Thursday, February 28, 2019

Allergy is a problem using CPAP..... ~ Allergy season is coming!


Hard to sleep when I have stuffy nose ....

I have been using CPAP when I sleep.  The symptoms such as sleepiness in daytime and some pain on my chest are going away.  However, I am having trouble due to allergy in spring time.

Started a few weeks ago, my allergy got worse due to pollen and it is a cause of problem to sleep with CPAP since it is hard to breath during sleep due to stuffy nose.

Solution for now?

To avoid the situation, I take an allergy pill which is anit-histamine pill a few hours before going to bed and put a gel which is shown in the top of this posting before sleeping per advice by a doctor.

It seems to be working for now, but I am not sure if the symptom gets worse....

Monday, September 17, 2018

Garmin Vivosmart 4 with pulse oximeter feature!


Garmin Vivosmart 4

Garmin Vivosmart 4 was announced.   It has pulse oximeter feature and it can track SPO2 value during sleeping.  However it is not very clear how often it samples the SPO2 value.  At this moment, I am not sure if it is useful to collect some reference data for Sleep apnea.  (This device has not been certified as a medical device yet and it will be just for a reference data)

This feature was introduced in fenix 5X plus a few months ago from Garmin.  But the price is very expensive and it is no way to get it just for a testing.  However, this is not very expensive and I would like to get it for some testing.   There are some posts for reviewing this device on the internet.


Friday, September 14, 2018

SPO2 trend during sleeping

I have been using CPAP during sleeping.  I do not have much update and not many thing to post this blog recently.  Today, I review SPO2 trend last a few months.

I have been collecting SPO2 data during sleeping almost every day since May 26, 2018.

Here is the average data and I can see a good improvement.

3rd week of May to 2nd week of June (without CPAP)
  • SPO2(Average)                            94.0 %
  • SPO2(minimum)                          87.0 %
  • SPO2 drop more than 5%            1.3 / hour
  • SPO2 drop 4 ~ 5%                       3.0 / hour
  • SPO2 drop 3 ~ 4%                       8.4 / hour
  • Weight                                          165.6 lb / 75.1 kg

3rd week of June to 2nd week of July (excluding days for CPAP trial)
  • SPO2(Average)                            94.6 %
  • SPO2(minimum)                          87.3 %
  • SPO2 drop more than 5%            1.1 / hour
  • SPO2 drop 4 ~ 5%                       2.4 / hour
  • SPO2 drop 3 ~ 4%                       6.9 / hour
  • Weight                                          161.4 lb / 73.2 kg
3rd week of July to 2nd week of August (with CPAP)
  • SPO2 (Average)                            95 %
  • SPO2 (minimum)                          89.2 %
  • SPO2 drop more than 5%             0.6 / hour
  • SPO2 drop 4 ~ 5%                        1.6 / hour
  • SPO2 drop 3 ~ 4%                        5.5 / hour
  • Weight                                           158.7 lb / 72.0 kg
8月下旬から9月中旬 (CPAP使用)
  • SPO2 (Average)                           95.6 %
  • SPO2 (minimum)                         91.2 %
  • SPO2 drop  more than 5%           0.3 / hour
  • SPO2 drop 4 ~ 5%                       0.9 / hour
  • SPO2 drop 3 ~ 4%                       3.8 / hour
  • Weight                                          156.1 lb / 70.8 kg
SPO2 drop less than 3%, I do not see any difference therefore I did not show here.  It is probably including some measurement error and I do not believe there is no point to compare them.

Before mid June, I felt some symptoms such as felt tired right after waking up and very strong sleepiness during daytime.   However they are going away after that.  I started using CPAP in mid July and the number is significantly improved.

The average SPO2 value is improved by 1.6%.  I think CPAP works very well.  However I think this improvement is not only CPAP but also weight reduction.  Before using CPAP, the value is improved with weight reduction.  I lost about 4 lb.  However, I also tried to improve the symptom with changing sleeping positions as well.  (I think sleeping position is one of factor to improve the value)

After starting using CPAP, there is some improvement.  I think this is due to weight reduction as well as I adopted using CPAP device and the quality of sleeping is getting better.  At least, CPAP and weight reduction works very well in my case.

Wednesday, September 12, 2018

Follow up appointment for Sleep apnea after started using CPAP

I saw a doctor for the first time since I started using CPAP as a treatment of sleep apnea.  It was really hard to make an appointment with the doctor and it took almost two months.   Finally, I saw the doctor today.   This is a summary.

Nothing to do with the CPAP device

When I made the appointment, I was told I had to carry the CPAP device when I would see the doctor.   Therefore, I packed it into a carrying case before the appointment.  However it was not touched at all during the appointment.
I just asked a question why I needed to carry it.  The reason is it is possible that the doctor consults how to use / adjust it if people have issues.  In my case, there is no issues at all and the doctor does not have to do that.

Thee symptom is improved, no issues

As a conclusion, the symptom is significantly improved and I just need to do whatever I have been doing with the CPAP device.  That is only instruction from the doctor.
The event per hour, which is breath stopping events detected by the device, is 0.5 per hour.  That is a pretty good number and I just need to continue to use CPAP.  The target is 5 per hour and my number below the target.  There is also no issue for air leak from the mask.

Possibility to eliminate CPAP

One thing I am really interested in was a possibility not using CPAP device.  As a conclusion, the doctor still believer I have to use it for a while.

The primary reason is the setting of CPA device is 6 cm H2O ~ 8 cm H2O.   Overall average is 6.1 cm H2O which is recorded by the CPAP device.  However, the maximum value is 7.5 cm H2O, that means the CPAP device adjusts the air pressure to high due to apnea events.   If there is no event, there is no reason the pressure is going up and staying below 6 cm H2O.   Therefore, it is better to use it for a while.

Weight reduction might help some improvement, however, jaw structure for Asian would be a primary cause of Sleep apnea in many cased.  Therefore, even if people loose a lot of weight, it is still better to use CPAP device in many cases.
On the other hand, reducing weight and keeping a right weight is very important to stay healthy for the other reason, thus, it is better to continue reduce my weight anyway.

Next appointment

The next appointment will be a year from now.   Of course,  I might need to see him any time if I have any issues / problems.  Other than that, the doctor thinks once a year would not be a problem in my case.

So, it seems that I have to use CPAP for a while and continue to do the weight reduction targeting to 63 kg.

Thursday, August 30, 2018

Progress of weight reduction ~ still getting very good progress!


Due to using CPAP during sleeping, I do not have much new topic....
Since it is the end of August and I report a progress of weight reduction project

The previous update for the weight reduction is about two weeks ago, the average weight of a week was 157.9(lb).  After that, the average changed 155.9(lb) -> 155.8(lb).  There were a few days the weight was less than 155 (lb).  My weight on April 18 was 170.6 (lb), therefore, I have done about 15 (lb) reduction!  My target weight is somewhere less than 140 (lb) so, it is probably a half way now.  (140 lb is BMI less than 22 with height 5 feet 6 inches).

I do not really restricted diet.  Therefore it was not very heard and I sometimes eat some extra when I feel really hungry.


Key is to be "Habit"

I realized that the key for the weight reduction is "to be habit".  I guess I could loose more weight if I more restricted diet.  However, I think it might be hard to sustain that diet.  I guess a better way to maintain a reasonable small adjustment.  For now, I am note sure if I need to reduce amount of what I eat to reduce more weight.  I just watch the trend of my weight with the current "habit".

Improvement?

Since I am using CPAP, the symptom is significantly improved.  The event of Sleep apnea CPAP device detects is somewhere less than 1 event per hour in the average.  (The original event rate in the sleep study was 7.1 event / hour)

Saturday, August 25, 2018

Web service by CPAP vendor ~ MyAir



I have not tried any new things recently.  I've just been using CPAP equipment when I sleep nowadays.
The device I am using is ResMed Air Sense 10 AutoSet.  It sends data during sleeping through mobile network and doctors and insurance companies can access my data.  They also offer to access the data through PC and mobile application.

The insurance company decides to cover this treatment based on the usage. 
Due to on-going weight reduction effort, my symptom is getting much better and the event is only less than one event.  (This is based on data the CPAP device detects)

I think weight reduction helps at least my case!

Monday, August 20, 2018

SPO2 @ 12000 feet elevation



SPO2 @ 12000 feet elevation (August 18-19, 2018)

I am monitoring SPO2 value during sleeping due to understanding the symptom of Sleep Apnea.  This is an extra edition about SPO2!

(*) This is not much about Sleep Apnea....

SPO2 value in higher elevation

As I posted before, the reason I am interested in SPO2 / Pulse Oximeter which measures SPO2 is a relationship between SPO2 and elevation as a part of my hobby, climbing and hiking.  When people in higher elevation, SPO2 value typically gets lower and it will be back to normal when people are acclimatized the elevation.  Thus, SPO2 could be a good index to show the body response in higher elevation or low oxygen environment.  Then, I found SPO2 value in my sleep study report and that was why I record SPO2 value during sleeping.

What does SPO2 value look like at 12,000 feet elevation?

I could not measure continuous measurement for SPO2 before since I do not have an equipment to do.  However, I got one which can measure continuous SPO2 data during sleeping and I was thinking to measure it when I would be in higher elevation.

Finally, I had a chance to measure it.  I went hiking to Mt. Whitney which is the highest mountain in California / USA.  The elevation of the summit of Mt. Whitney is 14,505 feet.  The camping site a day before the summit attempt is Trail Camp.  The elevation of Trail Camp is about 12,000 feet where many people feel symptoms of high altitude sickness.

The chart on the top is the data, the average of SPO2 is 77%, the minimum is 60%.   For a reference data, the chart below is the one a night before hiking.


Data at home (August 16-17, 2018)

The average is 95% and the minimum is 87%.  Just looking at the number, the data at 12,000 feet elevation is very low.  I have been using CPAP when I sleep and symptom of Sleep Apnea is getting improved.  Although the lowest value of the night was 87,  it might not be a true data.  It might be due to contact between sensor and the body.  The following is a data with a better resolution.


August 16-17 with a better resolution

If you look at the chart carefully, the data is discontinue right before dropped SPO2.  Therefore, the data right after the discontinue might not be  a correct measurement.   If I look at a similar resolution of data in the high elevation, I do not see such discontinuous part except the part sensor was off the body.


August 18-19 data with a better resolution

Those are data I captured....

This is main topic of posting today!

First of all, I was wondering why dropping SPO2 to somewhere below 90% in a sleep study is concern.  The typical duration of a drop is probably a few minutes, it is around 1 minute in my case.
On the other hand, the data in higher elevation (12,000 feet) is less than 90% almost all portion.  (Plotting in red shows the value is less than 90%).   However, I have never felt something wrong when I stayed there a several days.  Therefore, I did not take seriously when my report of sleep study shows less than 90% drop.

If you look at the data carefully, the range of SPO2 value is much bigger in the high elevation.  In fact, when I try to measure SPO2 in real time, the measured value is not really stable and it is hard to pick a number which value would be a reasonable measurement data.  This is due to how people breath, such as deep breathing might help to improve the number.  Also, it becomes unstable when we move.  Anyhow, the fact is the SPO2 value is getting much lower when people are in a high altitude.

What I found out from the data, there is heart rate data with SPO2 trend.  The average heart rate at 12,000 feet is 83.6 bpm, the minimum is 55 bpm and the maximum is 111 bpm.  On the other hand, the data at home is average is 52.8 bpm , the minimum is 46 bpm and the maximum is 90 bpm.  (The maximum heart rate at home  might be a false data since the right before the maximum value, the data is discontinues).  Even if we assume 90 bpm is true data, there is 30 bpm difference between the data at home and the data at 12,000.

Not only SPO2, but also heart rate is getting higher!

The data shows, SPO2 value is getting lower, however, due to low SPO2 in higher elevation, the heart rate is also getting higher.   I am not a specialist in this area and this is all speculation.  Increasing the volume of circulation, the total amount of oxygen could not be very low.  Another word, I think the human body might have enough oxygen even if SPO2 shows lower value.

I checked SPO2 drop due to Sleep Apnea that the heart rate is increasing when SPO2 value is dropped.  However, it is very short period and it is back to normal in a short time.  It is very hard to seem how fast a human body responds it.  But I guess it might be very low oxygen due to Sleep Apnea and this is the reason of bad impacts  to your body.

Almost all cases people are in high altitude, the elevation is not suddenly up, it is slowly changed.  Therefore it has enough time to adjust the circulation just looking into the SP value.  Therefore the chance to get really low oxygen situation could be very small.

I was not aware of the difference, when I just looking at SPO2 value.  Now I had a data in higher elevation.  With that data, I realize Sleep Apnea would be one of serious symptom people need to get some treatment wither way.

This is an extra edition of Sleep Apnea for SPO2 value