O2ring shows huge gradual drop in spO2 over half hour with new DS2. Cord tangling?

[aolamid]

I got my recall-replacement DS2 a week ago, and last night saw the most significant drop I have ever seen in the year or so I have been monitoring my spO2 with my o2ring.  Pressure=15, flex=2.  It is so different from anything I have ever seen that originally I thought it was the o2ring acting up, but the correlation between the pressure, heart rate, and motion seems to indicate that this was a real event.  Usually when I have a drop, it lasts a minute or less, and rarely goes below 70%.

My yearly visit with my sleep doc is coming up in a week so I will definitely bring this in, but I'm curious if anyone has any takes on whether this might be associated with the switch to the DS2.  I was more tired than usual going to sleep that night, and had taken melatonin, gabapentin, and hydroxyzine before sleep.  I have taken those drugs before sleep for months without ever seeing anything like this.  I did notice that my tubing seemed more tangled than usual when I woke up.  I also notice that the design of the DS2 makes tangling more likely than with the upward-facing, swiveling hose outlet on the DS1 I had been using before.

   

The DS2 dreammapper app also shows a higher than normal AHI on this night (the last of the nights shown below), further confirming that this was a real event.

   

BTW, this is my first post on this forum, although I have read it in the past.

[aolamid]

Correction: above post said "rarely goes below 70%" but should have said "rarely goes anywhere near 70%".

[StratCat48]

The hydroxyzine has some side effects that could cause an increase in heart rate and shortness of breath.
https://www.mayoclinic.org/drugs-supplem...g-20311434

Gabapentin is an anticonvulsant. Not sure why you would want to take that unless you have a condition that warrants its use(?)
https://www.mayoclinic.org/drugs-supplem...g-20064011

I usually avoid any types of medication before bed and I have a cup of Chamomile tea which is said to help sleep

For the tangled hose I would suggest an overhead hook hanger so it hangs above you. I had to reverse the orientation of my DS2 so the hose exits to the rear and loop behind the headboard of the bed up to the hook

https://www.amazon.com/gp/product/B07TWP...=UTF8&th=1

[aolamid]

Thanks for all that info.  The hydroxyzine and gabapentin are prescribed off-label for anxiety, and because they make me sleepy I take them as a sleep aid.

I also have my DS2 oriented with hose exiting toward the wall, so that I can avoid spilling the humidifier.  But I suspect that orientation leads to more cord tangles because the hose doesn't have as much space to gently loop out as when it exits away from the wall.

I have tried cord hangers but found them uncomfortable because gravity causes the weight of the tube to partially rest on my mask, making me feel like I'm tethered and torqued.  Letting the tube rest on the bed or pillow next to me (I do a lot of side sleeping) is more comfortable: less torque on the mask.  But maybe I should give cord hangers another go and see if the discomfort goes away with long term use.

[StratCat48]

I have tried cord hangers but found them uncomfortable because gravity causes the weight of the tube to partially rest on my mask, making me feel like I'm tethered and torqued.  Letting the tube rest on the bed or pillow next to me (I do a lot of side sleeping) is more comfortable: less torque on the mask.  But maybe I should give cord hangers another go and see if the discomfort goes away with long term use.

The part of the hose on the hanger behind the bed has had just enough weight that it tends to pull the side going to the mask gently upwards and out of the way. Perhaps somehow adding a little weight to the hose on the side that goes to the CPAP would find a good balance from the hanger to pull it up slightly(?). I as well am a side sleeper and roll around often.

[desaturator]

These traces look so strange that they almost have to be an artefact, don't they? The return to baseline at the end of the desaturation episode seems to take at most a few minutes. You might see this sort of desaturation with a cardiac arrhythmia, but the heart rate trace shows only a slow rise.

Because I have an intracardiac shunt, I see this sort of thing a lot, but nowhere near as significant as yours. Also, I see it all the time, because a shunt is something that doesn't come and go. Also, I sometimes see crazy readings from my Wellue when I get it trapped in odd positions, where the circulation to my hands might be reduced.

Is this a bad example of something you see all the time, or a completely unexpected, one-off event?

Does your PAP machine provide any more detailed (minute-to-minute) data?

BW, DS

[aolamid]

This is the first time I have seen anything at all resembling this event.
I just remembered that I wore my new Apple Watch to bed that night, so looked at that data. The sawtooth pattern seen on the o2ring data was from about 1:30am to 2am. The Apple Watch only gives hourly ranges but it says:
1-2am 51-68 bpm
2-3am 55-60 bpm
3-4am 55-59 bpm
4-5am 55-60 bpm

So the Apple Watch also recorded some much more extreme than normal heart rate during the time period when the sawtooth happened. As for spO2, the Apple watch didn't capture any measurements during the event. Interestingly it thought I started sleeping at 1:51am, right in the middle of the event. Perhaps the stillness (less motion) shown on the o2ring data triggered that.
Respiratory rate per Apple Watch didn't seem to be affected much if any:
12:52am 17 breaths per min
01:28am 16.5
01:41am 17.5
01:49am 18
02:07am 17.5
and after that measurements ranged btw 16 and 20 until 6am.

I have been told that there is a beta OSCAR version I could test which could pull more data off my DS2 card. I'll see if I find the time to try that.

I as well am a side sleeper and roll around often.

That is encouraging. I have never actually tried the purpose-built hanger; I just looped around the bedboard in the past, which clearly would cause more resistance to movement. Perhaps I'll experiment by jury rigging a hanger using the C-stand lightstands I have for film/video work, with a nylon strap loop to hold the tube.

[Jeff8356]

aolamid,

If you don't have any other serious health issues that might cause that strange event, I would guess that you rolled over and possibly were putting unusual pressure on the O2 Ring due to an odd sleeping position causing it get give an inaccurate reading.  Or maybe you were cutting off circulation after you initially moved.
Looking at the O2 report you posted, there is a large movement just as that event started.  Then another movement later when things shot back to normal.  So hopefully it was just an odd position you were in.

If this is the first time it has happened then it could just be an anomaly.  See if it happens again.

[desaturator]

Incidentally, I have a much better understanding of when my pulse oximeter gives crazy readings, now that I've started video recording my sleep. I can't say my wife is keen to have a video recorder at the end of the bed -- not at our time of life -- but it's quite revealing. I've noticed, for example, that my SpO2 readings appear to drop when I have the sensor tucked into my armpit. I wouldn't have thought that I would sleep in that position, or that it would affect the reading, but the video is conclusive.

In fact, I'm a convert to the practice of sleep videoing, and now recommend it to everybody who has a suspected sleep problem.

BW, DS

[aolamid]

I brought the posted graph to my sleep apnea doctor.  She didn't look too carefully, and didn't trust that is wasn't an artifact, but did say that she thought it looked like it could be a real event if it isn't an artifact.  Unfortunately due to issues with my DME she doesn't have the day by day DS2 machine data, and due to her setup couldn't access it through her local download of the SD card.   That did encourage me to try OSCAR beta for DS2 when I have time.