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Pulse Ox Monitoring

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Pulse Ox Monitoring

Postby shell74 » Fri Apr 29, 2011 11:26 am

My doctor, who is a pulmonary doc whom does Sleep medicine on the side has told me my pulse Ox is fine based on my ResMed compliance data and AHI average of 1.5. I have good nights and horrible nights with tons of clusters of events ranging from 20-40 seconds long for 15-30 minutes. Most of the time I rip the mask off and fall back asleep unmonitored when these are happening, hence why my average doesnt stay higher. If she would have looked at the graphs she would have seen this. She said this is OK since it stops and my all around average is low. I said how do you know that? She said as long as you arent having constant events all night your ox levels are fine. I really wanted to ask her is she was psychic,lol. If I am having 15-30 minutes at a shot in the 60's my body is being tortured. She wouldnt even acknowledge that I mentioned that some nights I am as high as a 15 AHI over 6 hours. I am pretty concerned at her answers considering I had documented drops as low as 63% at my sleep study. Is there something I am missing?

Since I am still dead tired and not doing much better, I still asked the PA for the pulse ox monitoring script based on the recommendation of the DME, even though she contested that I had no drops, just to see if this could be the reason why therapy isnt as effective as we had hoped. The DME said this would only cover 1 night, so if I had a great night I was out of luck. But the PA said it is not needed. I have asked my DME for recommendations of good sleep clinics in the area, but they are very limited and require a lengthy wait to get an appointment. This is something I will be doing though.

Previously in a post I had made some people had mentioned specific Pulse Ox monitors that they used in conjunction with their CPAP/BIPAP/etc... Well, I am now ready to make the purchase, just for my peace of mind at this point. Maybe I am just overly concerned and it is all completely unwarrented. The only way to know is to do it. I am just wondering what others use, and the pros and cons of the devices. I would love to have something I could just hook up to the computer and leave it be. Any suggestions would be appreciated.
DX-OSA 1/2011, ResMed S9 Elite with heated humidifier, Swift X and Mirage Quattro, ResScan 3.12
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Postby CrohnieToo » Fri Apr 29, 2011 11:56 am

Pulse oximeters are expensive and not covered by insurance. I have one of the least expensive FDA approved recording pulse oximeters and one of the mid-priced FDA approved recording pulse oximeters. Both do a good job. They would be the ConTec CMS-50D+ (note the Plus, the 50D w/o the + is NOT a recording oximeter) which sells around $100-$120 and the SPO 7500 which sells for around $350-$450. I've only found the SP0 75 online, whilst I bought my ConTec CMS-50D+ online I understand that WalMart sells them as well as a couple of other brands and models. Both came complete w/cable and software. But be sure to read the information wherever you buy them to make sure that both are included. I have heard that some online providers sell the SPO software separately.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Postby shell74 » Fri Apr 29, 2011 1:45 pm

CrohnieToo wrote:They would be the ConTec CMS-50D+ (note the Plus, the 50D w/o the + is NOT a recording oximeter) which sells around $100-$120 and the SPO 7500 which sells for around $350-$450. .


I think the first one was the one mentioned to me previously. I did find another one made by Contec, "Wireless Pulse Oximeter with alarm, CMS-50E, CMS50E". Looks like it may be just a step up with the ability to make it wireless and recharegable, which I would like. I found it for about $150 total.
DX-OSA 1/2011, ResMed S9 Elite with heated humidifier, Swift X and Mirage Quattro, ResScan 3.12
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Postby shell74 » Sun May 08, 2011 11:11 pm

I ended up buying the CMS-50E but didnt pay the extra $40 to get the wireless feature. I figured I needed to plug it in to the computer to charge it anyway so why not download then. It is exactly the same as the CMS-50D+ but rechargeable. The manual is not very user friendly and the program is OK, but for under $100 it works just fine. Now if I can only find the button to turn the darn alarm off when I hit 85%. My lowest % in the first 2 nights was 81% for about a minute, its not horrible by any means, but I am going down never the less. HHmmnn, doctor what did I tell yah!

For those that use this device is there a way to make it that you dont need to keep entering the time of day every night? Also, I havent figured out how to save the files, so I have just printed them. Any suggestions??

Thanks a bunch,
Michelle
DX-OSA 1/2011, ResMed S9 Elite with heated humidifier, Swift X and Mirage Quattro, ResScan 3.12
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Postby CrohnieToo » Mon May 09, 2011 6:23 am

*giggle* You mean you don't read or understand "chinglish" very well???

Unless the software has changed since I bought one of the early 50D+ the software autmatically saves the file when you exit. If you want to find the file, click on Review and then Find, a list of files should show up, each starting w/the patient's name and then a date comprised of the 4 digit year, 2 digit month and 2 digit day plus ConTec's choice of file number all as one number, i.e. John J Doe_201105081122.spoR

Be glad you CAN enter the time every night!!! This early 50D+ couldn't record the beginning and ending time at all. *sigh*
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Year Diagnosed: 2006

Postby shell74 » Mon May 09, 2011 7:59 pm

CrohnieToo wrote:*giggle* You mean you don't read or understand "chinglish" very well???

Unless the software has changed since I bought one of the early 50D+ the software autmatically saves the file when you exit. If you want to find the file, click on Review and then Find, a list of files should show up, each starting w/the patient's name and then a date comprised of the 4 digit year, 2 digit month and 2 digit day plus ConTec's choice of file number all as one number, i.e. John J Doe_201105081122.spoR

Be glad you CAN enter the time every night!!! This early 50D+ couldn't record the beginning and ending time at all. *sigh*


That Was Easy! \:D/ I guess sometimes I have no patience to figure these things out. Chinglish, yeah, I think my favorite was "Warning, the maintence man should not stare at the light".
DX-OSA 1/2011, ResMed S9 Elite with heated humidifier, Swift X and Mirage Quattro, ResScan 3.12
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Postby SleepyToo » Mon May 09, 2011 8:21 pm

CrohnieToo wrote:plus ConTec's choice of file number all as one number, i.e. John J Doe_201105081122.spoR

Isn't the 1122 the time the file was saved on the day it was saved?
SleepyToo
Philadelphia Area
Diagnosed September 2009, Respironics System One w/ C-flex and humidifier
Aloha nasal pillows
Not a medical professional, just a patient with severe OSA (31) who has done a lot of reading.
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Re: Pulse Ox Monitoring

Postby am0665 » Tue May 10, 2011 1:17 am

shell74 wrote:I have good nights and horrible nights with tons of clusters of events ranging from 20-40 seconds long for 15-30 minutes. Most of the time I rip the mask off and fall back asleep unmonitored when these are happening, hence why my average doesnt stay higher. If she would have looked at the graphs she would have seen this. She said this is OK since it stops and my all around average is low. I said how do you know that? She said as long as you arent having constant events all night your ox levels are fine. I really wanted to ask her is she was psychic,lol. If I am having 15-30 minutes at a shot in the 60's my body is being tortured. She wouldnt even acknowledge that I mentioned that some nights I am as high as a 15 AHI over 6 hours. I am pretty concerned at her answers considering I had documented drops as low as 63% at my sleep study. Is there something I am missing?

Shell, maybe I am missing something here. But having had similar symptoms, I have to ask:
what makes you believe that your bad nights and apnea clusters are an indication of low oxygen level?
Would the following be possible, as in my case:
- my O2 desats occur only when sleeping without a mask, not on CPAP
- the apnea clusters can be triggered by flow limitations, mask leakage, changing sleep state at onset, or going into REM sleep, turning from side sleeping to supine, etc. ... they're like a vicious circle, sometimes my S9 Autoset's compensation doesn't help ... and my cummulated nasal congestion wakes me up
- such clusters have been happening less and less lately
- what I have left to complain about is excessive sleep fragmentation, which nightly AHIs don't show ... but are visible to some degree in the detailed ResScan curves: flow, flow limitations, etc.
Moderate / Severe OSA (2 tests offCPAP).
CPAP ResMed S9 AutoSet EPR, Hi5 Humidifier.
ResMed Masks tried: nasal pillows Swift FX, nasal mask Mirage Activa LT, FF mask Mirage Quattro or FX.
Home CPAP data analysis: ResScan 3.16 sw, oximeter, pulsemeter
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Postby CrohnieToo » Tue May 10, 2011 6:09 pm

You may be right, SleepyToo. I never paid that much attention since it wasn't the time I went to bed and turned the ox on nor the time I got up in the morning and turned the ox off. Mine is one of the earlyl 50D+s that doesn't allow you to set the time which I understand the later models do allow for. *sigh*
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Posts: 7943
Joined: Mon Mar 20, 2006 9:18 pm
Location: Mid-Michigan
Machine: Resmed S8 VPAP Auto
Mask: Resmed Quattro FX Small
Humidifier: Resmed H3i
Year Diagnosed: 2006

Re: Pulse Ox Monitoring

Postby shell74 » Wed May 11, 2011 9:15 pm

am0665 wrote:what makes you believe that your bad nights and apnea clusters are an indication of low oxygen level?
Would the following be possible, as in my case:
- my O2 desats occur only when sleeping without a mask, not on CPAP
- the apnea clusters can be triggered by flow limitations, mask leakage, changing sleep state at onset, or going into REM sleep, turning from side sleeping to supine, etc. ... they're like a vicious circle, sometimes my S9 Autoset's compensation doesn't help ... and my cummulated nasal congestion wakes me up
- such clusters have been happening less and less lately
- what I have left to complain about is excessive sleep fragmentation, which nightly AHIs don't show ... but are visible to some degree in the detailed ResScan curves: flow, flow limitations, etc.


I am grasping at straws pretty much, I am questioning my situation just based on my history. During my sleep study (without CPAP) my "clusters" caused me to go down to 63% at the lowest. With CPAP those clusters dont happen as often of course, but when they do they are still extended and extensive. I am just trying to determine if my current clusters are still causing my level to go as low as during my study. Some nights I have only 1 major cluster, other nights I have them hourly.

From comparing my 2 sets of data, it looks like a cluster starts, my pulse goes up,no flow limitation or leak and my O2 goes down. So far even the major events dont cause me to go as low as during my study thankfully. If this sequence is consistantly happening every hour that could really be a reason I am not feeling great. I try and always take note of how I feel before I look at the data,it seems to be pretty consistant, the more clusters the worse I feel. This is only my experience for myself.
DX-OSA 1/2011, ResMed S9 Elite with heated humidifier, Swift X and Mirage Quattro, ResScan 3.12
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