Bad breathing pattern and high respiration rate

[elliotg]

Two nights ago I noticed from Oscar that I was getting an extremely high Respiration Rate(RR) approaching 50 per minute.       
Looking back I can see that this type of event has been occurring from time to time, but not to the same extent as seen here. I found this quite scary and decided to magnify a 30 sec interval from a bad area,    
And from an area with a more normal RR.    

It would seem that I have a abnormal breathing pattern, particularly during the periods of high RR, but also when the RR was at a more normal level.  What is happening in the more normal periods is just less extreme so the a whole cycle  (large exhale to full inhale) is countered as one event! Looking back to previous nightds trace in which RR was in the normal range, the strange patterns still seen in the latter example are still occurring.

I am using a ResMed F20 mask, with pressure min of 8 and a max of 13.  I am using EPR of 2. Most nights have been getting a very low AHI, and in fact it was 0 on the night in question.  There are some flow limitations recorded, but they seem to be dealt width by a pressure increase.

I have no idea what is going on, but this cannot be right!

[elliotg]

    I am just posting a trace from a couple of months back when the RR was normal so I didn't think of looking closely at the breathing pattern It is already showing a non standard pattern. I notice that the EPR was 3 back then.

[Geer1]

Try EPR of 3 and min pressure of 9 cm.

[SarcasticDave94]

Is this maybe a case of whatever it's called about cardiac artifacts messing up the breath rate to a double-ish count?

[elliotg]

Try EPR of 3 and min pressure of 9 cm.

My inclination was to lower the EPR.  But happy to give these two settings a try!

[elliotg]

Is this maybe a case of whatever it's called about cardiac artifacts messing up the breath rate to a double-ish count?

I am at all sure how "cardiac artifacts" can effect this measurement.  But as I do have a moderate valve issue I would like to follow this up.  Can you point me to some more information?

[Geer1]

The bumps are probably too large to be cardiogenic oscillations although frequency wise might be about right. Elliotg there is no clinical relevance of cardiac oscillations (I have tried researching them a lot as I have them). Cardiogenic oscillations can cause high respiration rate reporting since the bumps cause the 0 flow line making machine think a breath has been taken.

There have been a couple members that have had similar breathing to this. I believe it is some sort of paradoxical breathing and in the cases of other members increasing PS/EPR has helped which makes me believe this sort of breathing can be caused by excessive effort due to flow restrictions. First step is to try the higher EPR and then slightly increase pressure to see if either of these reduce or make these occurrences go away.

[elliotg]

The bumps are probably too large to be cardiogenic oscillations although frequency wise might be about right. Elliotg there is no clinical relevance of cardiac oscillations (I have tried researching them a lot as I have them). Cardiogenic oscillations can cause high respiration rate reporting since the bumps cause the 0 flow line making machine think a breath has been taken.

There have been a couple members that have had similar breathing to this. I believe it is some sort of paradoxical breathing and in the cases of other members increasing PS/EPR has helped which makes me believe this sort of breathing can be caused by excessive effort due to flow restrictions. First step is to try the higher EPR and then slightly increase pressure to see if either of these reduce or make these occurrences go away.

Thanks to you and the others who replied!

Tried an EPR of 3 last night.  The first 2 hours or so continued to have a high RR (though for less of the time than in previous nights and then seemed to sort itself out and gave me normal RR for the rest of the night!  Obviously I cannot suggest it is all better based on one night, but I will continue with this and let you all know after a week or so.

[SarcasticDave94]

OK well any improvement is good.

[Geer1]

Like you say can't just go off one night data but appears to be pointed in the right direction. Try this setting for a week or so then should be able to determine if the improvement is obvious, partial or minimal.