[Diagnosis] O2 Ring - what is the use of pulse & movement data?

[JoeDoe]

Hi, All,

I've been using the O2 Ring occasionally.  The value of the blood oxygen level is obvious, but I'm not clear how to make use of the pulse and movement data.  I can see spikes in the pulse and movement data, but I don't know whether they are just normal, meaningless spikes.  So questions like these arise: How many spikes are just normal and mean nothing?  How big does a spike have to be to be of concern?  And are there more subtle questions that should be asked than simply counts and magnitude?

I've attached a sample night's data for illustration.  Clearly some of the pulse and movement spikes correlate with events that the machine identified, but other spikes don't correlate.

Thanks for any insights you can offer!

[Jay51]

Good questions.  Your pulse spikes don't go super high; but they are spikes nonetheless.  When spikes line up with events, that is usually the reason for the spike.  Showing this data to your Dr.(s) would be a wise move IMO.  

As far as movement goes, it can show arousals and also help confirm PLM's.  There are other reasons for "tossing and turning" as well though:  arthritis, temperature, etc.  

I am glad that you posted because you show some positional apnea in your OSCAR chart.  Things like lowering pillow height, side sleeping vs. back sleeping (with something like the edge of the pillow tucked between your chin and chest to prevent chin tucking) and using a soft cervical collar at night can help lower or even prevent positional apnea.  The "clusters" of OA's are what are indicating positional apnea.  Here is some more reading about it from our wiki: 

• 5.3Positional Apnea
  

[JoeDoe]

Thanks so much, Jay, for such an informative answer to my questions.  This really gives me material to discuss with my sleep doctor in 10 days.  One follow-up question:  you suggested lowering pillow height, but apparently you use a 3-foot wedge pillow on your bed.  Seems like a contradiction, but maybe I just don't understand.  I have a full-bed-length wedge that is about seven inches at the head of the bed, tapering to nothing at the foot of the bed.  On top of that I have either a regular pillow or a body pillow.  I find it a bit annoying to constantly be sliding down the bed!  Let me know if you think any of this is counterproductive.

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Thanks so much, Jay, for such an informative answer to my questions.  This really gives me material to discuss with my sleep doctor in 10 days.  One follow-up question:  you suggested lowering pillow height, but apparently you use a 3-foot wedge pillow on your bed.  Seems like a contradiction, but maybe I just don't understand.  I have a full-bed-length wedge that is about seven inches at the head of the bed, tapering to nothing at the foot of the bed.  On top of that I have either a regular pillow or a body pillow.  I find it a bit annoying to constantly be sliding down the bed!  Let me know if you think any of this is counterproductive.

[Jay51]

Great question.  I have found it perfectly fine to lay my head flat against the wedge at night (or use a very thin pillow), so my head is not sticking forward (or my chin tucking towards my chest).  The distance of the chin in regards to the chest is key.  How much space between chin and chest regardless of the angle one is sleeping at (flat, inclined, etc.).  When the (distance) between the chin and chest begins to get smaller, the airway could be "kinking".  So, the larger the pillow, the greater the chance of chin tucking.  Not everyone suffers from positional apnea though.  

You are sleeping on a slight incline.  Gravity can help some keep their airway open better using inclined sleep.  Others it doesn't effect.

[JoeDoe]

Thanks, Jay, for the clarification.  Makes sense.  I bought a cervical collar months ago but haven't used it because I've been tweaking so many other factors.  I guess I should dust it off and give it a go.

[TomH FW]

I use the O2, pulse and movement graphs from my Wellue O2 ring data to cross-check against the timing of flow limitations or leak issues, or “junk” breathing in the Oscar flow chart derived from my ResMed AirCurve 11 Vauto. I am still relatively new to all of this, and am clearly still trying to get “dialed in”, but having the additional information helps me to see other parts of the overall situation.