Help reading Chart

[carl47715]

Hello, First timer to the forum and posting. I've attached a Sp02 report for some help reading. I have been diagnosed with O/A & C/A.
Currently on 2 liters of O2 after being on CPAP, BIPAP & VPAP all with no luck. The main issue was to much pressure each time. I think that I understand Sp02 side but not so sure of the pulse rate side. Any help would be appreciated. Could you please point me in the right direction in the forum that addresses this area. Thanks

   




[attachment=2068]

[Sleeprider]

That image is too small, low resolution to be read.

Have you ever discussed ASV therapy with your doctor? It maintains low EPAP/IPAP pressure until it detects a central event then triggers a breath with increased pressure support. It's unclear from your description what the problem was with "too much pressure".

[justMongo]

First, welcome to apneaboard
Sorry, I am unable to read your attachment. I suspect that's because for new user's attachments are limited to 200KB.
FYI: BIPAP and VPAP are the same thing; both are generically known as bilevel. One is PR's tradename and the latter is ResMed's tradename.
Mixed apnea is usually treated with a type of PAP machine known as an ASV.
Treatment with O₂ alone may help prevent deep desaturation a bit.

I cannot answer the heart rate question because I cannot read the attachment.

[carl47715]

I was having a problem adjusting to the CPAP, BIPAP where I would pull the mask off due constant air leaking due to the pressures. The VPAP would start out fine and then the same thing with air leaking out around the sides of the mask and making noise. I'd never sleep due to all this going on. Sleep, awake, sleep, awake all night.

No, regarding ASV therapy but will when I see my Dr. in a few weeks. Thanks

[carl47715]

Event Data Sp02 Pulse
Total events 192 141
Time in events(min) 155.8 85.3
Avg. event dur.(sec) 49.0 36.3
Index (1/hr) 13.3 23.1
% Artifact 0.1 0.1
Adjusted index (1 hr) 31.4 23.1

% Sp02
Basal Sp02(%) 92.5
Time(min) < 88% 79.8
Events < 88% 83
Minimum Sp02(%) 57
Avg Low Sp02(%) 87.1
Avg Low Sp02 < 88% 81.7

Pulse Data
Avg Pulse Rate(bpm) 59.1
Low Pulse Rate(bpm) 47

[carl47715]

Event Data
Sp02 Pulse Total events 192 - Pulse 141
Time in events(min) 155.8 - Pulse 85.3
Avg. event dur.(sec) 49.0 - Pulse 36.3
Index (1/hr) 13.3 - Pulse 23.1
% Artifact 0.1 - Pulse 0.1
Adjusted index (1 hr) 31.4 - Pulse 23.1

[justMongo]

Are you using one of those wrist watch like oximeters with the finger sensor?
I have one, and I find it only coarsely accurate.
The heart rate is rather accurate. Your average and low pulse rate are within norms.

Getting a mask to seal at higher pressure can be a bit of a challenge. I can do it at 18.
PaytonA can do it at 20. You just have to be determined to make the xPAP therapy work.
The long term effects of sleep apnea are detrimental to all major organ systems.

You need to make a commitment to wear the mask and adjust it to minimize leaks.
You need to follow up with your doctor regarding treatment with an ASV machine.

In some countries, one cannot drive a car without cpap compliance.
In the US it's a fact for commercial drivers; and likely soon to come to all drivers.

Healthcare is a two way street -- you have to work with your doctor; and your doctor needs to advise you of the best therapy.
In other words, you need to follow though with your doc.

[Sleeprider]

Carl, your SpO2 data suggest that even with supplemental oxygen, your desaturations are a concern worth discussing with your doctor. No matter how much oxygen the air contains, you still have to breath in order to exchange gasses in the lungs, and I think your mixed apnea is preventing adequate ventilation.

Adaptive Servo Ventilators (ASV) are non-invasive ventilators. The minimum exhale pressure is raised just high enough to prevent obstructive apnea, and the IPAP is set for good ventilation and comfort, usually a pressure support (PS) of +4.0. What sets this machine apart is its ability to increase IPAP pressure rapidly on a breath by breath basis to maintain respiratory volume and overcome a central apnea. That is something your BPAP/VPAP could not do. In fact, without that capability, there is a possibility your bilevel machines just made things worse.

Now you will still have to overcome leaking and find the right mask or nasal pillows. If you don't tend to mouth breath on CPAP, then something like the Resmed Airfit P10 pillows are very comfortable and resistant to leaking. If you do have issues with air escaping from your mouth, then there are many forms of full-face and hybrid masks that may work.

Please talk to your doctor about this. The health consequences of continuing to be inadequately ventilated are pretty serious in terms of your heart and even mental health. It is well worth a determined effort to make a mask work, but you also need the right tool for the job, and I suspect that you never had it before...ASV. Imagine how you might struggle if the bilevel you had simply did not treat a significant part of your apnea. They don't treat CA and elevated pressure was never going to help. I think if I was not breathing, I would tear my mask off too. You just have to understand the difference, between bilevel and bilevel ASV and you can have a productive discussion with your doctor. Give it another try.

[carl47715]

I have tried all mask including a full face and still no luck. The reason that I purchased the CMS50D+ was to see what my readings were at home. I've had three sleep studies performed and they all were I believe amount 17 or higher on pressure. I have seen an ENT and have scheduled a procedure for a deviated septum next month. One other concern we have in the family is I do have a grandchild with CCHS.

[Sleeprider]

It would be interesting to see the details of those titration studies. We have members here with very high pressure requirements, and the mask is a critical part of getting things right. If centrals are a significant feature of your apnea, you still have not been treated yet. There are dozens of models of masks, and a right machine for CA, so my best advice is keep trying. Surgical correction of a deviated septum may reduce obstructive pressure needs, but your apnea is not going away with that alone.

Sorry about the grandchild with CCHS, although it is treatable with similar technology to what we're discussing, it seems really rare, and has a lot of complications. Pediatric respiratory disorders are not much fun for parents or grandparents.