I am still anxiously awaiting my new xPAP setup. I just talked to the DME who indicated I will be starting out with a ResMed S8 Auto vantage with a humidifier. I will also be using an oxygen concentrator. Since I am new to xPAP I would appreciate any comments about this setup. I do not have a copy of my sleep study yet but I will get one when I meet with the DME tomorrow. Apparently my O2 levels were dropping considerably during my sleep test. I suspect I have both kinds of apnea going on but cannot confirm without a copy of my sleep study.

Mills wrote:I am still anxiously awaiting my new xPAP setup. I just talked to the DME who indicated I will be starting out with a ResMed S8 Auto vantage with a humidifier. I will also be using an oxygen concentrator. Since I am new to xPAP I would appreciate any comments about this setup. I do not have a copy of my sleep study yet but I will get one when I meet with the DME tomorrow. Apparently my O2 levels were dropping considerably during my sleep test. I suspect I have both kinds of apnea going on but cannot confirm without a copy of my sleep study.

Mills,

First off, do you have any other respiratory/cardiac conditions ?

What type of doctor are you attending ? Sleep/respiratory/GP ?

What type of apnoea etc do you have ?

Get a copy of the sleep study report first, also the titration study report. It is quite unusual to have additional oxygen to start with CPAP. Usually CPAP is tried first, and if unsuccessful in sorting out the drop in O2 sats, then oxygen is looked at. Those using supplemental oxygen are very much in the minority, so there would need to be a reason to introduce it immediately.

Please post back.

Daniel.

Jean & Daniel, Thanks for responding. It is good to know we are not alone in all of this strangeness. I got the machine home yesterday and I must say it is quite impressive. I decided to give it a chance in the bedroom last night and did not find it too noisy. We will see if that stays after I get more accustomed to all the paraphernalia. My wife said it wasn’t bad either (whew). I think I did pretty well for the first night. I only woke up twice due to coughing (probably un-related to the new machine)

Daniel,

I now have a copy of what looks like a summary of my sleep study. I will work to get the full deal from my doc, but this will do for now. Here is the Technical summary:

The patients total study time was 7.3 hours and total sleep time was 6.1 hours. Sleep efficiency was decreased to 84%. The patient’s lowest o2 saturation was 79% which appeared to be due to obstructive sleep apnea. During the course of the study, the patient had sleep onset in 3 minutes which is short and consistent with excessive daytime sleeppiness. His REM latency was 266 minutes which is somewhat prolonged and may be a result of the patient's sleep apnea and sleep disordered breathing. Sleep stages consisted of 31% slow wave sleep and 14% REM sleep.

The patient's apnea-hypopnea index was 45 events per hour. Associated with these apncic events, he had multiple significant o2 desaturations down into the low 80s and occasionally into the high 70s.

Periodic limb movements were common and occurred at the rate of 225 per hour. These however, were not unusually associated with arousals. The apneas, however, caused approximately 16 arousals per hour.

<< End Technical Interpretation>>

I'm still not sure what it all means but it is pretty clear that my o2 was lower than it should be, even with the CPAP. (It was a split study night). I suspect it has some to do with the altitude here we are above 4000 ft.

As far as I know I do not have any other cardiac or respritory issues.

hhopper wrote:My O² sat went as low as 65% and I don't need O² on my cpap.

It is when the O2 levels are below 92% with CPAP that O2 is added. Almost everyone with SA has low O2 levels before CPAP, then they go to normal levels once treatment begins.

Off Topic: I wish I knew how to forward some fantastic cat pics to you HH. I think you would enjoy them immensely. If you would like them PM me with your email.

Mills wrote:Jean & Daniel, Thanks for responding. It is good to know we are not alone in all of this strangeness. I got the machine home yesterday and I must say it is quite impressive. I decided to give it a chance in the bedroom last night and did not find it too noisy. We will see if that stays after I get more accustomed to all the paraphernalia. My wife said it wasn’t bad either (whew). I think I did pretty well for the first night. I only woke up twice due to coughing (probably un-related to the new machine)

Daniel,

I now have a copy of what looks like a summary of my sleep study. I will work to get the full deal from my doc, but this will do for now. Here is the Technical summary:

The patients total study time was 7.3 hours and total sleep time was 6.1 hours. Sleep efficiency was decreased to 84%. The patient’s lowest o2 saturation was 79% which appeared to be due to obstructive sleep apnea. During the course of the study, the patient had sleep onset in 3 minutes which is short and consistent with excessive daytime sleeppiness. His REM latency was 266 minutes which is somewhat prolonged and may be a result of the patient's sleep apnea and sleep disordered breathing. Sleep stages consisted of 31% slow wave sleep and 14% REM sleep.

The patient's apnea-hypopnea index was 45 events per hour. Associated with these apncic events, he had multiple significant o2 desaturations down into the low 80s and occasionally into the high 70s.

Periodic limb movements were common and occurred at the rate of 225 per hour. These however, were not unusually associated with arousals. The apneas, however, caused approximately 16 arousals per hour.

<< End Technical Interpretation>>

I'm still not sure what it all means but it is pretty clear that my o2 was lower than it should be, even with the CPAP. (It was a split study night). I suspect it has some to do with the altitude here we are above 4000 ft.

As far as I know I do not have any other cardiac or respritory issues.

Well, you fell asleep fairly quickly and your O2 sats dropped as low as 79%............some here have dipped below 50%. Normally in a hospital environment, O2 sats dropping to 95% cause concern, below 90% requires intervention. Your full study report will give you the number of times your sats dropped and the length of time involved.

Your sleep architecture should be broken down a little better, but it looks like you spent 55% of your sleep in stages 1 & 2, with 31% in stages 3 & 4......Non REM sleep. Stages 3 & 4 are where you get restful sleep..........also known as slow wave and 14% in REM sleep.

You have an AHI of 45.............severe apnoea. You had a lot of limb movement...........better coverage in the report.

Without getting full details............I think (IMHO) the introduction of O2 at this stage is a little premature and a period with cpap alone might allow it and your body deal with the low sats.

Personally, my own O2 sats dropped to the late 60's (68/69) and have been well catered for with cpap alone (over the last 13 years). My most recent study (July 06) showed my O2 sats at a fairly constant 99/100%.

Best of luck.

Daniel.

JeanInMontana wrote:

hhopper wrote:My O² sat went as low as 65% and I don't need O² on my cpap.

It is when the O2 levels are below 92% with CPAP that O2 is added. Almost everyone with SA has low O2 levels before CPAP, then they go to normal levels once treatment begins.

Off Topic: I wish I knew how to forward some fantastic cat pics to you HH. I think you would enjoy them immensely. If you would like them PM me with your email.

my oxygen 86% with events on cpap.

I have COPD so I suspected that I might need overnight oxygen. My sleep pulmo was of the opinion that xPAP would take care of the desats. According to my titration studies I only needed 6 cms of pressure. After a couple of months on xPAP at 6 cms I requested an overnight oximetry whilst on xPAP but an Auto loaner was ordered instead. We tried a 2 1/2 week loan of an AutoPap (which my DME quite effectively sabataged) and my sleep pulmo then upped my pressure to 8 cms. Some improvement but not much. I finally kicked loose and bought my own recording oximeter, recorded multiple nights w/my xPAP set at 8 and gave my sleep pulmo the printouts. I was just started on 2L of 02 w/my xPAP and lo and behold the change in my overnight sats have been dramatic. So far each night my SA "and" my 02 sats are GREAT!!! (In all fairness its "only" been 5 nights but w/such dramatic difference ..... )

its funny my dr didn't say anything about my low oxygen % but did say i had a lot of leg movement.

Its not just how low your sats go but how often and how much time is spent below 88%.

I'm going to ask my doctor to prescribe another sleep test. I started CPAP 18 months ago and felt better the first year but the last six months or more I"ve been sliding downhill, to the point now where I feel worse than I ever did before CPAP. Either I have something else going on or CPAP alone is not handling the 02 levels. I use an APAP and have the software which shows that I am always in the 6-9cm range during the night but 2 nights ago I switched it to straight CPAP with no CFLEX and set it at 9, which was my titrated pressure. Still no improvement and I'm suspecting that I'm not getting enough oxygen. The daily fatigue I have is enormous, I feel like I got only 2-3 hours of sleep every night for the last 2 months and it's at the point where I struggle to get through the day, and that's with taking 400mg of Provigal every day.