Deciphering pulse rate data from oximeter

[sean333]

I'm a new board member, although I've been on a CPAP machine for a little less than two years. I have moderate sleep apnea with a twist -- every two years or so, I suffer a tonic-clonic seizure in my sleep. This started happening out of nowhere in my mid 50s. Extensive epilepsy testing and CT/MRI brain scans have turned up nothing. Meanwhile, using a recordable oximeter has turned up an odd pattern in my pulse that my cardiologist is puzzling over.

Basically, I have a sawtooth pulse pattern -- fluctuating between 45 and 75-90 -- for three or four hours. then my pulse flatlines around 45-50 for an hour or so. The flatline period is when bad things happen -- desats down into the 80s that can last 10 minutes or more without apneas, as well as the occasional seizure. Usually, it's when my heart is making the transition from sawtooth to flat or back.

I recorded one seizure on the CPAP -- a 38-second obstructive apnea preceded it.

I tried to attached an oximetry report showing the pattern, but it wouldn't attach.

This make sense to anyone?

[justMongo]

Not really...

There is a small expendable monitor used by cardio docs called the ZIO patch. It can be worn for as long as 2 weeks and has no wires to snag.
They superglue it to the left pectoral region.

Any other medical conditions? Perhaps diabetes? Long term diabetes can result in something called systemic neuropathy. It interferes with nerve conduction.

[Possum]

Does this pattern occur consistently, over say an entire week's worth of oximetry data? Recording oximeters are not without their limitations, as they require wearing a large, awkward probe on your finger all night. Unless you are perfectly still all night, the probe can get banged around out of place and generate artifactual profiles like what you're describing.

[sean333]

Happens every night in similar but varied patterns.

I'm wearing an event monitor as I write for three weeks. This is supposed to pick up any arrhythmias that might be causing this. I do have bradycardia, but it has been considered nonsymptomatic until now.

I'm trying to do research ahead of the cardiologist's findings because they sometimes miss more subtle conditions that another doctor might have picked up on with another apnea board member.

I think I've just inserted a jpg file of the oximeter report. Let's see whether it works.

   

[srlevine1]

I'm a new board member, although I've been on a CPAP machine for a little less than two years. I have moderate sleep apnea with a twist -- every two years or so, I suffer a tonic-clonic seizure in my sleep. This started happening out of nowhere in my mid 50s. Extensive epilepsy testing and CT/MRI brain scans have turned up nothing. Meanwhile, using a recordable oximeter has turned up an odd pattern in my pulse that my cardiologist is puzzling over.

Basically, I have a sawtooth pulse pattern -- fluctuating between 45 and 75-90 -- for three or four hours. then my pulse flatlines around 45-50 for an hour or so. The flatline period is when bad things happen -- desats down into the 80s that can last 10 minutes or more without apneas, as well as the occasional seizure. Usually, it's when my heart is making the transition from sawtooth to flat or back.

I recorded one seizure on the CPAP -- a 38-second obstructive apnea preceded it.

I tried to attached an oximetry report showing the pattern, but it wouldn't attach.

This make sense to anyone?

As JustMongo said, the Zio patch is a great device for detecting irregular heartbeats and arrhythmias over relatively longer period of times and is comfortable to wear up to two weeks. BTW -- ask them to use surgical tape on the ends as the patch tends to loosen over time with motion, sweat, etc. It is effective and cheap. They put it on, you take it off and mail it back to the manufacturer, and they send the report to the doc.

Have you checked for an indication of periodic breathing (Cheyne-Stokes Respiration) which will show up in both ResScan and ResMed?

[trish6hundred]

Hi sean333,
WELCOME! to the forum.!
Hang in there for more responses to your post and good luck to you as you continue your CPAP therapy and also with getting your problem straightened out.