What is optimal respiration rate, minute vent, tidal volume, etc?

[ATeam91]

Dear Apnea Board Community,

You have been a godsend in optimizing settings, thank you to the moon and back. I have tweaked my settings to where my AHI is very low each night. Some mornings I feel better than others, but all in a huge improvement. Using an F20 full face mask.

I have read more into respiration rate and how athletes who are fully recovered have lower respiration rates (below 15). I bet this is different when you are on CPAP, but I want to make sure I am not over-ventilating myself. On bilevel, my aircurve 10 measures my respiration rate between 16-19 per night, with 18 seeming to be the average. My Oura ring data going back 5 years measures slightly lower (with no difference before vs after starting PAP), between 16-18 per night with usually 16 being the average.

OSCAR has been super helpful. How do I interpret and optimize my respiration rate, minute ventilation, tidal volume, and proper inspiration/expiration time?

Thanks for all that you all do

[Sleeprider]

There is no "optimum" for respiration rates and volumes, and yours falls into a normal range for healthy individuals. Factors that affect pulmonary health is your size, weight, age, fitness and exposure to smoking or pollution. Your respiratory requirements are likely fully met, or you would likely be the first to know. We don't really use the Oscar data to judge respiration unless it fall outside of our expectations. In your case the inspiration:expiration ratio is normal, the tidal volume is inversely proportional to your respiration rate which results in a steady minute vent, even when respiration is faster or slower. Check out the respiration rate spike at 01:20 and how it doesn't even move the needle for minute vent? Every time you start therapy at the beginning of the night or following a break, your tidal volume is high and respiration is lower. You could research the individual metrics to understand what they represent and how they work together to balance out. The most appropriate way to learn your respiratory health is to ask your doctor for a pulmonary function test (PFT). This is a simple procedure where you blow into a spirometer and it measures your total tidal capacity, maximum expiratory volume, and can identify any pulmonary issues that could affect your health. It's always good to have a baseline measurement to see if your pulmonary health changes as you age. I'm sure you will be told your test is "normal".

[ATeam91]

Thanks as always Sleeprider, was looking forward to your response. Makes sense!

Outside of that, surely there has to be some research on what optimal rates are? Or is this an area for future development?

[BoxcarPete]

The optimal rate for you is based on your particular physiology including basal metabolic rate, lung capacity, effective airway resistance, etc. and these things are impossible to generalize for a population and then reconstitute for an individual. You're in the right ballpark, so unless you have a reason to believe something isn't right it's usually OK to trust your body to get an appropriate amount of air.

If you want to compare to me, what's your height and weight? I'm 6'3" and 200lbs, and my stats looked very much like yours other than I had on average a little more insp time. I thought TV and MV were a little low for my size, and I saw evidence of spontaneous arousals following periods of low MV, so I suspected under-ventilation. When I was looked at, doc found tons of airway restrictions in my nose and recommended me for surgery. Haven't hooked up to the PAP machine yet post-op to see if there's any difference yet, but I think I may try it soon.

[ATeam91]

Oh fascinating. I'm 5'7" and 175lbs. Also have nasal issues and docs have recommended turbinate reduction and septoplasty, but I'm not enthusiastic about surgery if I don't need it and I'm managing fine on PAP without it.