[CPAP] Need help with low pulse ox data/CPAP data

[Dan E]

Hi, I started with my CPAP machine months ago for severe OA  and really have not noticed much  Improvement so in January I purchased a pulse ox device to record my overnight data.I am concerned about the very low numbers that occur during the night five or six times a night. sometimes the pulse data gets down into the 50s and 60s and a few nights even in the 40s. 

I do not know if I should be concerned about this When I look at videos of people pulse ox data it seems like no one has these downward spikes like I do so that concerned me 

I attached my most recent data and this data is Not Unusual is very typical for what I am experiencing with my CPAP and pulse ox meter. My CPAP numbers seem to imply I'm doing great but my oxygen numbers look kinda bad??.

Thank you for any help in interpreting this data.


note: in this data I got up for the restroom and stayed up for 45 mins but the data is still very typical

[TechieHippie]

I'm sorry for the bad news but unless you have COPD that's a huge issue and most likely damaging your body quickly. If your pulse ox is accurate, you qualify for nocturnal oxygen ASAP from what I see. An average of 88% seems very low (under 93% can be a sign of congestive heart failure) and those drops might be enough to cause a heart attack. Drops under 80% can cause brain disfunction. If you have COPD the ranges are different so talk with your doctor.

This is probably low enough that your oxygen will be swinging during the day as well. You might want to monitor that some too, but I'd talk with your doctor on Monday. Let's see what others think...maybe I'm just oxygen-privileged

I'm not an expert but it looks like your CPAP graph/numbers may be misleading and there may be a good bit more tuning you should do. You could use a collar or tuck something under your chin and only sleep on your side in the meantime and see if it helps - my oxygen plummets on my back and even on my stomach. Spend some time relaxing in bed and see what it does. One of the experienced folks here probably will say increase your pressures since it maxxed out quite a bit, and use EPR, but I'll leave the details to others.

Also in the meantime, consider setting any alarms the pulseox comes with to 84% and see if you can tolerate it waking you up. If you sleep through, you'll have to set it higher, and ideally the alarm should be 86-88 but that will disrupt your sleep a lot more. Every time you feel it buzz, don't panic, just breathe fully and evenly, change position and go back to sleep.

Be careful getting up at night also with those oxygen levels. You may want to sit on the side of the bed for a bit before standing.

[Dan E]

Thank you techiehippie I really appreciate you taking the time to look at my post. I have an appointment with a PCP Tuesday and I will bring this up with him. and I also have an appointment with a pulmonologist on the 14th. thank you for your interpretation I knew there was something else going on and no I do not have COPD as far as I know. thanks again you're very kind for helping me with this.

[TechieHippie]

No problem. I get help from others, it goes around. Good luck with your appointment. Bring in multiple nights of supporting data in case he doesn't trust the monitor.  Bring the device in too in case he wants to compare it. (You should compare it yourself to a standard clip-on if you have one - watch it for about 10 minutes). It'll always be 1-3 points different, maybe more in the first few seconds, that is normal, each device has a different algorithm.  If the doc doesn't want to treat without more tests, ask him how he would feel about a trial of nocturnal oxygen in the meantime and how to titrate.

You could also pick up a couple of (unflavored) Boost 02 cartridges if treatment will take a while. I've never used them but see them in supermarkets. Have a breathe or two before you go to bed and anytime you wake at night.

You might also try improving the air in your bedroom; it's low chance of helping immediately but won't hurt. Run an air filter, clean bedding, no air fresheners, etc.  You also could try stopping media two hours before and meditating/chilling before bed.  (I love Resist Nothing disk 2 from Sounds True, no affiliation!) My autonomic nervous system seems to play a surprisingly big part in sleep and oxygen - core muscle tension effects breathing a lot.

Now I have to take my own advice! 

[Dan E]

Wow, techiehippie you're a genius. I did what you said exactly: I set the alarm on my pulse ox monitor and wore a neck collar. My results were so good my spikes were so much shorter and narrower so not only did I reduce my amounts of hypoxia but did it for less time. I will continue to raise the alarm forSpO2 Level up everyday and hopefully my body will just get used to breathing right. **** another note I usually have high blood pressure in the mornings in reaction to the hypoxia I believe and and today it's down to normal range.
Again I really do appreciate your kindness and helping me.

[TechieHippie]

That's an improvement for sure. You are very welcome!

I would still bring the reports into your doctor and see if he'd like to do a trial of oxygen therapy. The reason I say this is that I managed my apnea for over a year with the oxygen monitor only, and got it pretty good most of the time, but it's not really treating it to wake yourself up. You need that REM sleep! So you're borrowing Peter to pay Paul, even though it's the lesser of two evils to disrupt your sleep rather than having so many oxygen drops.

I think we also should analyze your Oscar data and increase your pressures. I was hoping someone else would help with this, but I can take a stab at it and they can correct me. I don't think it'll hurt.

I think your pressures are way too low. Your pressure is topping out at 12 and staying there. You could increase the max by a couple of points. I think you could raise your min slowly, too, or add EPR (every time you add one unit of EPR, you have to add one point to your min, just to keep it the same.) Have you tried EPR? I'm thinking increase max to 15, min to 7-9 (You are spending 95% of your time overnight anyway) and add 1-2 EPR if you've never tried it. Keep working on positioning and your 02 levels.

you should to turn off the ramp even though it's short unless it's too uncomfortable.