RE: Huge SpO2 dips at sleep onset (with and without bi-level)
If it was me one drop would not be of concern, especially as we know what is happening just not why. TImax is the max time it will stay at IPAP and your chart posted here is < 3s, so you could drop it back to 3.0 or even 2.5 to see if it has any impact.
My advise, for what it is worth, is don't over-analyse things. If you look for something you will likely find it.
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
When I am up and moving about then lay down my oxygen level drops to the mid 80s then after I am laying for maybe 5 minutes it is back to normal. A walk to the end of the driveway and back is good for mine to drop into the 80s.
When my wife sits still in a chair or goes to sleep hers will plumet to the mid 70s...
We are both on 2L O2 at night and she sometimes uses it in the day -
Oxygen will change depending on what you are doing....
Are your dips after you have been laying quiet for a while or just after you lay down?
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
Yeah, I am probably over-analyzing (out of frustration of not getting quality sleep for years). I will let it go, maybe only change the Ti-max as a test but only if it does not interfere with my awake period (I hate breathing against the stupid machine).
Guess what, tonight it did not happen. I did drink some beers and fell asleep within 5 minutes. Do not worry, I am not going to use beer as a solution for this issue ;-).
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
While doing a more thorough investigation on old data, I noticed I never had this SpO2 dip on CPAP! In the past I did not often try EPR as it did not much for me, but when I did, I also see this extremely shallow breathing at sleep onset resulting in the SpO2 dip (EPR 1/2 and 3).
On my bi-level I have trigger to "very high" and I now wonder, am I polishing away artificially my CA's? Maybe I need to try ASV, the CA wonder.
I am a bit concerned bi-level with my current settings is over-ventilating me due to the high PS with trigger very high. In 5 weeks I have a sleep test where I will request blood gas analysis while on bi-level to get this worry (dis)-confimed.
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
So,
In my sleep study - the cpap and the bipap both made my breathing worse - the constant pressure in the throat made cause the cells that trigger breathing to think I already was.
Once on ASV that went away.
NOTE - The ASV measures minute-vent - so the volume you breath over the course of a minute and if you aren't inhaling it will force you to inhale with pressure.
The pressure can be quite a bit higher than the cpap/bipap.
Here in the states you need a titration study in a lab to verify the central apnea and you have to have an EKG prior to verify left ventrical ejection fraction - i.e. if your heart isn't happy they don't put you on an ASV. This is linked to british study that has since been debunked - but the AMA hasn't caught up yet.
BUT - if you don't have centrals there is no point in using an ASV and a bipap will work better for you.
Also note - treatment emergent central apnea generally will go away on their own after a while.
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
Hi thanks for the input. As for treatment emergent CA's go away, I have been on therapy 3.5 years now.
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
Robbob2112 (or anybody else), do you have some link for me showing the heart risk for ASV has been debunked? Could be helpful for me as my sleep doctor also wants EKG before allowing ASV.
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
I have similar looking O2 events that keep me from falling asleep. My sleep doc prescribed Ambien, which usually helps me get to sleep, but the O2 drops kept happening, down to as low as 70%. Doctor put me on BiPAP S/T a few weeks ago, and it’s kept my O2 from falling so far, but it still goes down into hypoxemia range. Looks like I’m going to ASV, too. Anyway, just wanted to say you’re not alone and good luck!
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
My sleep doctor told me this is pretty normal during sleep onset (to have a short SpO2 reduction) where the body is baselining a new balance. She is thinking I am too sensitive (read: stressed) due to all health issues I am dealing with for so long without noticable improvement. And I have to admit, working on stress/anxiety reduction, accepting the current situation, believing there will be improvement has helped.
In short, the dip is still there in my case but I have not been bothered by it for over a week. Hopefully it will at some point also impact my RERA's waking me, as she also thinks there my bi-level therapy is near perfect (which is a compliment for me as I did setup that myself ;-)) and she does not have another explanation anymore for my high number of RERA's that wake me up.
RE: Huge SpO2 dips at sleep onset (with and without bi-level)
Just a note,
Many sleep medications can cause this sort of issue as well. As can pain medications. In particular oxycodone which is used for chronic pain depresses the respiratory system. For chronic pain there are only a couple of things that you can have your pain managment Dr prescribe.
