time one of my nostrils is a bit clogged. I think because of allergies.

[ikwtif]

Tonight, according to my O2 ring, I had the worst SPO2 night ever since I started using it. I noticed big dips during a period I was still watching tv in bed with the CPAP on so that made me wonder if there was just something else going on. Specially since I also didn't feel like I had a particularly bad night of sleep even though the wellue app claimed I was 60% of the time tracked between 90-94% O2 saturation and got my lowest "O2 score" ever of 7.9 

So I put the O2 ring on this morning together with my Medisana PM100 (which I'd assumed would be more accurate), and I was right.  
comparison Wellue vs Medisana
The Medisana showed 97% while my O2 ring showed 92%. I tried thumb/index for the O2 ring but it didn't really matter, some times there was a big difference. I guess I should be looking for a replacement for my O2 ring at this point. Kind of bummed that after ~3 months the O2 ring is already having errors like this. 

The only thing I do notice is my leak rate has had a significant bump with the new settings, I assume because I open my mouth sometimes during the night because of the increased pressure. I did tighten the mask straps before going to sleep so I don't think it would be coming loose. 
  
   

[Lucky7]

"I guess I should be looking for a replacement for my O2 ring at this point"

IMO, everyone should.

In fact I'm returning my CheckMe O2 Max tomorrow.