[Pressure] Lower respiratory rate after EPR, ok or too low?

[cupcakechinchilla]

I enabled EPR 3 on Mar 27th and have noticed a significant drop in respiratory rate since. I am getting deeper sleep but feel a little more tired in the afternoon than I remember (that that could just be the heat wave!). I was wondering if anyone can tell me if the current respiratory rates look alright.

Thank you!


Before EPR was enabled:
   

Last night:
   

[Gideon]

Your respiratory rate would be somewhat down since with EPR you would be breathing deeper and thus not have the need for a higher breathing rate.

[cupcakechinchilla]

Thank you. In your experience, new levels look typical? Not too low or too high?

[Gideon]

yes, but you can tell more by looking at the flow rate curve where you can see the individual breaths.

[hh9797]

You are also looking at that slightly backwards as well, let's look at the two dates given
5/27
99.5% highest -31.80
which if I am reading that right it would be the average or median of the top 0.5% of the data points
95% highest -22.60
which if I am reading that right it would be the average or median of the top 5% of the data points
Median - 17.20
Remember Median just just the middle number in a set of numbers it is not the average so if you had the numbers 0, 0, 0, 1, 39, 48, 967 the median of that set of numbers is 1 despite the average being 150.7
minimum - 2.6
or putting all in order                             31.8, 22.6, 17.2, 2.6
now 6/14 the numbers in the same order 26.8, 21.4, 16.8, 4.4

Now to break down that data you absolute quickest rate was 5 greater BUT that only deals with 0.5% of the data points so that number doesn't hold that much weight.
Your top 5% quickest breathing rate was 1.2 greater which sure may be 5% quicker but that is only roughly 1 extra breath per 60 seconds.
Median sure was .4 greater but like I said that means absolutely nothing because Median is a totally worthless number as per my example of a median, the data you would want to show is ideally the mean or average or second best would be the mode (the number that occurs most often) but median is almost useless.  Though I know you can not get that data with Resmed machines seeing as in Oscar it says right in the CPAP settings "Note: Due to summary design limitations, ResMed machines do not support changing these settings" above the settings that would allow you to change between median, mean, and mode.
And lowest rate actually increased by 1.8 meaning even though your peak (fastest) breathing decreased post change your slowest actually nearly doubled. And as such if you take into account that before hand your slowest was half the rate then that accutaly explains the 4 difference in the peak highest because odds are your quickest rate was immediately after your slowest rate trying to catch up on your breathing.

Think of this this way if you are stationary you have a certain rate you breath on average, but then if you were to increase your C02 levels, wither that be from burning more oxygen via running or by someone holding your head under water at a pool or your breathing rate slowing to a crawl immediately following that CO2 build up you are going to breath much more rapidly to get that CO2 out of your body to allow new O2 in, not necessarily hyperventilating but still breathing more rapidly. As such when your minimum rate is 50 lower you can expect your max rate to increase as a direct result of trying to catch up from that minimum rate.

You can see this quit clearly in my data since while I have been using the machine for a longer time I didn't actually get an SD card to save the data till recently If you look at 6/9 you will see that while my 95% and median rates were pretty much unchanged from the norm with having a breathing rate of 0 breaths per minute because of having 3 back to back 20-30 second long apneas once I started breathing again my peak 99.5% breathing rate jumped up from the average of 32 .6 on other days to 42.2 (actually peaking at 52.8, but like I said it takes either the average or Median of the top 0.5% to give the 42).2 on that day because right after not breathing for over a minute straight my body tried catching up on removing the CO2.

[cupcakechinchilla]

yes, but you can tell more by looking at the flow rate curve where you can see the individual breaths.

So if I understand correctly, compare the flow rate curves for the same two dates, and I should see a LOWER flow rate, as well? And if so that is a sign of at least some improvement?

[cupcakechinchilla]

You are also looking at that slightly backwards as well, let's look at the two dates given
5/27
99.5% highest -31.80
which if I am reading that right it would be the average or median of the top 0.5% of the data points
95% highest -22.60
which if I am reading that right it would be the average or median of the top 5% of the data points
Median - 17.20
Remember Median just just the middle number in a set of numbers it is not the average so if you had the numbers 0, 0, 0, 1, 39, 48, 967 the median of that set of numbers is 1 despite the average being 150.7
minimum - 2.6
or putting all in order                             31.8, 22.6, 17.2, 2.6
now 6/14 the numbers in the same order 26.8, 21.4, 16.8, 4.4

Now to break down that data you absolute quickest rate was 5 greater BUT that only deals with 0.5% of the data points so that number doesn't hold that much weight.
Your top 5% quickest breathing rate was 1.2 greater which sure may be 5% quicker but that is only roughly 1 extra breath per 60 seconds.
Median sure was .4 greater but like I said that means absolutely nothing because Median is a totally worthless number as per my example of a median, the data you would want to show is ideally the mean or average or second best would be the mode (the number that occurs most often) but median is almost useless.  Though I know you can not get that data with Resmed machines seeing as in Oscar it says right in the CPAP settings "Note: Due to summary design limitations, ResMed machines do not support changing these settings" above the settings that would allow you to change between median, mean, and mode.
And lowest rate actually increased by 1.8 meaning even though your peak (fastest) breathing decreased post change your slowest actually nearly doubled. And as such if you take into account that before hand your slowest was half the rate then that accutaly explains the 4 difference in the peak highest because odds are your quickest rate was immediately after your slowest rate trying to catch up on your breathing.

Think of this this way if you are stationary you have a certain rate you breath on average, but then if you were to increase your C02 levels, wither that be from burning more oxygen via running or by someone holding your head under water at a pool or your breathing rate slowing to a crawl immediately following that CO2 build up you are going to breath much more rapidly to get that CO2 out of your body to allow new O2 in, not necessarily hyperventilating but still breathing more rapidly. As such when your minimum rate is 50 lower you can expect your max rate to increase as a direct result of trying to catch up from that minimum rate.

You can see this quit clearly in my data since while I have been using the machine for a longer time I didn't actually get an SD card to save the data till recently If you look at 6/9 you will see that while my 95% and median rates were pretty much unchanged from the norm with having a breathing rate of 0 breaths per minute because of having 3 back to back 20-30 second long apneas once I started breathing again my peak 99.5% breathing rate jumped up from the average of 32 .6 on other days to 42.2 (actually peaking at 52.8, but like I said it takes either the average or Median of the top 0.5% to give the 42).2 on that day because right after not breathing for over a minute straight my body tried catching up on removing the CO2.

Took me a few times to wrap my head around this. Very informative!

What are the ramifications of the current status? Meaning, if my slower breathing is lower and my faster breathing is higher, could that lead to more hyperventilating? Is one ideal versus the other, or is it a wash?

[hh9797]

That would be a question for your doctor and not for on the forums. I can explain the reason why your highest breathing rate was higher when your lowest breathing rate was lower, but I can not analyze the data in full. My point was simply that looking at the highest highs can be misleading because the highest highs would most likely happen on the same days as the lowest lows. The fact that prior to the change your highest high was 4 or 5 higher then after the change does NOT mean after the change you are breathing slower if the lowest low is inverse of the highest high. As such you may think you are breathing less often but unless you have the mean (adding all data points and dividing by how many data points there are), or second best the mode (finding the number that appears the most often in all the data points) then you don't really have data that would support or decline that claim since the Median (taking all data points and taking the data point that happens to be in the very middle of the data) is pretty useless as per the example of 0,0,0,17, 39, 87, 967 the median being 17 despite the mean/average being in the hundreds. Unfortunately with ResMed machines there is no way to get the mean or mode data and you can only get the median data the most useless of the three.


The two main points to take from what I wrote was 
1) The Median is useless and very misleading
2) The slower your slowest breathing is increases the chances of your highest breathing rate being higher to "catch up"

The fact that your lowest rate after the change was not as low as prior to the change would explain why your highest rate was higher before the change because those two numbers are very likely to have an inverse relationship (not always but it increases the likelihood) and as such the data you think reads one way can very much read the opposite way of what you are interpreting but without the mean/average there is no way to verify one way or the other.

But yes from that information you could conclude that the longer your apnea event takes the increased CHANCE of hyperventilating in order to expel that built up CO2 from when you were not breathing. It is not always the case but is increases the odds. But again that would be a question for your doctor to explain because they are the ones who have more training and probably more detailed information that you do not have since let's be fair CPAP manufacturers would not want to give it's standard user access to 100% of the data without requiring going to the doctor to get that information so that people don't accidently do something stupid by trying to self medicate and change settings outside of a safe range because they misunderstand what the data is saying. Plus there are certain things that people who look at the data all day every day can pick up on that the standard user would not catch off of just their own data.

[DaveL]

Thanks for the wonderful explanations here. You've helped me understand better.