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.

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.

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.