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Why is my RR higher asleep than awake?
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ArthurLaurent Offline

Members

Posts: 11
Joined: Jul 2015

Machine: ResMed AirCurve 10 ASV
Mask Type: Full face mask
Mask Make & Model: ResMed
Humidifier: ResMed Internal
CPAP Pressure: 10-25 (ASV)
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Virginia

Post: #1
Why is my RR higher asleep than awake?
I downloaded SleepyHead last night, and imported data back to 2012 from my two older Respironics machines (Bi_PAP and AVS). I've only had my new AVS machine 5 days, so I'm going to wait a week before importing any data from its card. (I'm obsessive, but not THAT obsessive! Ha Ha Ha)

I noticed my RR during sleep therapy is much higher than in waking life. When awake, I'm down near the lower end of "normal" when resting: mostly 8 to 10 with a scattering of 11's and 12's. On the machine, I swing widely between 15 and 22 r/min. The RR doesn't seem to follow any event in the other graphs.

Does this higher RR have any clinical meaning, or is it just another number?

The past three years, my AHI has declined steadily, from 18.6 weekly average to somewhere between 1.5 and 0 (Yay, zero!). So the machine seems to be working. I just wonder why the RR is higher.

Thanks for any help.
08-03-2015 10:31 PM
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quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #2
RE: Why is my RR higher asleep than awake?
I am not sure RR has any clinical meaning, but would guess that most have heightened RR in periods scattered through sleep while the same condition does not occur while awake. RR is just calculated, and dips when you have a chain of events. RR rises above the broad normal 8 to 14 breaths per minute to somewhere in the 16-24 range in periods where hyperventilation is occurring and I associate most of my episodes to REM sleep, as the minute ventilation stays somewhat stable. In most cases, while the breathing is more rapid, it is also more shallow (tidal volume decreases), and the flow rate waveform looks more like sine wave.

In the below graph, you can see the transition at about 23:06:10.

[Image: nQMP5W3.png]

there are other times when Sleephead overcounts the respirations, but these look a lot different. Still clearly asleep, I get a bump after exhale (possibly a reaction to exhale pressure relief) that is counted as an extremely shallow breath.

Notice what happens to tidal volume in these cases, seen below:

[Image: MKitPsX.png]

I would not be alarmed at either of these cases.

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
(This post was last modified: 08-04-2015 05:30 AM by quiescence at last.)
08-04-2015 05:28 AM
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trish6hundred Offline

Advisory Members

Posts: 6,436
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #3
RE: Why is my RR higher asleep than awake?
Hi ArthurLaurent,
WELCOME! to the forum.!
I don't know the answer to your question but hang in there for more responses to your post and much success to you with your CPAP therapy.

trish6hundred
08-04-2015 01:09 PM
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vsheline Online

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #4
RE: Why is my RR higher asleep than awake?
(08-03-2015 10:31 PM)ArthurLaurent Wrote:  I've only had my new AVS machine 5 days ...

I noticed my RR during sleep therapy is much higher than in waking life. When awake, I'm down near the lower end of "normal" when resting: mostly 8 to 10 with a scattering of 11's and 12's. On the machine, I swing widely between 15 and 22 r/min. The RR doesn't seem to follow any event in the other graphs.

Hi Arthur, welcome to Apnea Board.

ResMed ASV machines target 15 breaths per minute. They are programmed to slowly drive the Respiration Rate toward 15.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
08-06-2015 02:34 AM
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