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In general, awake RR is higher than RR during sleep. As I mentioned, I do see that my RR is a little lower when I'm lying in bed waiting to fall asleep. I don't know how common or uncommon that is.
As several of us have noted, your RR with the machine on is unusually low, though your TV compensates and gives you a reasonable MV. In other words, you breathe slowly but more deeply, which maintains your level of air exchange over a period of a minute.
You should discuss the low RR rate with your doctor. Show him or her the chart with RR, TV and MV. There's probably no big problem, but it's good to make sure.
Usually the difference is not very noticeable when looking at the RR chart. Your RR changes significantly, at least in the example given.
As stated I would try and determine what your normal awake respiration rate is without PAP on. If you are only having this low RR while awake and using PAP it would appear that you are either consciously or unconsciously adjusting breathing because of the feel of pressure, settings etc. If that is the case an adjustment of settings may change that and potentially affect your quality of treatment. This is one of the first things I thought of because I see you are using very low pressure on a fixed pressure machine, it could be that you are taking long deep breaths because you feel you are starving for air (not an uncommon complaint at minimum pressure settings).
If this is the case I would try a slightly higher pressure (say 7 cm) and higher EPR (2 or 3, whichever feels most comfortable). This will make it easier to breath and may improve feel while awake and if the theory is right it may slow your sleep RR a bit by making it easier as well.
I'm not sure the slower deeper breathing is necessarily a problem. Some people are belly breathers, and I think they naturally breathe deeper and slower. I am one, for example, but I don't see much difference awake or asleep.
I'm not sure how to capture the awake RR without instruments; if you are counting, you are paying attention, and that will change things.
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(02-19-2022, 06:47 PM)pholynyk Wrote: I'm not sure how to capture the awake RR without instruments; if you are counting, you are paying attention, and that will change things.
Lay down, get comfortable and relaxed and breath normally with eyes closed. Have someone else count your breaths (can hold hand in front of nose if necessary to detect breath) and they can do it at a couple different times and when you aren't aware they are counting (hence eyes closed). If you are laying there focusing on relaxing and not sure when person is going to count the breathing will be normal.
02-20-2022, 02:21 AM (This post was last modified: 02-20-2022, 02:26 AM by Jo1cpap.)
RE: Breath Frequency
Hello thanks everybody,
I'm currently in a process of finding out what is going on with my breathing.
I'm a prof. brass player 53 years but can't do my job because of breathing problems and jaw, neck, shoulder problems.
(unilateral posterior cross bite with mandbular shift)
I was on 100% teaching but even that is not possible anymore.
Before starting CPAP I slept 3 to 5 hours a night.
My AHI was +50
Without CPAP I needed 1 hour in the mornig to get some tonus in my muscels.
No with CPAP this is better but I still does not feel natural. (neck, jaw, chest)
When sitting I have the feeling belly breathing does not work anymore.
I have a feeling as I put my body in standby.
Hart rate during sitting and reading is between 50 and 55.
As soon as doing something that brings me out of my standby I have the feeling I don't get enough oxigen.
Riding a bike or walking does make me open my mouth widely and puting my tounge out to make breathing possible.
I have a feeling my breath is al upper. (no belly breathing anymore)
I read the wiki and try to post a new screenshot of last night.
Is this better?
Johna,
Do you have any lung issues like asthma, COPD or allergies that you know off. It sounds like you are short of breathe but you are not using that word. How long has this been happening?
02-20-2022, 08:07 AM (This post was last modified: 02-20-2022, 08:20 AM by Jo1cpap.)
RE: Breath Frequency
Hello,
I had some tests: No indications for astma or COPD.
Also no clear indications for diaphragm dysfunction.
It feels like I put my body in standby when awake. Breathing only a bit just enough. When I need more breath I do it not natural. ( no belly anymore) Especialy sitting is difficult. (biking, playing piano)
I have this problem for years. But since I hace my CPAP I found out it is really a big problem.
I have similar symptoms as you but I have asthma, COPD and allergies. Have you seen a pulmonologist? They could do a lung function test. I have exercised induced asthma and high blood pressure. If I go past my normal activity level I have breathing problems. Maybe a stress test would show how your lungs work at a higher level.
Another possibility is GERDs which is acid reflux which can back up into your lungs. It is called "silent reflux" because you are not aware of it. I recently have to give up coffee because of that condition.
Do what Geer suggests regarding comparing awake respiratory rate with and without CPAP. If machine causes it, try the suggested settings.
As far as your screenshot. You can use your minute vent for some rough sleep staging. You fell asleep at 12. Had 3 clear REM cycles with more variable and higher minute vent. The spikes outside the REM stages are probably arousals or awakenings. The flat line minute ventilations are likely deep sleep. You might want to zoom in the 5:05-5:15 period where you transition from sleep to wake. If you were awake, nothing to see, but if that period caused you to become awake, zoom in on it as you have minute vent spikes and CA events.
Also, add flow rate, flow limits, leaks and zoom in and explore your REM stage minute vent spikes as they are probably some events as well. During your likely legitimate OA and hypopneas, your minute vent spikes crazy. In addition, put a median line and zoom y axis on your minute vent as it seems an important marker in your case.
