"please keep me updated about oximeters "
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Does anyone know how to read oximeter "wave forms"?
I bought an oximeter that records overnight, and have been using it almost nightly. I use CPAP. I realize oxygen and pulse are just part of the information we need.
So I'd like to know ---and not just guess -- how to best read the results, especially the "wave forms" -what's the importance of those, if your oxgen and pulse levels are normal?
I've looked online to no avail to find normal graphs comparee abnormal overnight oximeter graphs. That way I could get a better idea what my graphs represent. .
Oh I found dozens of scholarly articles, nursing artlicles, sophisticated information, which are over my head, and almost never even show a graph from overnight oximeter reading. Maybe I need to get a text book for respiratory therapists, maybe that would have some clear examples .
The results of my oximeter recordings are good -- as far as I can tell. My oxygen is 95% or so on average most nights, with nothing lower than 90, and that only very briefly, My heart rate is constant and in lower 60's.
Oddly, I slept part of one night without CPAP -- my graph for that period was as good as any WITH the CPAP. What does THAT indicate? I have a lot to learn.
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Replies to This Discussion
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Permalink Reply by Banyon on
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"My heart rate is constant and in lower 60's."
Was it like this the night you did not use CPAP?
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Permalink Reply by Mark Douglas on
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I only tested PART of the night -- from 4 30 am on -- without CPAP. Three hours. But my oxygen was 95 ish and my HR was low 60's.
I was kinda surprised it was APPARENTLY as good as when I used CPAP. I see "saw tooth" patterns in that graph, but Ive seen those when I had CPAP on too.
So I'd like to know the significance of the saw tooth things -- and learn more generally about interpreting graphs of oximeter overnight home "studies". I will try to attach the graph here to show, just for grins.
Banyon said:"My heart rate is constant and in lower 60's."
Was it like this the night you did not use CPAP? - Attachments:
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Permalink Reply by Judy on
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I'm not good at reading the wave forms themselves - but - those black slashes above the Sp02 wave forms are "events". They didn't drop your 02 saturation below 88%, of course, BUT there was a reduction in breathing by 75% of the baseline breathing for at least 10 seconds (apnea) or a reduction in breathing by 50% of the baseline for 10 seconds or more (hypopnea). At least that is MY understanding. And the black slashes under the pulse line also mark "events" but I don't have a definition for them at my fingertips.
HOPEFULLY our pros will jump in and clarify my mistakes or misinformation. I'm just a patient, no medical background.
If I knew how to remove my name I'd post one from my ConTec CMS-50D+ on a night when I didn't use my VPAP Auto but did use just 2L of 02 (I have COPD). Its NOT a pretty sight. My Index is only 6.9 - BUT - my Sp02 was BELOW 90% for 78.9% of the time!
And another using my VPAP Auto at too low IPAP and EPAP settings to effectively treat my OSA - BUT - WITH 2L of 02 supplementation. I have NO Sp02 events and very few pulse rate events - BUT - an AHI of 24.6.
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jnk to the rescue - yet again!!! Thanks, jnk. (((hugs))) Actually, the first (top) link you posted, the spo2-data2 shows what I was trying to explain - the black slashes - except in this view the slashes are below the Spo2 line and the Pulse line whereas in Mark's view they were on top of the Sp02 and the Pulse.
jnk's second (bottom) link shows the squiggly line graphs stretched out to 10 second intervals so we can better see and get some grasp of our breathing and pulse.
And that second link shows just how good you are at translating the translated ConTec software manual!!! I haven't gotten that far w/it yet. As you know that is what I like about ResScan - being able to stretch the graphs out to 10 second intervals. I'm gonna have to talk you about how to do that!!! I knew it had the capability, I just hadn't been able to figure out what the manual translation was trying to say.
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Permalink Reply by SleepMBA on
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The graph you posted looks like a typical untreated apnea patient coming through our lab. A normal or treated OSA patient will have a much straighter line throughout the night. The one you posted has frequent fluctuations. At a certain point, it has more extreme fluctuations. At that point you are probably having more events (apneas & hypopneas). I'm just guessing here, but you were probably in REM, where OSA is usually more severe. If you compare that graph to one where you are using your CPAP, you will notice a difference.
Now that I mention it, please do post a graph of what it looks like when you are using CPAP.
I just looked at JNK's oximeter reading. It looks fairly straight (under the influence of xPAP if I'm correct). There are some periods where it fluctuates. By the timing and duration, I'd say it's REM. It's ok to have some periods like that, it really depends on the person. Many people have a straighter oximetry graph when using xPAP. It depends on many things (body habitus, underlying conditions, etc) For JNK, if he feels rested and refreshed, no worries. If it was somebody that was undiagnosed, had the same oximetry, and felt tired, they would probably need a sleep study.
Let's see those Oximetry Graphs!
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Hey SleepMBA and anyone else,
I would appreciate your comments on a recent nightly pulse-ox study with CPAP.
http://www.sleepguide.com/photo/07052010-1?context=latest
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Banyon said:Hey SleepMBA and anyone else,
I would appreciate your comments on a recent nightly pulse-ox study with CPAP.
http://www.sleepguide.com/photo/07052010-1?context=latest
In my professional opinion, you got up at 2:30 for a bathroom break. Sorry, industry humor.
All joking aside. It is difficult to come up with specific things about oximetry graphs because fluctuations can be caused by many things. With that in mind, I can shoot from the hip here. The SpO2 (Oxygen Level) graph looks to fluctuate often. The graphs I see when somebody is titrated or getting titrated are usually "flatter" than that. It's okay if it gradually fluctuates, but this one seems to do it abrubtly and often.
Looking at the graph of the heartrate, notice the "mountain peaks" at 22:50, 00:50, 3:45, and 5:15 roughly. At those points your heart rate is increasing trying to compensate or keep up with something. From what I have seen in the lab, this is usually from respiratory distress like apneas and hypopneas. For the person that this recording is from, I can't be certain without a PSG hookup on them.
For my bottom line/ educated guess, I would say there is a mask leak, mouth leak, or a pressure change is needed (probably increase).
To know for sure, see your Sleep Doc and get another sleep study.
Have a look at JNK's oximeter and heartrate graphs, the last two on his post. Those are picture perfect. Notice how the heartrate graph is fairly flat. Thanks for putting those up, JNK.
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Permalink Reply by RockRpsgt on
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I disagree MBA jnk has issues. I see it in his charts, graphs, and post :)
j n k said:Thanks, SleepMBA!
To put the other chart into perspective, here is the O2 info from my NPSG two years ago:
Note the 39 minutes below 85%, with a low of 71%. Which, in my opinion, makes this one look pretty durn good by comparison. (On autobilevel, 10cm minimum EPAP and a 4cm fixed delta):
SleepMBA said:. . . I just looked at JNK's oximeter reading. It looks fairly straight (under the influence of xPAP if I'm correct). There are some periods where it fluctuates. By the timing and duration, I'd say it's REM. It's ok to have some periods like that, it really depends on the person. Many people have a straighter oximetry graph when using xPAP. It depends on many things (body habitus, underlying conditions, etc) For JNK, if he feels rested and refreshed, no worries. If it was somebody that was undiagnosed, had the same oximetry, and felt tired, they would probably need a sleep study.
Let's see those Oximetry Graphs!
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Rock Hinkle is feeling his oats and in good spirits! He's pulling legs again! When do you hit the road, Rock? Are you still gonna have time for us?
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I see where you're coming from Rock. Thanks for chiming in. But I didn't say he was perfect. When you compare the before and after, he is doing much better. I've done titrations where I've been able to "clean" people up better than that and I've done titrations where that is as good as it gets. We actually need more details about JNK's medical history and some data from his S9 (I think that's what he has) to say if it could be better.
JNK, please don't feel obligated to give any details. If you want to, great. If not, we'll respect your privacy.
Have a good weekend all!
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Permalink Reply by Rooster on
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jnk said: Below, attached, as a PDF
"The technician reports that the patient was calm and cooperative."
jnk, I think you attached the file of someone else by mistake.
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Thanks -- let me ask you this, cause Im not clear on it. You may have answered it, but Im not clear on it.
If your oxygen is 92 or better pretty much all the time, and the average is like 94, do you need to worry about the saw tooth pattern of an overnnight oximeter? I mean if the oxygen is good -- aren't you doing well? Isnt that the most important aspect? I hear of people in 80's and even 70's, for oxygen. I thought Im doing pretty good in mid 90's
In your opinion do you need to go in for further sleep studies to get "tritrated" if your oxygen seems pretty good, other than the saw tooth pattern at times?
j n k said:SleepMBA,
Ask away if you have any questions.
Below, attached, as a PDF with more info about me than you might care to know. It contains both my diagnostic and my titration. I warn you, it is pretty ugly. :-)
Rock is right. He's known me long enough to know I have "issues." :-)
I'm using a VPAP Auto autobilevel, which is an S8, but sort of an S8 one and a half, I think, since it has some features of the S8 IIs. I consistently get an AI of 1 or less, and my HI is usually below 10. (It's an 8-series ResMed, so it counts FLs in with the Hs.) I am on no meds. My nasopharynx is tiny. I am in the diabetic range and am subclinical hypothyroid.
jeff
SleepMBA said:I see where you're coming from Rock. Thanks for chiming in. But I didn't say he was perfect. When you compare the before and after, he is doing much better. I've done titrations where I've been able to "clean" people up better than that and I've done titrations where that is as good as it gets. We actually need more details about JNK's medical history and some data from his S9 (I think that's what he has) to say if it could be better.
JNK, please don't feel obligated to give any details. If you want to, great. If not, we'll respect your privacy. Have a good weekend all!
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