Chin Tucking as cause of apnea

[UnicornRider]

 The O2 readings were so low at times I concluded it does not work properly.  One Forum member saw my O2 report and claimed it was me moving that caused the extremely low O2 readings. 

  I believe in the Submariner's philosophy "Until proven otherwise, trust your instrumentation". Aviation Pilots are encouraged to follow the same principal.

I had the opportunity to ask my anesthesiologist to check the accuracy of my Checkme O2. The Wellue only goes down to 70%, he showed me a drop to 40%, the Wellue tracked everything from 98% to 70% with a +/- 2% max deviation, most was dead on, and he was monitoring on the opposite hand.  Now, he only had that one extreme excursion. He did note several other drops well into the 80s% and a few into the 70s%, there again the Wellue tracked close enough he was impressed.

Lesson learned, a very stern lecture from the Anesthesiologist to always forewarn Doctors, Surgeons and especially Anesthesiologist of CPAP use and tenancy to drop O2.

I figured the fact I showed up and inquired if he would check the accuracy of my Welleu O2 monitor, would give him a heads up.  Luckily they had a nurse call my friend to find out what type of *PAP and pressure settings I used.

The ring must fit tight to record accurately. Ambient light and temperature can also affect accuracy. Because I keep the bedroom ~62*F to 65*F and I do run a 625 nm red light for sleep, therefore I wear a wool fingerless gloves, with the mitten conversion. while I sleep. 

The reason I opted for the wrist mount O2 monitor was the replaceable measuring ring unit. If that little flap, that provides tension and adjustment room, got torn I could always replace it for ~$25. I also took the three year insurance plan offered on Amazon. I plan on recovering my insurance cost, although we have two units in use daily for over six months and no breakage, yet.




...

[UnicornRider]

Your close up of the Flow Rate wave shapes does show Upper Airway Restriction Syndrome (UARS) type distortion of the flow rate graph.

Could you post ~ a 3 minute zoomed view between 01:00 and 01:05 of the same day the cluster shots came from?

Your new post really looks like chin drop, confirming your need for some type of support.

Does your Primary have you take Calcium, Magnesium, Vit C & D3 supplements for your extended Omeprazole use? I take my magnesium just prior to bedtime with a SleepyTime Tea, After a couple of weeks use I noted an extended calming effect throughout the next day. I had already been taking the Calcium, Vit C & D3 from a previous recommendation.

[ejbpesca]

Here is a few minutes OSCAR image starting at about 1:00 as requested (I think I got the right area.)

I have my O2 Wellue Ring charging up.  It is taking hours to do so.  I don't recall it taking that long.  It has only been used a few times but the battery I guess drained a great deal while idle.  I will try it on my thumb instead of my ring finger.  It may get a better reading there.  I compared it with another O2 device and once on the thumb it gave a more accurate/stable reading.

I will wear the Wellue tonight and give my collar yet another go.  I will cool down bedroom too.  Thank you for your patience and help.  

My primary doctor only suggested D3 due to hearing that I am not out in the sun much.  I tried D3 but like other supplements, it aggravates my acid reflux.

   

[ejbpesca]

I looked up airway resistance syndrome.  I fit the profile to an extreme of what causes airflow restrictions.  Photos of my anatomy could be used as examples of what causes it.  I wonder if CPAP pressure can blast through the restrictions.  Maybe I need a constant 20 setting?  

I recall when I first got started CPAP telling my pulmonologist, "I think I need more pressure.  A lot more pressure."   I also asked for O2 to be added to the CPAP.  He said O2 addition was possible.  I never got it.  Maybe Medicare does not pay for that.  

Having yet another "can't wake up," day, I did the usual thing.  I start to feel I'm going to fall asleep.  Sometimes I go into a nether land of nodding out/waking for hours on end, but sometimes like today I go back to sleep.  I woke after an hour dawned the CPAP mask, and got back to sleep, with these results:

   

Is that OSCAR chart an example of successful CPAP treatment? (a first for me if it is)  Can you see my UARS in it?  Can my AirSense 10 help with UARS?  How's the flow limitation graph looking in this report?

Thank you so much for your help.  Here's hoping a Merry Christmas is upon you.  I am alone so not much to do about the holidays.

[UnicornRider]

Yes, your ring will take extra time to charge fully after being idle. 

Do you have the Wellue smart phone App. "ViHealth" ?

 Do you have the Wellue "O2 Insight Pro" program for your computer?

Congratulations on achieving a O.OO AHI

Is that the first time you have recorded an AHI of  0.0 ?

"Is that OSCAR chart an example of successful CPAP treatment?" NO! It is not a successful CPAP Therapy session. Your Flow Limits need to be addressed.

 If you are up to it , increase your min pressure by 0.2 (cmH2O)  that should put you at 13.6 (cmH2O). We do not want to increase it too fast, you will start having CA events (Clear Airway) and that can potentially cause O2 drops.

 I need you to zoom in and take a screenshot of ~15:54 to ~15:56.

 Before you take the screenshot, I would like you to rescale the y-axis to +60 to -60 for the flow limits graph. If you need help with that, let me know.  

A friend of ours here on ApneaBoard forum, CPAPfriend, has some You Tube videos I would like for you to see. There are several OSCAR YT videos that May benefit you, we can get to them later.

https://www.youtube.com/watch?v=32JwMc6dphQ&t=10s

https://www.youtube.com/watch?v=ujaoKvBnP00

I look foreward to hearing from you.





....

[Jay51]

Congratulations on the improvements.  Great points to try by UnicornRider. 


A few things in your OSCAR chart jump out at me as very suspicious.  An inspiration median time of 3 seconds and an expiration median time of 4 seconds.  These are skewed, correct (experts)?

Also your median respiratory rate of 8.4 is lower than normal.  Normal can vary, but usually 12 to 20 for a median is average.

[ejbpesca]

Thank you for the replies.

Yes, this is the first time in over 15 years that I've ever seen 0.0 AHI.

My min. pressure is now 13.6.

The OSCAR chart with 0.0 AHI ends at 15.23.  Times requested for zoom are not on chart.

Yes, I have a VHealth App Version 2.74.84  It worked last night with O2 Lookee Ring so I have an O2 report on an Android cell phone, and yes, I have the O2 App that goes with it on my MacBook.

Last night with tape and collar:

Hypop 11
OA 4
UA 1
RERA 8
Large Leaks 66

Please let me know if you want another time spread of the OSCAR chart with 0.0

Thank you.

[ejbpesca]

Congratulations on the improvements.  Great points to try by UnicornRider. 


A few things in your OSCAR chart jump out at me as very suspicious.  An inspiration median time of 3 seconds and an expiration median time of 4 seconds.  These are skewed, correct (experts)?

Also your median respiratory rate of 8.4 is lower than normal.  Normal can vary, but usually 12 to 20 for a median is average.

How would the data become skewed?

What does the median respiratory rate low score (8.4) imply?

[ejbpesca]

 I need you to zoom in and take a screenshot of ~15:54 to ~15:56.

 Before you take the screenshot, I would like you to rescale the y-axis to +60 to -60 for the flow limits graph. If you need help with that, let me know.  

In lieu of ≈15:54 to ≈15:56 I have a screen shot of the rescaled last few minutes of Flow Limitations from the nap that produced 0.0 AHI.

Merry Chistmas, I hope to hear from you soon.  Just maybe after 15 years of very little good therapy from CPAP use, your advice will bring me to better therapy.  I am doing okay today.  I will work on getting my O2 report placed into an OSCAR report.  Thank you so much for your expertise and taking time to help.

   





....

[ejbpesca]

Congratulations on the improvements.  Great points to try by UnicornRider. 


A few things in your OSCAR chart jump out at me as very suspicious.  An inspiration median time of 3 seconds and an expiration median time of 4 seconds.  These are skewed, correct (experts)?

Also your median respiratory rate of 8.4 is lower than normal.  Normal can vary, but usually 12 to 20 for a median is average.

Thank you Jay51.  I looked back at a dozen OSCAR daily reports and found my respiratory rate mostly within 12 to 20 (95% and 99%) so I guess that one 8.4 rate is not an issue.

Thank you for taking time to help.  I get none locally from DME or doctor.