Why would supplemental Oxygen be added to CPAP?

[kc90]

Good afternoon all -

I have been on ASV for a bit over 2 years, saw a new doctor this week locally to start getting my supplies and he asked if I was ever still tired and I said yes I still sometimes need daytime naps. He decided to do an overnight oximetry test, and while I don't know the results directly yet (DME office just called but doctor's office is closed now) I was told I was at the levels of approval for supplemental oxygen.

I had a complete echocardiogram 23 months ago before going on the machine so I don't think it is a heart issue, and I haven't smoked for the better part of a decade and do a lot of cardio so emphysema/copd don't really line up either.

Is this just something that happens to some folks? Where even when the AHI is 0 the oxygen levels still continue to dip? I would appreciate any insight as this is all new to me and I have to play the waiting game until hearing from my doc again. Cheers.

[Gideon]

Get the results and post them, and post your OSCAR charts. If this is true you should get your own recording pulse oximeter to monitor your results.

Medicare says if you have over 5 cumulative minutes at or lower than 88% you may qualify for overnight

To cover the may part your doc asked you those questions.

Provide the data and we will be better able to comment.

And yes, there are cases where the use of a pap device is not enough to manage your desats

[kc90]

Get the results and post them, and post your OSCAR charts.  If this is true you should get your own recording pulse oximeter to monitor your results.

Medicare says if you have over 5 cumulative minutes at or lower than 88% you may qualify for overnight

To cover the may part your doc asked you those questions.

Provide the data and we will be better able to comment.

And yes, there are cases where the use of a pap device is not enough to manage your desats

Thank you for the reply Gideon, while I will not have access to the overnight oximetry results until early next week (when they are uploaded to the provider portal) I can pull the data from my SD card into OSCAR now for the night of the test. Is there anything specific I am looking for in the data?

[SarcasticDave94]

If you don't have one yet, you'll want to consider a recording oximeter to self monitor the oxygen level. Some will import the data to OSCAR and compile them with the CPAP chart.

I'm fatigued constantly, possibly due to my Emphysema COPD and currently untreated central apnea, that's not yet bad enough on record for supplemental oxygen. Not indicating that's why you have probable need to get oxygen.

It's easy enough to add oxygen onto your ASV via a heated hose with oxygen bib.

[Gideon]

I could write multiple pages on what to look for. Best to post the charts, otherwise go thru the wiki, starting with OSCAR-The Guide.

I among other things id be looking for other non-apneic issues.

So how is your health, other than the apnea?
Any TBI, strokes, neuromuscular issues, pain killers, antidepressants etc?

[kc90]

Gideon pid='497263' dateline='1703903299']I could write multiple pages on what to look for.  Best to post the charts, otherwise go thru the wiki, starting with OSCAR-The Guide.

I among other things id be looking for other non-apneic issues.

So how is your health, other than the apnea?
Any TBI, strokes, neuromuscular issues, pain killers, antidepressants etc?

Good health other than apnea, in the obese category of BMI, but no cardiovascular or pulmonary problems, normal blood pressure, resting heart rate.

I do use antidepressants/anxiety meds

former opiate misuse for close to a decade, may have to do with my central apneas?

but nothing serious healthwise. I am attaching my charts from the night of the Oximetry test here as well. Thanks again for your response

[Sleeprider]

Charts all look good and nothing obvious on why you are experiencing desaturation. Your Minute vent and other respiratory statistics are fairly constant (normal) and good tidal volume, respiration rate is present through the night. I'm going to suggest you read the wiki on Oxygen Bleed with CPAP so you understand a bit more that an oxygen bleed attempts to maintain a higher fraction of inspired oxygen (FiO2) in order to increase SpO2 in individuals that experience low oxygen levels. https://www.apneaboard.com/wiki/index.ph..._with_CPAP

In your case, no obvious pulmonary impairment is evident from your ASV statistics that should prevent normal saturation. When we see good respiratory results with low SpO2, a V/Q (Ventilation/Perfusion) mismatch or high altitude may be things to look into, but that would be in the wheelhouse of a pulmonary specialist, not me.

[robbob2112]

These are my numbers from night before last.  Look at the event around midnight - 

The SpO2 and pulse rate are from a viatom o2ring.

This is with 2L/min supplemental oxygen.  Without the added Oxygen my SpO2 plumets to the 70s and stays there.   My AHi and other charts look more or less normal without O2 added, but I feel like death warmed over without it.


Lucky you are on a aircurve 10, you can get a climatelineOxy hose to hook up the Oxygen tube to verse having to run the O2 line all the way up to the mask.

[Sleeprider]

If we have not said so already, the cluster of events at midnight and 01:45 are positional. A median minute vent of 4.75 is poor, and based on settings, I would suggest at least 3.0 cm PS min for you to increase the vent rates. You need PS min to maintain tidal volume and reduce variability in your results. I don't know how you ended up with a zero PS min, but change it! This will require a change in PS max to 8.0. This will solve most of the problems, other than positional. If you have problems with aerophagia or higher pressures, take out some of the EPAP max, but I think EPAP 6-8 and PS 3-8 is your secret sauce.

[kc90]

Charts all look good and nothing obvious on why you are experiencing desaturation. Your Minute vent and other respiratory statistics are fairly constant (normal) and good tidal volume, respiration rate is present through the night.  I'm going to suggest you read the wiki on Oxygen Bleed with CPAP so you understand a bit more that an oxygen bleed attempts to maintain a higher fraction of inspired oxygen (FiO2) in order to increase SpO2 in individuals that experience low oxygen levels. https://www.apneaboard.com/wiki/index.ph..._with_CPAP

In your case, no obvious pulmonary impairment is evident from your ASV statistics that should prevent normal saturation. When we see good respiratory results with low SpO2, a V/Q (Ventilation/Perfusion) mismatch or high altitude may be things to look into, but that would be in the wheelhouse of a pulmonary specialist, not me.

Thanks for taking the time to look into my chart! I read the wiki on oxygen and it still seems overwhelming but I decided to share the OSCAR charts with my pulmonologist hopefully he knows OSCAR ha. I live in Missouri so no altitude issues here but just find it really curious you can still have low SpO2 with 0 AHI I had never heard of that! Again I appreaciate your response

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These are my numbers from night before last.  Look at the event around midnight - 

The SpO2 and pulse rate are from a viatom o2ring.

This is with 2L/min supplemental oxygen.  Without the added Oxygen my SpO2 plumets to the 70s and stays there.   My AHi and other charts look more or less normal without O2 added, but I feel like death warmed over without it.


Lucky you are on a aircurve 10, you can get a climatelineOxy hose to hook up the Oxygen tube to verse having to run the O2 line all the way up to the mask.

Thanks a lot for sharing robbob very interesting we are on the same machine and basically having the same situation. What prompted you to look into your SpO2 if I may ask while having low AHI? This is my first machine and I'm only 2 years in but had no idea you could still be having oxygen issues if your AHI was being properly treated.

Also that climateline Oxy hose sounds nice, hopefully my DME has that as I just use the heated tubing right now. Is the oxygen concentrator loud? Portable? I don't know too much outside of what little I've read over the last 24 hours.

Cheers