Low SpO2 Levels when using Bi-Pap Machine

[palerider]

I also think you should get another opinion. My family member doesn't need his bipap at all if he has oxygen fed by canula. Seems to me her overall quality of life is superior with oxygen only.

oxygen desaturation is not the only problem associated with sleep apnea.

[JSL747]

The lack of O2 desaturation could be because she is being awakened b4 desat can happen due to apneas. This would not be good.....

[carlechols]

Pulmonary Doctor said to use bi-level 24/19. 5L O2
She had previously been on bi-pap 17/13 3L O2
Sounds like a headache just waiting to happen but we will try tonight.
The sleep study he is basing the new settings on showed that her SpO2 was <88 for 295 out of 324 minutes sleep
Appointment tomorrow to discuss why use a machine that lowers SpO2 level.
Nasal cannula alone shows 100% above 88%

[kwhenrykerr]

I hope all is well. What is the outcome of your doctor visit. Best wishes

[carlechols]

Actually she had to be admitted to the hospital for another week's stay just after the doctor visit.

I asked him if he "read" the results of the sleep study and of course he said "yes." When I pointed out that her SpO2 were below 88 all but 6 minutes in 8.5 hours then he "READ" the results of the sleep study and said I needed to see the sleep doctor. Could not get an appointment until I was actually admitted to the hospital and my heart doc got him to come and adjust my machine. Right now after several adjustments all seems well.

Will be seeking second opinion from another pulmunologist to see if they think I am being treated properly.

[kwhenrykerr]

It is a shame that we must at time "Push" the doctor. My PCP now seems to have taken the path of asking me what I want then going about his work. He has said that I should keep "Pushing".

I try to be soft spoken and take care with my words. He/They are the doctors and I respect them for their work. I wish they could work with each other better. Information sharing is a problem.

Let us know the outcome of your changes, best wishes.

[Matt00926]

IPAP 24/EPAP 19 doesn't give for much pressure support, so when she uses bi-level with supplemental oxygen she is probably retaining a lot of CO2 which is both messing up gas exchange and probably the culprit of her bad headaches.

As far as I know for COPD you need a longer exhalation time due to air trapping and being unable to expel CO2. Try adjusting her rise time setting to 1 or 2 so it cuts off the inspiration in a timely fashion and also allows a higher peak flow rate.

I would recommend getting her a new sleep doctor, and have her do a bi-level titration in a hospital sleep lab, do a bit of research to find a good doctor and lab. Sounds like her current doc doesn't really care at all.