A Question on Respiratory Rate

[rich2905]

Hi,
I recently went from a Resmed S9 to S10.

Since then i have notice there was an increase in my Respiratory Rates.

While on the S9 the 95% value was always under 20 with a max getting as high as 29

While on the S10 the 95% value are 22-23 and a max of 47.

My AHI is under 5 but that has also increase as well.

While on the S9 I was averaging under 1 and even got a 0.0 one day.
Since going to the S10 it has gone from 1.7 to 2.1.

Mind you the last night would have been good except for a batch of hypopneas around 6:40 - may be when I was waking up.

Thanks for any help,
Richard

PS Another observation is that the Resp. Rate increases seem to correlate with a flow limit increase

[attachment=2813]

[justMongo]

It would be nice to see the flow and pressure, high sample rate data on that screenshot.
How are you running that machine? It's an autoset; but are you running in CPAP mode?
Your profile says Pressure = 15. Is EPR on or off?

Anyway, here's a stab at the respiratory rate: It is occurring during flow limitation.
If you were to zoom in on the high sample rate flow waveform during one of those periods, I think you'd see the flow wave become ragged.
You might even be able to pick out where the flow waveform is making a wiggle where it crosses the zero flow line where it normally would not.
The machine picks up that zero crossing as a breath. You are artificially doubling your respiratory rate at that time.

[surferdude2]

If possible, have the DME check the pressure on your old unit and compare it to the new one. It looks like you may need to raise the pressure slightly as demonstrated by the respiratory disturbance you are getting when the limitations appear. Possibly the old machine was set slightly higher or was not accurately reporting the pressure.

Dude

edit: I'm assuming you're running in cpap mode and set at 15 cm, as given in your profile. If you changed from cpap to apap, that could cause what you are seeing and would indicate the need to raise the lower pressure setting and possibly the higher one as well.

[rich2905]

Hi
I am running on fixed 15 still as shown in pic below.

I do note my medium resp rate has stayed fairly stable, only the 95% and max values have increased due to the spikes I am getting.

I have not included pressure in graph as they are fixed.
The mask pressure stays about 13+
And pressure is 15 all the time.

Hope that answers all the questions

Not sure why the new machine and I need to say new mask (same make and model though) are causing this. It is possible the two machines/models have different setting values with the same number.

I do have a sleep doctor I have seen (only 3 time so far) but he usually sees me for 5 minutes then palms me off to some one else. I am not under the stricter controls some of you guys appear to be under I think. Here in OZ we are just paying customers.

My overall AHI are still low but do spike to over 5 on occasions during the night.

Thanks again for comments,
Richard

[attachment=2814]

[justMongo]

I stand by my hypothesis that your respiratory rate is an artifact of your flow waveform when in flow limitation.

[Sleeprider]

For respiratory rate, check out the median or average, rather than the 95%. You are well within normal ranges. I can't explain why your "less than 5% exceedance" is higher than before, it's not a very relevant statistic.

We use 90 or 95 percentile in pressure evaluations but when it comes to breaths per minute, not so much.

[rich2905]

Thanks for info.

I am very new to all this and just looking at trends - over a short period which is probably not good.

I am not overly concerned but am trying trying to work out what is important and what is not, so appreciate your comments

I have been having a bit of trouble with my new mask but thought last night was better than before, yet AHI was higher. I guess that usually happens.

Any way I will keep at it and see how I go.

Thanks again

Rich

[chill]

In support of Mongo's theory, have a look at your Tidal Volume graph on the old and new machines. Has it gotten "fatter" top to bottom? My respiration rates are very similar to yours and my breathing matches what Mongo is describing. My Tidal Volume is very fat from to bottom when I am creating like this. FWIW, when I turn my Flex (EPR on your machine) down or off, my reported RR rate drops and my Tidal Volume becomes much thinner.

[rich2905]

Here is a few of my tidal wave graphs.

I used the new on 31/8.

I think it appears as the one with 1 september in the bottom


Richard

[chill]

There are a few short segments of that which resemble mine (the bottom one, near the end, sorry I can't make out the time). That could explain the summary stats.

Here is what mine looks like: