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Random periods of elevated respiratory rate
#11
RE: Random periods of elevated respiratory rate
Based on your initial post, Your respiration rate is 16, more or less.
The high rate is a false indication because your breathing is crossing the zero line several times per breath.
I've seen the false indication several times, typically you see only one extra, I'll call it a pant for now, a quick, very short breath, doubling the breath rate, you have 3 "pants" in a single breath.

I'll dwell on this overnight, someone else may come up with a better suggestion.
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#12
RE: Random periods of elevated respiratory rate
That happen only when you're in the high pressure parts, so try to set EPR option to 3.

That will help you for expirations and I'm pretty sur that will solve the problem.

Share the result with a good zoom in Wink
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#13
RE: Random periods of elevated respiratory rate
(03-20-2021, 09:54 PM)Gideon Wrote: Based on your initial post, Your respiration rate is 16, more or less.
The high rate is a false indication because your breathing is crossing the zero line several times per breath.
I've seen the false indication several times, typically you see only one extra, I'll call it a pant for now, a quick, very short breath, doubling the breath rate, you have 3 "pants" in a single breath.

I'll dwell on this overnight, someone else may come up with a better suggestion.

For me it's like he's trying to expel the rest of the air and it causes the "pants", like a panic attack.

What you think about that?
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#14
RE: Random periods of elevated respiratory rate
No answer for you but I will monitor this thread as I have exactly the same issue with the high resp. rate which happens for about 30-45min 2-3 times per night and goes up to about 45 during these times. I am a terrible mouth breather and after 50 days of CPAP I have found the resp. rate  looks normal'ish only when I use tape on my mouth. I use the F20 FFM.
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#15
RE: Random periods of elevated respiratory rate
It's amazing you are sleeping through this. You are asleep here, yes?

If it was me I would be wide awake, time to GT*MO (Get The * Mask Off.)

What I see on the charts is high recorded RR, with correspondingly low Insp time and Exp Time with wide variation in minute ventilation, at times with highish mask pressures but unknown leak rate.

No idea, others will chip in but I would think of these possibilities: 

Panic attack, either awake or asleep?
Very low Tidal volume with overlying cardioballistic effects making the recorded reading unreliable.
Machine error? interference?

You have high flow limitations, so prior suggestions about EPR apply.

In your periods of high RR your expiration pattern is abnormal: palatal prolapse or tongue bouncing against the palate?

(If you could, in future charts also include the left panel under Daily Details, but without the pie chart and the calendar. Follow Sleeprider's tips in #5.

Include the Flow limitation graph.

Use F12 to capture the full data we need to see.

It would help if you put the zero line on your flow Rate chart.

Also change the Mask Pressured Graph's scale so we can more clearly see what is happening at mask pressure level.)

Good luck!
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#16
RE: Random periods of elevated respiratory rate
I've been told, when I saw something similar for a time, that it is chattering of the esophageal sphincter, which is not always holding pressure of the airway. EPR of 3 must have solved it back in 2015, a temporary and episodic thing for me then. 

My pressures now with VAuto are about the same as then with the AutoSense, but I use pressure support of 4. Here are a couple of shots of my experience in early PAP, 12-2015

   


   
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#17
RE: Random periods of elevated respiratory rate
@2SleepBetta

Well now that is fascinating. First I have heard of this. Did you also have GERD/reflux?

Glad the Vauto PS 4 is sorting you out.

@ budor: I am interested you said you woke up at these times: are you aware of what it is that is waking you? the pressure of the PAP? noises? reflux?
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#18
RE: Random periods of elevated respiratory rate
Thank you Severe Apnea.
I believe these are Cardio-balistic effects. Yes, on occasion we can see,on occasion, your pulse embedded in your flow rate.

Those variations, as I called them "pants", are most likely effects from your pulse. This can be validated by comparing them to your pulse while you are having such an episode. Do you have a recording pulse oximeter? Preferably one compatib.le with OSCAR.

This artifact renders your breathing stats, inspiration time, expiration time, minute vent, tidal volume, i/e ratio, and obviously respiration rate as potentially inaccurate.
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#19
RE: Random periods of elevated respiratory rate
I see you got some very capable help before I got back to the forum. The two screenshots you posted are very helpful and we can see the high respiration rate is a form of flow limitations that involves opening and closing of the airway such that flow repeatedly returns to zero during inspiration causing the high respiration rate count. This falls within the definition of a Class 3 inspiratory flow limitation, and is often related to soft tissue moving in the nose or throat in a way that causes these oscillations.  I agree with Gideon your breath rate in that image is approximately 15 bpm.  The other image showing your normal respiration shows flattened inspiratory peaks, however, while flow limitation is present, the airway remains stable and the breath rate is correct.

The first thing we want to try is exhale pressure relief (EPR) full time at a setting of 3. You are currently using your Autoset with a pressure range of 5-20 without EPR. You need to change to a minimum pressure of 8.0, maximum pressure 16.0 and EPR 3.

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#20
RE: Random periods of elevated respiratory rate
Wow, thanks for all of the great feedback.

I do not have gerd or similar issue that I know of, but this would make sense. I know I woke up during most of the episodes because I turned my CPAP off and on which shows in the chart, but I don't know what woke me up. Maybe is was something like a chattering of the esophageal sphincter which eventually woke me up. It's strange that it doesn't happen every night. A couple times a week it will happen 2-3 times for 10-20 minutes a time.

The Cardio-balistic effect also makes a lot of sense. It looks like there is a secondary wave pattern. I do have a pulse oximeter so I can use to test this theory. In fact, OSCAR and a pulse oximeter is what helped me figure out I have sleep apnea. I was waking up during the night and tired in the morning so I did some research, got a oximeter and OSCAR. It showed my SpO2 dropping into the mid to low 80's for extended periods. That prompted me to do a sleep study which shows an AHI of 31. After getting my CPAP my SpO2 is consistently in the mid to upper 90's.  Smile I should be using the SpO2 more often, but the batteries only last a few nights and its not comfortable.

I set the EPR to 3 and will be using the pulse oximeter. Lets see if this resolve it.
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