SpO2 Interpretation

[forrestc]

I was wondering if someone could look at the attached SpO2 graph and let me know if this is indicative of what I think it is?



My guess = this screams apnea-related desaturation, but relatively minor (but still of concern). I'm also guessing that my DME's setting of 12 at the top range wasn't correct - but she doesn't have the SpO2 data yet... which brings me to:

My Airsense 10 didn't score a single AHI last night. At all. I'm assuming that since the Airsense 10 doesn't know about the SpO2 numbers, there are likely some events (maybe a lot of events) which aren't being scored which would be if it had direct SpO2 access?

[justMongo]

What oximeter are you using? Prima facie, I do not see a problem with your SpO₂.

[surferdude2]

Looks like you have frequent disturbances (possibly awakenings) when the pressure is maxed out and some minor desats are occurring around that time. It may indicate the need for higher pressure so discuss that with your respiratory tech.

Blow that graph up and look at the flow pattern during those periods and you can get a better idea of how to proceed. Also check the coincident flow limitations, if such there be.

Dude

[kwhenrykerr]

Good question. I am also learning to read the charts. Any advice or ideas to read about are welcome. Thanks for asking the question and thank all for answers.

[forrestc]

What oximeter are you using? Prima facie, I do not see a problem with your SpO₂.

CMS50D+ right now.

[PoolQ]

first off, I wish I had your graph.
it looks like your 12 is on the low side, but you are not having events which is the whole point
the O2 does look like mine and Doc said not to worry until it gets below 88% and stays there for some time-but that's my Doc and not yours.

Like I said I would like to have yours.

[forrestc]

Looks like you have frequent disturbances (possibly awakenings) when the pressure is maxed out and some minor desats are occurring around that time. It may indicate the need for higher pressure so discuss that with your respiratory tech.

I was actually surprised with the lowering to 12, especially since the sleep study includes phrases like "He appeared to do best at the final pressure of 15 cm".

Blow that graph up and look at the flow pattern during those periods and you can get a better idea of how to proceed. Also check the coincident flow limitations, if such there be.

I've attached a few that I'm not sure if are normal or not (still learning here)....

   
   
   

I can say that once I reach the top end, everything seems to start oscillating. I.E. tidal volume starts bouncing from ~100 to ~900. Insp and Exp time starts bouncing around. Flow limit generally increases, etc. And most of what few scoreable events I do have seem to occur during these periods.

Because I was concerned about whether my treatment was sufficient, I added the SpO2 logging and it and the pulse rate do the same thing - once I hit 12, they start bouncing around as well, which I have no idea if this is normal or not....

I do have a hard time asking these questions because when I look at other people's graphs, I just cringe. I feel kinda like a kid whining about a tiny little scrape when his friend has a compound fracture. Feel free to let me know that I'm worried about nothing and I'll stop whining.

[forrestc]

first off, I wish I had your graph.
it looks like your 12 is on the low side, but you are not having events which is the whole point
the O2 does look like mine and Doc said not to worry until it gets below 88% and stays there for some time-but that's my Doc and not yours.

Like I said I would like to have yours.

Yeah, as I pointed out in a reply I was posting while you were posting, I somewhat feel like I should just be happy with how good I've got it. Sort of the Apnea equivalent of a 'first world problem'. I'm just very very very thankful that my chart does look like it does - my study AHI was 99.4 and they woke me up at 83% of SpO2 before it could drop any lower.

Part of the underlying concern here is that I want to make sure that this treatment is working as well as it could be, mainly because I seem to have acquired resistive hypertension along the way somewhere - no matter what medication we try, I am still at about the same high blood pressure. I'd hate to proceed onto the next attempt at a solution to the blood pressure problem, not realizing that the apnea wasn't really under control.

[palerider]

I was actually surprised with the lowering to 12, especially since the sleep study includes phrases like "He appeared to do best at the final pressure of 15 cm".

sleep studies are often inaccurate, our sleep varies from day to day, and even from hour to hour.

sleep studies are a small slice out of all that.

[green wings]

So do I! It has improved slightly since I started using CPAP, but it's still not controlled. I'm on 3 BP meds.

I had very high hopes that CPAP use would help my blood pressure more than it has, since the development of the treatment-resistant hypertension happened during the period when my sleep apnea symptoms started becoming obvious.

I'm glad that you posted the sPO2 & pulse graphs. I'd like to learn more about what's normal and not normal.

I'm not clear on what's the lowest acceptable sPO2 while sleeping. 92%? 90%? If it drops to 86% a few times, but comes right back up, is that a problem?

Part of the underlying concern here is that I want to make sure that this treatment is working as well as it could be, mainly because I seem to have acquired resistive hypertension along the way somewhere - no matter what medication we try, I am still at about the same high blood pressure. I'd hate to proceed onto the next attempt at a solution to the blood pressure problem, not realizing that the apnea wasn't really under control.