Therapy Questions, EPR, CA, Low O2

[Sleeprider]

My last post is far too sarcastic. I meant to say there may be a better way to solve the problem, and the lab really let you down.

[kingskid]

Sleeprider
My last post is far too sarcastic.  I meant to say there may be a better way to solve the problem, and the lab really let you down.

Thanks for your honest input.   Considering all things, i’m a bit surprised that I feel great with lots of energy regardless of what cpap settings I use.  A tech from the sleep center said something about I must have accommodated and just gotten used to low O2, possibly based on the questionnaire I filled out before the test.  Be that as it may, my heart and brain may be affected in time with persistent low O2.  My dr’s RMA did say that I would be getting an overnight oximetry test at some point to see how the 2L O2 is working.

[Sleeprider]

I think the O2 supplement is great, and many people benefit from it. This is a good solution if it makes you comfortable and feel better. I think I must have missed something. Was there a previous study?

[Gideon]

Question, since you are from the Colorado Rockies, what is your home altitude and what was the altitude of the sleep study?

You had no REM in the diagnostic portion of this split study.

My take is they saw significant desats all night and chose to put you on supplemental oxygen as soon as they could.

I too would like to see what higher pressures do for you but the important thing is that you will be treated from this point forward.

Because of the low level of your oxygen desats if it were me I would purchase an oximeter that is compatible with OSCAR and use it periodically to verify the lack of desats. I would do this with or without CPAP just to make sure you are having no issue.

Once you have your machine and the oximeter, we can see what happens over time in your normal environment.

You are going to a place where all this can be both monitored and managed.

[Sleeprider]

After a night of sleep and clearing my head on this, I was just taken back by the fact this was not a CPAP or BPAP titration, but an oxygen titration. From that perspective, it was very effective in finding an effective solution to keep your oxygen levels at a satisfactory level at low pressure. Given that, adding an oximeter to your monitoring would be inexpensive and will ensure long-term effectiveness.

[kingskid]

I think the O2 supplement is great, and many people benefit from it.  This is a good solution if it makes you comfortable and feel better.   I think I must have missed something. Was there a previous study?

Yes, one done 4 years ago.  I can edit the personal info out and post those.  With that history, it might give a bigger picture of what is going on.

[kingskid]

Question, since you are from the Colorado Rockies, what is your home altitude and what was the altitude of the sleep study?

You had no REM in the diagnostic portion of this split study.

My take is they saw significant desats all night and chose to put you on supplemental oxygen as soon as they could.

I too would like to see what higher pressures  do for you but the important thing is that you will be treated from this point forward.

Because of the low level of your oxygen desats if it were me I would purchase an oximeter that is compatible with OSCAR and use it periodically to verify the lack of desats.  I would do this with or without CPAP just to make sure you are having no issue.

Once you have your machine and the oximeter, we can see what happens over time in your normal environment.

You are going to a place where all this can be both monitored and managed.

My test was done at 8500’ and that is my general home altitude.  The sleep lab in my dr’s network is about 2000’ lower, so I insisted on the one at higher altitude and that is where both my sleep tests were done.   Bonjour, I did try the setting of 8 min/12 max with EPR 3 and posted charts on my “EPR question” post.  I thought this post should be separate with a different topic.  The higher settings made me really uncomfortable and it felt like I was being too pumped up.  Also those higher settings increased my AHI and reras and centrals, I believe.  BTW, I am looking at the CMS 50F, which seems to be the one recommended.  Not sure if it is compatible with OSCARS or Mac computer though.  Also will see what Medicare may cover for oximeters, if any.  I did have REM in my first sleep study and will try to post that report later today.  Thanks for all your help!

[Gideon]

As a general rule, anything dealing with YOUR therapy should be in the same thread. That will maintain history. If you wish a Moderator can merge threads, or even partial threads and can even change the thread title, all you need do is ask.

Can you post some current OSCAR data please.

[kingskid]

After a night of sleep and clearing my head on this, I was just taken back by the fact this was not a CPAP or BPAP titration, but an oxygen titration.  From that perspective, it was very effective in finding an effective solution to keep your oxygen levels at a satisfactory level at low pressure.  Given that, adding an oximeter to your monitoring would be inexpensive and will ensure long-term effectiveness.

Hi Sleeprider.  I believe this was a second test for the sleep apnea, although I made my dr well aware of my O2 concerns.  Also made it known to the sleep tech, but he went by the orders.  An overnight oximetry test will be done at some point, I was told.  I made an app’t with the sleep dr in my dr’s network to go over my concerns.  It’s for Oct 10.  I will ask about how to resolve the flow limitations and Bilevel therapy.  But with fixed level of 6 and now an EPR of 2, aren’t I getting BiLevel therapy? It’s lower level, but lower settings are more tolerable.  All this is a bit confusing to me.  The doctor who wrote my sleep report did recommend further testing, most of what I have already had just recently, like the pulmonary test.  Was normal.  Am looking at the CMS 50F but want to see also what Medicare might have.  BTW, as I mentioned to Bonjour, my 8 min/12 max/EPR 3 charts are shown in my “EPR question” post.  Thanks for all your help!

[Sleeprider]

I don't know that the flow limitations are much of a concern at this point. With low pressure, you are comfortable and the oxygen supplement solves the discomfort that might arise from the flow limits and altitude. A pressure of 6/4 with EPR 2 is bilevel to a limited extent, and as long as you're comfortable, and the oxygen supplement provides refreshing sleep, there isn't really any need to be overly concerned with the flow limits that left you feeling you weren't getting enough air.

If you don't mind, I think combining this with your other thread might be a good idea, as it will help future users that have similar problems. Again, I apologize if I missed the concern about oxygen levels in that earlier thread.