Respiration Rate

[wickedsleepy]

Hi,

Any idea why my respiration rate is higher when I use a full face mask?  Pressures go higher, so I suppose that could be a factor.  Looking at the flow-rate graph, it looks like flow limitations are being handled even with my EPR at 1.  Anyone else have higher respiration rates using a full face mask?  I'm trying to identify reasons why I feel much less rested using my FFM as compared to the nights I can tolerate using my nasal pillows with mouth tape.  I'm wondering if respiration rate is part of it.

Below are my graphs from last night using my FFM, pressure 9-15.4 and EPR at 1.  It's actually not the best example - I typically have larger blocks where the respiration rate is up around 50.   I don't have them when I use my nasal pillows and mouth tape.  Looking for anything that can explain the fatigue and occasional waking up hyperventilating with the FFM.

           

[Sleeprider]

Your elevated respiration corresponds to periods where flow limits are high. your close up does not include one of those periods. You have positional apnea most of the night, and you are breathing through the resistance, but your breathing is really irregular. Do a zoom at just about any other time than 21:00 to 21:30. Increase EPR to 3 and eliminate the cause of positional obstruction. Your zoomed flow rate was immediately after masking up, during ramp and not representative.

[wickedsleepy]

Once I can get access back to the laptop with OSCAR, I will look!  Interesting.  

Why does it not seem to happen when I wear my nasal pillows and mouth tape?  AHI is lower, pressures lower, can roll on my back with much less issue.  Are the higher flow limitations related to the type of mask too?  Or the path of the airflow (nasal only versus mouth too)?

I will try EPR 3 tonight, but I am slightly nervous that I’ll have more central apneas (as I have in the past with higher EPR).  I feel like I have done this before, but I will give it another shot.

[Sleeprider]

Interesting question regarding the mask type. I have to assume you changed the machine response to the type of mask in use? A better answer is it depends on how upper airway resistance arises. If you have issues with your nasal airway like deviated septum, enlarged tubonates or if you're sensitive to having a full-face mask press on your sinuses, then direct nasal pressure will help improve flow through your nose by expanding that airway. A full-face is really an inferior interface and can pull the jaw back, or encourage sleeping with an open, slack jaw restricting airflow further. I would only suggest it if you cannot control air from a nasal interface. You might be able to train yourself to control air with your nasal pressure by learning to talk or sip water while using it. That probably sounds unlikely to you, but most of us with nasal pillows can converse fairly normally and drink water from a straw, and that translates to the subconscious so you can leave tape behind.

[wickedsleepy]

Omg leaving tape behind would be amazing.  Some nights theres enough swelling from either allergies or even small amounts of alcohol that nasal only doesn’t seem to work without waking up with confusion and a headache.  Low oxygen? No idea.  I had septoplasty and turbinate reduction but it’s still not perfect.

Anyway, I have wifi issues at the moment but took a photo of the flow rate at around 11:42pm last night, while asleep, and it looks kinda weird.

[wickedsleepy]

Ok, so I put EPR up to 2 and raised the lower end of my pressure range from 9 to 10.  I hesitated to jump all the way to EPR 3 because I've had some issues with CA's before.  I also switched masks -not because of this but because I have been alternating between my older F30 and the relatively newer (since December) Evora to see which one seals better for me.  Now I remember why raising the EPR didn't really help before and I wound up putting it back down to 1.  This morning, I feel worse.  I did have more leaks last night with the Evora (no matter what I read about fitting it, it doens't really help).  But my AHI was higher last night -could be for a number reasons.    It went from 1.03 the night before (with my F30, EPR 1) to 2.2 last night (with my Evora, EPR 2).  But the most noticeable thing is that I feel much groggier (like I took a bunch of benadryl) and spaced out, like my head is floating and dizzier.  Now I remember this is how I feel when I raise EPR, no matter the mask.  I remember that I felt the same way with the F30 back in like October.  Not sure what to make of that -maybe not enough pressure support on exhale? (that plus the occasional CA/feeling like I can't breathe issue with lower pressures is why I raised the min pressure to 10)  No idea why.  Man... this stuff is such a pain to get right.  I can't just be unable to function all day.

As an aside, I lowered my MAX pressure about a week ago to clamp down on the spikes and the resultant high leaks (which lead to more spokes and tighter straps and higher AHI).  15 was slightly too low so 15.4 seems like a good level that keeps my AHI down, but it could be the higher AHI last night was because it wasn't enough.  

Anyway, I don't have a chart to show because I can't find the SD card.  I either never put it back last night or took it out to view things this morning and misplaced it.  I have no memory of either, so yeah... memory issues not good.  I don't think raising EPR goes well with me.

[Sleeprider]

Wikedsleepy, enter this search term in your browser to see the many other threads related to your situation: rapid breathing tachypenea site:apneaboard.com

[wickedsleepy]

Interesting.  I'll keep reading.  I saw one post where someone suggested that the machine is double-counting the breaths because of the flow limits.  So part of this high resp rate could be fictitious??

[MrIvanDrago]

I notice my respiratory rate goes up with my FFM if I have congestion and I end up breathing more out of my mouth than I normally would.

[Crimson Nape]

The respiratory rate is calculated by how often the flow direction crosses the zero line. Snoring, coughing, or sniffling can affect the reporting of this value.

- Red