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[CPAP] Jo1cpap - Therapy Thread
#21
RE: Breath Frequency
Your respiration rate (RR) is also tied to your Minute Ventilation and your Tidal Volume. As the latter 2 go up, your RR can slow down. Your body is still getting the same amount of oxygen. Without an oximeter reading, it is difficult to form a good opinion.

Here is the Wiki link to "Respiration Rate": http://www.apneaboard.com/wiki/index.php..._rate_(RR)

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Crimson Nape
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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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#22
RE: Breath Frequency
An inverse relationship to respiration rate and tidal volume is completely normal, and many people experience a more rapid respiration rate and lower tidal volume in deeper levels of sleep. Our respiratory drive is controlled by the autonomic nervous system when we are asleep, and there is nothing unusual about a much more regular and faster pace to breathing. A normal sleep respiration rate for adults is 12 to 20 BPM. You are slightly on the high side of that, but I seriously doubt that any change in CPAP settings will result in significant changes to either respiration rate or volume during sleep. Bilevel pressure can increase tidal volume and slow respiration rate. As has been observed in this thread the relationship of breath rate, and tidal volume tend to balance out t maintain a constant minute vent. I cannot think of any reason to manipulate these variables if you are experiencing comfortable sleep. Being able to see you data can result in anxiety over artifacts that are not significant, and sometimes it is better to recognize there are variations among individuals that deviate from averages, but are still normal.

Rapid shallow breathing is technically referred to as tachypnea. With the caveat that in my opinion your respiration rate is normal, this technical article describes tachypnea in individuals during CPAP therapy. https://pubmed.ncbi.nlm.nih.gov/30353818/ Note, this article describes respiration rates of 46 to 68 BPM and is still inconclusive whether such rapid breathing is abnormal.
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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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#23
RE: Breath Frequency
In that recent example your respiration rate starts out around the same 16 when you are clearly awake (just after putting mask on) then your respiration rate decreases prior to increasing after you fall asleep. Your counted 10 BPM is in between what your CPAP data shows which is kind of inconclusive but might support that your RR decreases for some reason when wearing CPAP while awake. Not sure that it has any relevance but I am curious in trying a setting change to see if it has any effect.

I would like you to make two changes. First one is to turn off ramp, it is doing nothing but hiding data (machine doesn't record events in ramp). Second is to turn EPR on full time and set to 1. You will probably notice it is a little bit easier/more comfortable to breath with the EPR on. What will be curious is if it has any effect on your AHI and awake/sleep respiration rates.

You do have some central apnea in both nights of data posted so far. Some of these seem like they might be real central apnea, some seem like they might be sleep wake junk. Trying EPR could make central apnea worse which is why we are starting at 1 (can go as high as 3). 

Along with these results it would be good to see a copy of redacted sleep study results (remove personal information) to understand if your original diagnosis was strictly obstructive in nature or if central apnea was also present.
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#24
RE: Breath Frequency
Thanks everybody!

@Geer1 - I will try the settings.
About sleep study results. (problem 6 pages and language is Dutch)

Obstructieve Apneu-Hypopneu Index (OAHI): 49.2 /h
Centrale Apneu-Hypopneu Index (CAHI): 3,7 /h
Apneu-Hypopneu Index (AHI) 53.0 /h
Apneu-Hypopneu Index / TIB: 37.0 /min

A pneumologist from astma test (not from sleep study) found it strange my CPAP setting constant 5 is very low for a AH index 53

Kind regards, Johan
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#25
RE: Breath Frequency
The pressure needed for successful apnea treatment is not proportional to the AHI at diagnosis. People with mild apnea may need fairly high pressures; people with severe apnea may only need fairly low pressures.
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#26
RE: Breath Frequency
Hello thanks again for helping!

This morning I discovered I can now open my mouth without air escaping through it. Earlier this was not possible. Does this mean CPAP does change me fysically?
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#27
RE: Breath Frequency
Hello,

I hope you all don't mind me asking maybe stupid questions.

This morning I changed EPR from off to 1 and tried it out awake to feel the difference.
In that short session I was reading this forum with my phone in bed.

When checking last night CPAP data in oscar I found that in that short session I had an AHI 8.33

Is this normal.
I would expect no AHI being awake.

See screenshots.

Thanks,

Johan


Attached Files Thumbnail(s)
           
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#28
RE: Breath Frequency
You should not count events while awake. There were some mask pressure issues as no breaths >10s were detected at nasal mask. Maybe you were mouth breathing or sth. If you simply paused your breath it should have been detected as CA based on FOT, if you zoom in flow rate, you can see if there were fot impulses
https://document.resmed.com/en-ap/docume...ac_eng.pdf

If simple pauses in breath, not sure why it would count them as OA and not CA.
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#29
RE: Breath Frequency
Hello and thanks,

Maybe the events were me discovering I can breath through my mouth.
That seems logical and I didn't think of it.

Kind regards,
Johan
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#30
RE: Breath Frequency
For your next trick, get a glass of water and a straw. Turn on the CPAP and drink. Learning to control the pressure while using nasal pillows is all part of adapting and better therapy. I can talk, drink and not cause embarrassing noises, all while using pressure.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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