Sudden onset of desats - can't figure out why

[MCS2014]

Sudden onset last 4 days in worsening desats.

CPAP pressure still @ 8.6
02 concentrator still @ 2.5L/min

Readings posted HERE (dates shown are not accurate; my 02 Ring messes up the date unless I refresh the app after each use).

As you can see, in the first 12 days of the month (and prior) my 02 score was always 9+ - no worries.

Do not notice any disturbances during sleep nor any increase in daytime sleepiness

Mask seal shows ok on myAir app.

I was getting dry mouth on/off, but not during these reduced 02 readings.

Thoughts as to what's causing this sudden drop and whether I should make adjustments to my pressure & my O2 concentration before I see the doc?

[srlevine1]

I would appreciate knowing what O2 ring you are using.

[MCS2014]

I would appreciate knowing what O2 ring you are using.

https://getwellue.com/products/o2ring-we...Z6EALw_wcB

[srlevine1]

[TechieHippie]

The change in score doesn't seem severe, and the score doesn't always correlate well with lived experience. But you do also show a change in drops and a bit of a change in time < 90%. If I had to guess the reason for the change is that either you were more stressed during the day, -or- you were more relaxed about your sleep treatment and so your body is catching up on phases of sleep that have more drops. (which I would think more likely for you given the steadiness of the data.) I've had both scenarios happen often.

It's hard to say about pressure without OSCAR data, but my guess is that it wouldn't be a bad thing to try going up to 9; that might help in the "catching up on sleep" theory. If you want to dial it in more closely, post some OSCAR graphs. You might see data that would indicate raising your min pressure, your EPR, etc.

Looking at your reports, you have had almost no significant time under 90%, and even when the score went to 7.7, your average was 96 (that's great) so I would say it's not time to up your oxygen. I would only adjust oxygen up after trying all other things (unless you have damaging drops, of course) because it's tough to go back to lower 02 in my experience. Ask your doctor what criteria he looks at for that. I'm guessing it's very similar to the criteria for adding oxygen in the first place...significant time under 90% is what I've read most recently but it's an art. My intuitive sense given your graphs is that you are very well-treated on 2.5 L.

If you are going solely off 02 data (but you shouldn't if you have concerns; use the PAP data too), here's what I look for, for myself:
average 95% or above - when I see 96 or 97, I don't worry much about the other numbers. When it hits 94, I need to adjust something.
time under 90% less than 1-2 minutes total (ideally; I have some nights with more and it's fine).
time under 94% less than 25% of the time, ideally less
3% drops less than 5-8 / hr (I think they correlate high compared to AHI for me).

But, for my dad when he was alive, the numbers were much different. He had CHF, COPD, and a slew of others and was on high-flow oxygen 24/7 and BiPap for all sleeping. We didn't want to see him up in the high 90s. 88-93 was normal for him because of the effects of COPD. All of his o2 ranges were about 5 points lower.

I recently had a segment of my night where I went low oxygen for about 20 minutes (18 min <90). When I looked in Oscar, I had apparently taken off my mask for that section. Oddly, I didn't feel like my night had been oxygen deprived....it makes me think I am reacting to the variability of oxygen as well as or more than the actual level. Have you felt "off" after these lower scores?

Hope that helps!

Lisa

[MCS2014]

The change in score doesn't seem severe, and the score doesn't always correlate well with lived experience. But you do also show a change in drops and a bit of a change in time < 90%. If I had to guess the reason for the change is that either you were more stressed during the day, -or- you were more relaxed about your sleep treatment and so your body is catching up on phases of sleep that have more drops. (which I would think more likely for you given the steadiness of the data.) I've had both scenarios happen often.

It's hard to say about pressure without OSCAR data, but my guess is that it wouldn't be a bad thing to try going up to 9; that might help in the "catching up on sleep" theory. If you want to dial it in more closely, post some OSCAR graphs. You might see data that would indicate raising your min pressure, your EPR, etc.  

Looking at your reports, you have had almost no significant time under 90%, and even when the score went to 7.7, your average was 96 (that's great) so I would say it's not time to up your oxygen.  I would only adjust oxygen up after trying all other things (unless you have damaging drops, of course) because it's tough to go back to lower 02 in my experience. Ask your doctor what criteria he looks at for that. I'm guessing it's very similar to the criteria for adding oxygen in the first place...significant time under 90% is what I've read most recently but it's an art.  My intuitive sense given your graphs is that you are very well-treated on 2.5 L.

If you are going solely off 02 data (but you shouldn't if you have concerns; use the PAP data too), here's what I look for, for myself:
average 95% or above - when I see 96 or 97, I don't worry much about the other numbers. When it hits 94, I need to adjust something.
time under 90% less than 1-2 minutes total (ideally; I have some nights with more and it's fine).
time under 94% less than 25% of the time, ideally less
3% drops less than 5-8 / hr (I think they correlate high compared to AHI for me).

But, for my dad when he was alive, the numbers were much different. He had CHF, COPD, and a slew of others and was on high-flow oxygen 24/7 and BiPap for all sleeping.  We didn't want to see him up in the high 90s. 88-93 was normal for him because of the effects of COPD.  All of his o2 ranges were about 5 points lower.

I recently had a segment of my night where I went low oxygen for about 20 minutes (18 min <90). When I looked in Oscar, I had apparently taken off my mask for that section. Oddly, I didn't feel like my night had been oxygen deprived....it makes me think I am reacting to the variability of oxygen as well as or more than the actual level. Have you felt "off" after these lower scores?

Hope that helps!

Lisa

Much appreciated for taking the time and responding in such detail 


Here is my OSCAR data:

DAILY SPREADSHEET

DAILY REPORTS

[MCS2014]

The change in score doesn't seem severe, and the score doesn't always correlate well with lived experience. But you do also show a change in drops and a bit of a change in time < 90%. If I had to guess the reason for the change is that either you were more stressed during the day, -or- you were more relaxed about your sleep treatment and so your body is catching up on phases of sleep that have more drops. (which I would think more likely for you given the steadiness of the data.) I've had both scenarios happen often.

It's hard to say about pressure without OSCAR data, but my guess is that it wouldn't be a bad thing to try going up to 9; that might help in the "catching up on sleep" theory. If you want to dial it in more closely, post some OSCAR graphs. You might see data that would indicate raising your min pressure, your EPR, etc.  

Looking at your reports, you have had almost no significant time under 90%, and even when the score went to 7.7, your average was 96 (that's great) so I would say it's not time to up your oxygen.  I would only adjust oxygen up after trying all other things (unless you have damaging drops, of course) because it's tough to go back to lower 02 in my experience. Ask your doctor what criteria he looks at for that. I'm guessing it's very similar to the criteria for adding oxygen in the first place...significant time under 90% is what I've read most recently but it's an art.  My intuitive sense given your graphs is that you are very well-treated on 2.5 L.

If you are going solely off 02 data (but you shouldn't if you have concerns; use the PAP data too), here's what I look for, for myself:
average 95% or above - when I see 96 or 97, I don't worry much about the other numbers. When it hits 94, I need to adjust something.
time under 90% less than 1-2 minutes total (ideally; I have some nights with more and it's fine).
time under 94% less than 25% of the time, ideally less
3% drops less than 5-8 / hr (I think they correlate high compared to AHI for me).

But, for my dad when he was alive, the numbers were much different. He had CHF, COPD, and a slew of others and was on high-flow oxygen 24/7 and BiPap for all sleeping.  We didn't want to see him up in the high 90s. 88-93 was normal for him because of the effects of COPD.  All of his o2 ranges were about 5 points lower.

I recently had a segment of my night where I went low oxygen for about 20 minutes (18 min <90). When I looked in Oscar, I had apparently taken off my mask for that section. Oddly, I didn't feel like my night had been oxygen deprived....it makes me think I am reacting to the variability of oxygen as well as or more than the actual level. Have you felt "off" after these lower scores?

Hope that helps!

Lisa

I made it easier to scroll through the Oscar reports HERE.

[TechieHippie]

Please don't quote the post when you respond, unless a snippet is needed and then only sparingly.

I don't see huge changes in Oscar either... A little increase in AHI but not excessive. Maybe try to get away from focusing on the data for a while, and optimize sleep routines and environment.