[Pressure] Newb HELP Request. Low AHI SO2 still dropping

[ngali]

Hey all...

Basically it's as the thread title says. I'm new to CPAP use and am going in a little blinder than most I guess. Where I am we don't have sleep clinics per se, and no specialists but was getting worrying sleep O2 levels as reported by my Samsung Galaxy. Typically they were low 80s and into the 70% range and that's been for years. It was never a concen since I'd always been feeling fine during that period. But, for that last 10 months or so I had been experiencing some neuroathy and some suddenly severe symptoms associated with their onset. Doesn't seem to be any obvious cause, and apnea is the last candidate standing. So... went out and got myself an Airsense 10 and have been using it for the last 2 months. No sleep doctors or clinics to help out or advise, so here I am.

My consistency is hit and miss, but in the first month or so my AHI and O2 levels corresponded for the most part and if there were dips below 90% they were quick drops and didn't last long.

But they continue to occur despite what appear to be pretty good AHI scores. Is there some adjustment I can make to the machine to help this? Doesn't seem to warrant supplementary oxygen, or does it?

Thanks

[Heracles]

Sleep apnea is one thing. Hypoventilation is another. Here, my wife is an olympic champion when it comes to sleep apnea! Without treatment, her AHI is around 150! I got her an AirSense 11 then and calibrated it properly. I tuned her AHI down to about 3. Still, the symptoms were there and her SpO2 was dropping. Last set of measurement was as low as 75 in her deep sleep. Despite asking the healthcare system for help, nobody did anything until recently.

We just got out of the ICU where we received her diagnosis of hypoventilation, a new BI-PAP instead of a CPAP and a therapy plan they optimized for her. In her case, she also ended up with some additional oxygen when sleeping. Now all her vitals are way better including her Sp02. They gave us a range of 88 to 92 for her (it is normal to desaturate a little while asleep) and she is well within that range now.

It is sad to say but before going to BI-PAP, hypoventilation and more, one must proves that CPAP failed to treat the condition properly and that means collecting this kind of data for a little while. No need to stay on CPAP failure for 2+ years like my wife but a few months for sure. Unfortunately, it is already hard enough for the average guy to workout a CPAP solution. To demonstrate CPAP failure and move to BI-PAP is even harder.

[staceyburke]

I have been on Oxygen while I sleep, for over 30 years.  My Dr was very worried when I went in and my O2 was in the low 80s.  The first thing I would do is get a O2 sensor that records the entire night. There are several out there for 100 to 150 US dollars.  Start recording your O2 stats.  If you need O2 you can but a used concentrator and use it.

As far as the cpap goes I would give you a couple things that may help.  To start with you have some large leaks, large enough that the machine can NOT deliver any therapy during those times.  The leaks are Mouth leaks - not mask leaks.  A full face mask could help and many people use this but a large number use mouth tapping. There are many posts on this you can look them up.

The other thing is Flow Limits - yours are quite high and need to be worked on.  We use EPR to stop as many flow limits as we can.  FL are apnea also just like O and H events.  But they do not last long enough to be counted as O or H events and are not part of the AHI.

To help with the FL I would try the following settings.

min 7
max 20
EPR full time
EPR 3

Give these setting a try and post your OSCAR charts again with these settings.

[Jay51]

Here are some additional tips to help lower mask leaks from our wiki:            

• 1Mask Primer                                                                                                                                                                                                       I was diagnosed with hypoventilation as well.  Keep an eye on your tidal volume and respiratory rate in the future to make sure they don't get much lower.  Stacey explained the supplemental oxygen situation.