Hyperventilating during sleep with cpap on. Please advise?

[MrsGrohl]

Hi all, I'm new here, I have sleep apnoea and a cpap machine, and my husband is the same. He was diagnosed later than me, and has a more modern machine, but we both have single pressure cpap. So I hope you'll help me, my question is about him, he's hyperventilating (65 respirations per minute) whilst fast asleep with his cpap on, not leaking/blowing, and it's going on for hours at night, if not all night. Everything tells me this is totally unacceptable, and that at the very least he's not getting the benefit from his cpap, and at the worst there's something far more serious going on eg heart issues etc. So I've searched and searched online, I have access to all the journals I could want, but I can't find anything worth documenting on hyperventilating during sleep with a cpap machine on!!!!! It's driving me crazy. If I could find something tangible I could a) convince him to call the sleep clinic or b) adjust something on the machine and solve the problem. Can anyone please offer any advice? I would be eternally grateful.

[srlevine1]

• Might I suggest you download and install OSCAR to document what your device is recording and post the screen shots to the forum to get more specific suggestions.
  
• Also, you may wish to consult with your sleep doctor to evaluate your husband's EEG during a sleep test to rule out advanced causes like lung disorders -- COPD, asthma, and emphysema-- or head injury, etc.  
  
• Is your husband taking stimulants or other drugs prior to bedtime? Is he having dreams which have exciting or emotional content? 
  
• Is your husband a mouth breather? Perhaps a nasal mask to force breathing through the nose to increase the amount of air that is exhaled and immediately re-inhaled, which may be richer in carbon dioxide.
  
• Have you read the article at https://www.sleepdisordersguide.com/arti...-treatment
  

Best of luck. -- Steve

[MrsGrohl]

Hi, thank you for replying! He doesn't take any stimulants, doesn't drink coffee, has to have a leg falling off before he even takes a painkiller!!!! I'll get reading, and see what I can learn, and I'm telling him straight now that he's got to call them!!! I've just looked and there is an SD card in there, so I can download etc. I'll come back to you with some data. Thank you again, Helen.

[Sleeprider]

The reason the OSCAR charts help is that it lets us drill down on the cause of the high respiration rate. In some cases, we see an extremely disrupted respiration rate due to cardiogenic oscillations that show up in the respiratory wave. Another source can be severe flow limitations that cause a halting inspiratory flow that shows up in the respiration rate. In others, we have seen a form of central apnea that is helped by using bilevel with either adaptive servo ventilation or an extended inspiratory pressure support that allows for a full breath once inspiration begins, and removes the oscillations. In every case above, the patient is not hyperventilating, but has an underlying normal or even slow respiration rate with a highly disturbed respiratory wave that appears like hyperventilation. True hyperventilation is not sustainable due to the loss of carbon dioxide from the blood stream that results in a reduction of respiratory drive and periodic central apnea. Hyperventilation or respiratory oscillation that seem to go on for long periods of time are actually a form of obstructive or central respiratory disturbance that we can sometimes mitigate. This requires analysis of the respiratory wave. How have you determined he is breathing so rapidly?

Here is an example of how we can use OSCAR to view flow limitation and interpret causes and possible mitigation approaches. In this example the original poster did not continue to follow-up. http://www.apneaboard.com/forums/Thread-...using-CPAP

In this example, the author resolved the problem of hyperventilation by using ASV http://www.apneaboard.com/forums/Thread-...#pid223896 Long thread, but you can start where I linked and skip to near the end to see the resolution results.

[MrsGrohl]

Hi sleeprider, thanks so much for such a detailed response. I have watched him, looked for the movement of his chest in and out with each breath, and counted. Thankfully he has phoned them this morning, they've upped the rate and they're monitoring him remotely (fancy, can't do that on mine!!) for the next seven days and they'll go from there. Hopefully he's on a path to a resolution one way or the other. I'll definitely get that programme and download the data if we don't get anywhere, but I'm hopeful the team at the hospital will help. As I said, I massively appreciate you taking the time. Helen x