[Treatment] What should a normal heart rate graph look like during sleep?

[vHungry]

Hello,

I have been recording PulseOx data along with my usual OSCAR data and have many pulse spikes throughout the night (25-30+ times per night). 

After extensive experimenting with pressure and EPR, I have concluded that I am unable to tolerate higher pressure (discomfort/a lot of aerophagia), and will be seeking a BiLevel prescription from my doctor.

Does anyone have some PulseOx data/graph that shows what a HR/O2 graph SHOULD look like over the course of a night? I would like to know what I should aim for my PulseOx data to look like.

Thanks in advance.

[Jay51]

I don't have an exact graph, but I can describe what normal should look like.  

1st - SPO2 - As long as you stay above say, 90 or better yet 92 all night (your lowest spikes don't go below this, then you are probably ok).  When you start spiking downward towards 90 (or below it), that is a cause for concern (and probably adjustments to your therapy).  A normal person's average SPO2 for the entire night should be around 95 or 96 (or possibly even a bit higher than that). 

2nd - HR - Narcil just posted a chart recently that showed concern should definitely begin if HR gets above 100 or below 40.  Average HR is around 60 to 70 or so.  Some variation in HR during sleep is normal.  Large spikes are usually not normal though.  A smooth relatively straight line of HR data is better than one with spikes upward or downward.  

The best thing to do would be to post your SPO2 and HR data along with your OSCAR data once you get your new machine for us to look at and give more suggestions.

[BigWing]

Here's a sample full night from my AirSense 10 APAP and Wellue SleepU oximeter.

[Jay51]

Your SPO2 in this OSCAR charts looks ok IMO. It doesn't drop too low.   Also, your HR looks ok also.  Nice and largely smooth channel.  Not many spike, but a few large spikes.  

I am glad that you included your movement chart here also.  Lots of movement during the night.  Several large spikes.  Could be PLM's or arousals or something?  I am not sure.  How rested did you feel when you got up in the morning?  Your large spikes in HR line up with your large movement spikes.

[BigWing]

Lots of movement during the night.

Indeed - and I was very surprised at that. I actually added SomnoPose to my arsenal a few days later, and that clearly shows me rotating slightly at each "arousal with waking".

Several large spikes.  Could be PLM's or arousals or something?

My PSG showed I don't suffer from PLMs. These are all arousals - some with waking but most without.

How rested did you feel when you got up in the morning?

Well rested. I felt I had a pretty good night, though I had 9 awakenings.

Your large spikes in HR line up with your large movement spikes.

Yes, though actually the HR spikes are generally about 10-20s after the arousal (as seen in the detailed flow waveform) and subsequent movement.

[Jay51]

Everything else on the chart you posted looks good IMO also.  0.03 95% flow limitations (good).  Good minute ventilation and tidal volume and respiratory rate, etc.  I think you are pretty much optimized on your current machine as far as getting therapy with your current settings also.

[BigWing]

....that clearly shows me rotating slightly at each "arousal with waking".

Damn - what I actually meant was each "arousal withOUT waking" makes me subconsciously turn a little. 

[Jay51]

If you want to, try to do a 3 minute zoom on maybe 2 or 3 places in your OSCAR chart where your movement chart spikes straight up.  Maybe start 30 seconds directly before it and have it about 3 minutes long.  Just click with the cursor on your OSCAR where you want to start this zoom close up and drag the cursor to the right for a 3 minute section, and then upload it here.  It might give some clues as to what is happening.  Kind of like looking at it through a microscope. 

Maybe around 2:30am; 3:45am (just slightly after this); and then 5:07am or 5:08am or so.