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RERA .6 or so, Respiration 35-50?
#1
RERA .6 or so, Respiration 35-50?
Been a hosehead for over 20 years with little relief. My RERA is consistently .6 or so. Most events are Hypopneas with some OA and CA. AHI stays around 3-5 with a random 1-2 and random over 5. Respiration rates are not believable - 35-50 about 1/2 of each night. Leaks are always under 3 with no LL. OSCAR reports leaks at 0-.2. Mirage Quattro masks for many years and a Papillow too. S10 auto. Can someone tell me what is going on and what to do to fix it please?
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#2
RE: RERA .6 or so, Respiration 35-50?
Hi CROWMAN,
Welcome to Apnea Board!
I suspect you need a pressure adjustment, but really no way to advise without seeing a chart.
And yes, those respiration numbers seem high.

Are you able to post a screenshot of your daily page from OSCAR?
The tutorials for doing so are below in my signature line.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization


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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#3
RE: RERA .6 or so, Respiration 35-50?
Welcome to the forum.

Post some charts.
See the organization link in my signature,

Post a full night plus some zoomed in 2 minute views during your 'rapid breathing. This will let us see what is going on.

You mentioned RERAs which also means you have a lot of flow limitations happening as well. The flow Limitations chart is included in the organization I asked for.

I'll suggest you address your flow limits, hypopneas, and RERAs by setting your EPR to ON full-time and EPR=3. Also increase your min pressure by the same amount as your increase in EPR.

That should help some.
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#4
RE: RERA .6 or so, Respiration 35-50?
        Here are two screen shots. First time I have done this.

Another screen shot.


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#5
RE: RERA .6 or so, Respiration 35-50?
2 minute view.


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#6
RE: RERA .6 or so, Respiration 35-50?
A retry if you please,

There are the base graphs,  Flow Rate was why I want to see the 2 min close up
Events
Flow Rate
Pressure (not Mask Pressure)
Flow Limits
Leaks
Snore

I do see a tendency for positional Apnea, (Obstructive Apneas are clustered together)
You have RERAs which implies that you also have flow limits.

Your 2 min view was an hour.  You can't see the detail of the Flow Rate at that level
For the 2 min view show
Flow Rate
Resp rate
Insp Time
Exp time
minute vent
tidal volume
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#7
RE: RERA .6 or so, Respiration 35-50?
Sleep study showed I get centrals above 15. That is why I set 15 as my max pressure. Only tried pressure relief once and it turned out to be a bad night for me.


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#8
RE: RERA .6 or so, Respiration 35-50?
Your current min is 11.8.  I would like you to try min 13.8 and EPR Full Time with EPR=2, possibly going to min 14.8 and EPR=3
These keep your EPAP or exhale pressure at your current pressure and maintain the current therapeutic pressure for OSA.  The inhale pressure will start at 13.8 with your exhale pressure at 11.8.  That should be comfortable for you.
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#9
RE: RERA .6 or so, Respiration 35-50?
Back.

The closeup.  This is periodic breathing, it is not CSR.  These breaths all exhibit flow limitation.  Your breathing tapers off then you have an event, these were classified as Hypopneas, then a recovery breath and repeat.  The flow limitations are so persistent that I doubt the machine can correctly identify them.  Ending with a Recovery breath or arousal.  The definition of RERA.

See where your Respiration rate graph increases?  Look at the flow rate chart and see how in 1 breath you see it crossing the zero line several times, your machine is counting each of those as a breath incorrectly.  Your respiration rate is 20 thru this period and fairly steady at this rate.

With that much periodic breathing, I would monitor oxygen levels overnight for a few nights.

Regarding the EPR, I'd rather see you using a BiLevel (ResMed AirCurve 10 VAuto) where we can work with pressure support greater than 3.
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#10
RE: RERA .6 or so, Respiration 35-50?
Thanks much. I have a busy weekend so I don't want to make the recommended changes until Sunday night. I WILL make the 13.8/EPR=2 FT change that night and see what happens in OSCAR on Monday morning. Thanks so much for taking your time to try and sort this out. Could my breathing pattern be why I stay tired most of the day? By the way, I have an old Respironics SV machine that still works fine. Have not used it for several years and have not checked to see if I can use it with OSCAR.
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