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Persisting sleep apnea after CPAP therapy

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
First let me say I have a history of heart palps and SVT. Have had three ablations minimal success. Not overweight at all had sleep study diag at 25 events per hr. On cpap. It is REsmed elite II set it at level 7, higher levels feel uncomfortable. I am having a very weird phenom at night its like my body alarms me to wake. I pull out of sleep with what feels like fast heart/chest vibration rate but as I feel my pulse in wrist it is normal and the fast rate/chest vibration tapers off.Almost like having two pulses going on. I wore a heart monitor, showed nothing. Now I have bought a oximeter. I have some dips in o2sat only to about 93 or 92 maybe 2 per hour (spikes). Why am I doing this? My body is waking me for a reason and it has to be sleep related because it diminishes upon waking. I feel it is worse off cpap then it is on cpap. This developed maybe 8 months ago and does seem to effect my palpitations in the mornings. On my SpO2 report I see no correlation in pulse rate and these low O2 spikes.
Is 92 or 93 low enough for your brain to alarm in sleep?
Should I adjust cpap pressure up , Is this a sign I have intermittent events in lack of air?
Do you know of this symptom and what causes it?
Posted Wed, 18 Apr 2012 in Sleep Disorders
Answered by Dr. Raja Sekhar Varma 18 minutes later

Thank you for your query.

I would like to know the complete sleep study report. You could upload it to the website.

From your symptoms, I feel that the sleep apnea is still persistent and has not been relieved by the current settings of the CPAP. The benefit of CPAP will depend on the type of sleep apnea that you are getting. That is why I would like to see the complete report of the first diagnostic sleep study.
Since there is no apparent benefit now, another complete sleep study while on CPAP may need to be done.

I would also like to know your height and weight. Also, are there any other illnesses that you are suffering from. What medicines are you taking? What is your neck circumference? Also, please append the results of any blood investigations, chest x-ray etc that may have been done.

Kindly get back to me with the answers to the questions above so that I can give you a more specific reply.

With regards,
Dr RS Varma
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