Respiration climbing higher

[michael9346]

I have pretty much had my apnea well under control the past month or two. I have a concern about my high respiration rate. It seems to be getting higher and I am afraid it could lead to something serious. I have had a heart attack in the late 1990's, a triple heart bypass in 2004 and have been dealing with A-Fib since 2012. I have my first sleep doctor's appointment next Wednesday since my sleep study in February, but expect very little out of him. All he can say is leave the pressures alone. 

I see my cardiologist in December and she won't even return calls much less move my appointment up. My last stress test was just a few months ago and seemed to be ok according to her. If anyone can look at my screenshot and share their thoughts I would be grateful. Thank you.


   

[Walla Walla]

You might want to try C-Flex on step 1 or 2. It may relax your breathing and slow down your respiration.

[Sleeprider]

I don't think Flex will be useful to alter the resp rate. Tou have a minute vent of 9.6 L/min, and your tidal volume is only 420 ml/min. These statistics are related. If your breath volume is 420 ml, it takes almost 23 breaths per minute to satisfy your respiratory volume demand of 9.6 L (9600/420=23 or 420 * 23 = 9660 ml or 9.6 L/ min).

To lower the respiration rate, you need to increase tidal volume or live with less air, and the latter is not an attractive or comfortable option. Using bilevel it is possible to increase tidal volume using pressure support, which means the difference between IPAP and EPAP does more of the work and more completely fills the lungs. Bilevel machines can also extend the inspiration time and a few other neat tricks. The mechanics of ventilation offer a simple and logical solution for manipulating respiration volumes and rate. The question that should be asked before diving down this rabbit hole is, whether your increase in resp rate has followed a decrease in tidal volume, and what has caused that change. Those are the medical questions. Keep in mind your respiration rate and tidal volume are both well within normal range, but I can't say whether they are normal or optimal for you. Hope this helps you understand your options and the problem, if any, better.

[michael9346]

Thank you WW and Sleeprider for responding. One of my earlier posts was on low tidal volume and before that was the struggle to get a mask that fit.
Sleeprider, we talked about it and you told me Lou Groza was a family friend. I grew up in Parma and used to swim at the Berea Quarries. We talked about my low TV number at that time. (about 260 to 320). I then went back to a F20 Airfit mask from a pillow mask and my tidal volume went from an average 300 to 460 which I was very pleased with. For whatever reason it must have increased my respiration upwards.

I recently downloaded a "snore lab" app and although I am not presently snoring i have listened to sessions where I am rapidly breathing. I am wondering if this may be to a rapid heartbeat from A-Fib? I know very little about this, however I am aware that rapid respiration rates and tidal volume are warning signs leading up to congestive heart failure. With my history of heart disease (possibly from ignoring OSA for 30 years) it's entirely possible.

As I mentioned I will be seeing my sleep doctor next week but I doubt he would listen to anything I was concerned about, and as far as a bilevel machine I'm still waiting on my Airsense 10.

Mike

[mesenteria]

I just checked my own SH readout for yesterday.  My respiration rate was med. 15, but a high of 39.  My assumption is that the higher rates are probably highly coincident with REM, or dreaming during REM.  This would be demonstrated conclusively in a sleep lab.

[michael9346]

Mesenteria, 15 sounds good but 39 and I would feel i just ran a marathon.

[mesenteria]

That or the bogey man was chasing me.  Or I was headed for a military parade and realized I'd forgotten my beret at home. 

[michael9346]

Last night I tried a Resmed P10 and determined this mask is not for me. (it was my back-up mask.) As you can see on the new chart I had major leaks and although my respiration was a little lower than my first chart, my TV tanked out. Is it normal for numbers to change just because of the mask? I had the same problem with the Wisp so I am led to believe I need to stick with my FFM. If the mask can easily change our numbers, how many of us using the wrong mask are fighting events that possibly are caused by poor mask fits? I truly think it is a good idea for us to have a back-up mask due to different nasal problems. Does this make sense?

Mike
[attachment=8850]

[Sleeprider]

Respiatory statistics become more error prone in the presence of leaks. BTW it would help to show the leak graph when that is the subject of your concern.

[michael9346]

Sorry Sleeprider. My subject of concern was not really about the leaks, as I have used both the P10 and the Nuance Pro with the results being low TV and higher respiration rates when there were no leaks. My point was more about the importance of a proper mask fit at the beginning of Cpap therapy, yet no sleep doctor or Clinician emphasizes this importance. Neither my doctor or the 3 dme's took the time or effort to ever give me a proper mask fit. They would hand it to me and have me take it home and "see if it works." Maybe it's just me and the luck of the Irish that I get people here where I live who don't give a rats a$$ about me and my therapy. That's why I have to take matters in my own hand. I'd be willing to bet that's why many come to this forum.  It sickens me to think that there are clinics and medical equipment suppliers who are content about a failure rate of 50% when it comes to Cpap. Thanks for allowing me to vent.
(here is my leak graph)
[attachment=8851]