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Apparent Hyperventilation
#11
RE: Apparent Hyperventilation
(06-07-2017, 09:32 PM)justMongo Wrote: I do not believe you are hyperventilating (high BPM).  The BPM count is being doubled and tripled.  We need to figure out what is causing that ragged flow rate.  Every zero crossing (minus to plus) in the flow is counted as a breath.  The count is an artifact of that; and is not real.  Your true rate is in the teens.

So there's some kind of period-doubling going on there? Or is it more like higher harmonics?
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#12
RE: Apparent Hyperventilation
(06-08-2017, 12:03 PM)Sleepster Wrote:
(06-07-2017, 09:32 PM)justMongo Wrote: I do not believe you are hyperventilating (high BPM).  The BPM count is being doubled and tripled.  We need to figure out what is causing that ragged flow rate.  Every zero crossing (minus to plus) in the flow is counted as a breath.  The count is an artifact of that; and is not real.  Your true rate is in the teens.

So there's some kind of period-doubling going on there? Or is it more like higher harmonics?

I think what is recorded shows real physiological effect and potential impact.  The respirations are not brain induced, though. The machine really did change the pressure in the mask, and the patient really did get extra air in and air out.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#13
RE: Apparent Hyperventilation
The BPM count is an artifact of a wiggle in the expiratory waveform. Every minus to plus zero crossing in flow triggers IPAP and is counted as a breath.
I've seen it in my own machine. I changed the trigger to prevent double triggering on my VPAP. PaytonA has seen similar false triggering.

At EPAP, the OP seems to have some obstruction that is vibratory in nature. I suspect it is snoring; but have not seen the snore graph.

A little more EPAP would likely "fix" the problem. I suggested lowering EPR, which I can see is set to 3 from the pressure graphs. Setting it to 2 might do it; or raising min pressure.

No one could sustain a hyperventilation rate of nearly 40 BPM. The shift to lower pH would cause vasoconstriction and they would pass out.
The real rate, when looking at the BPM graph is the lower extend of the BPM graph -- around 16 to 18 BPM.

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JustMongo passed away in August 2017
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#14
RE: Apparent Hyperventilation
@JAR14 perhaps you could show us the whole night with 2 new traces - (1) snoring and (2) minute ventilation.

you are hearing reduce EPR from nearly everyone. can you do a test on that?

good luck with sorting this out.

QAL
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You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#15
RE: Apparent Hyperventilation
Has RLS been eliminated as a possibility? This looks a lot like what we see from physical movement that affects the respiratory smoothness, and the machine counts each deflection as a breath change. RLS would explain the tiredness as well. Do you have a spouse or bed-partner that can verify you are sleeping quietly?
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#16
RE: Apparent Hyperventilation
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[attachment=3599 Wrote:quiescence at last pid='209443' dateline='1496943542'][attachment=3598][attachment=3597][attachment=3596][attachment=3595][attachment=3594]
(06-08-2017, 12:03 PM)Sleepster Wrote:
(06-07-2017, 09:32 PM)justMongo Wrote: I do not believe you are hyperventilating (high BPM).  The BPM count is being doubled and tripled.  We need to figure out what is causing that ragged flow rate.  Every zero crossing (minus to plus) in the flow is counted as a breath.  The count is an artifact of that; and is not real.  Your true rate is in the teens.

So there's some kind of period-doubling going on there? Or is it more like higher harmonics?

I think what is recorded shows real physiological effect and potential impact.  The respirations are not brain induced, though.  The machine really did change the pressure in the mask, and the patient really did get extra air in and air out.

Based on suggestions of board members, I have captured expanded portions of the SleepyHead charts for flow rate and mask pressure.  The time of capture is during "apparent" high respiration rates recorded on the charts. The waveforms are indeed ragged, and may be responsible for the doubling or tripling of actual respiration rate. AHI for the night was "0".


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Wink May the ZZZZs be with you.
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#17
RE: Apparent Hyperventilation
(06-08-2017, 02:00 PM)Sleeprider Wrote: Has RLS been eliminated as a possibility?  This looks a lot like what we see from physical movement that affects the respiratory smoothness, and the machine counts each deflection as a breath change.   RLS would explain the tiredness as well.  Do you have a spouse or bed-partner that can verify you are sleeping quietly?
Spouse reports that there is little leg movement during the night.  I have spent over a year teaching myself to sleep exclusively on my stomach, as supine position produces obstructive apneas. Sleeping on my stomach has dropped the AHI to less than 0.76 average for the past year.

Just posted a bunch of traces on this thread.

Will try reducing the EPR from 3 to 2 then to 1.  Also looking at raising the minimum pressure.
Wink May the ZZZZs be with you.
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#18
RE: Apparent Hyperventilation
Thanks Mongo!  Your specific insights are very helpful, as the ragged shape of the flow rate waveform indicates that this may be the source of the doubling or tripling of the actual respiration rate.  I will lower the EPR sequentially and look for changes in the "apparent" respiration rate and shapes of the flow rate waveforms.
Wink May the ZZZZs be with you.
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