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Tachypnea and Being Awakened during the night.
#1
Tachypnea and Being Awakened during the night.
I am looking for information or input on a concern I have about waking up during the night. During my sleep study I asked what was waking me up and they said that at the times of my being awaken there were no events. After two months of reviewing my sleepyhead data I did find a correlation. In the chart below I woke up at 2:15 am in the morning and there were no events near the time of my awakening. Of course if you look just before the 2:15 am mark I had about 60 minutes of tachypnea (at least that is what I think it is) that ended when I woke up! I found it interesting that my CPAP machine does not flag it nor does it raise the air pressure when it occurs. So in my tachypnea rate of breathing increases while amount of air per breath decreases. If the volume of air that I breathe in with every breath gets small enough I am not exchanging air but re-breathing it and O2 levels will go down far enough and I will wake up. I have a appointment with my doctor at the end of the month and I will discuss it with him. Does anybody have experience with this?  Should this be flagged as an event?  Should my CPAP keep the pressure maxed instead of backing off a little?  I wondered if my max pressure should be raised but my thought was my machine does not appear to be reacting to tachypea.
   
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#2
RE: Tachypnea and Being Awakened during the night.
I've seen tachypnea in any number of people on the forum. Obviously, not a very efficient form of breathing as it tends to be rapid, does not clear the dead space of CO2 and kind of tends to compound itself as hypercapnea kicks in. If this is a one-off occurrence, then it's nothing to deal with. You don't have any centrals, so this appears to be an out of control reaction to the preceding obstructive cluster. Had you aroused and done some deep recovery breathing at 01:10, I doubt it would have happened.

You're at the maximum pressure of 15/12 as this occurs, so I don't think an increase in pressure is going to be helpful once it starts, and it's odd that you went 45 minutes to an hour in this state without awakening. Maybe the question is what triggered the obstructive cluster that occurs from 00:50 to 01:10. Do you have similar obstructive clusters followed by tachypenea on other nights?
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#3
RE: Tachypnea and Being Awakened during the night.
Sleeprider that is a very good point about tachypnea following clusters of OA's.  I went back and looked at three months of data and the tachypnea does follow clusters of OA's.  I have no way for sure to tell what causes the clusters of OA's, but my guess is that I try to sleep on my side and I get the OA's when I sleep on my back during the night.  And of course this is strictly and educated guess on my part.
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#4
RE: Tachypnea and Being Awakened during the night.
An obstructive cluster is usually a sleep position that obstructs the airway by restricting it, specifically, either chin tucking or a bend in the head and neck that causes obstruction. A soft cervical collar has proven time and time again to be an effective way to prevent that. You only had the one cluster, but if you want to prevent future clusters, a comfortable fitting collar or at least some thought on what might be causing it could be worthwhile. It's good you have found what is likely the root cause. It makes sense.

I'm not saying this is a solution that insurance would cover, but if you had a Resmed Aircurve 10 Vauto, a TiMin (minimum inspiration time) of 1.0 would certainly break this cycle by forcing a longer, more typical inspiration time.
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#5
RE: Tachypnea and Being Awakened during the night.
I am interested in learning more as I have a friend with similar issues. In his case, if you zoom in the wave form have bumps which were giving a false reading of respiratory rate.
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#6
RE: Tachypnea and Being Awakened during the night.
I zoomed in on a section of the area where I was showing tachypnea. I show some bumps in my graphs but for the most part they do stay in the high zone.


   
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#7
RE: Tachypnea and Being Awakened during the night.
Hi Michael,
I use an older machine with a different data collection system...so I can't help you there.  But if position is preventing treatment...it should show up in your oxygen level.  Recording oximeters are reasonably priced and would give you a better idea of what's happening during the OAs and tachypnea.  Just a thought.
JD
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#8
RE: Tachypnea and Being Awakened during the night.
(06-05-2018, 08:57 AM)Michael Shaw Wrote: I zoomed in on a section of the area where I was showing tachypnea. I show some bumps in my graphs but for the most part they do stay in the high zone.

Your graphs seems to show a high resp rate, but we need a view of the flow rate, no more than 2 minutes in duration so the individual breaths are visible and can by counted for a unit of time.  It basically looks to me like the tachapenea is real.
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#9
RE: Tachypnea and Being Awakened during the night.
Do you also get tachycardia during the sleep,or waking up to it?
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#10
RE: Tachypnea and Being Awakened during the night.
(06-05-2018, 08:54 PM)Sleeprider Wrote:
(06-05-2018, 08:57 AM)Michael Shaw Wrote: I zoomed in on a section of the area where I was showing tachypnea. I show some bumps in my graphs but for the most part they do stay in the high zone.

Your graphs seems to show a high resp rate, but we need a view of the flow rate, no more than 2 minutes in duration so the individual breaths are visible and can by counted for a unit of time.  It basically looks to me like the tachapenea is real.

Sleeprider thanks for your help.  I have attached two graphs the first one is zoomed in  for 1 minute showing flow rate and the second is two minutes.
         
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