[Symptoms] Need help with low respiratory rate issue

[Lfmichel]

I am making great progress, and this forum has been of great help. I have literally zero leakage with current mouth taping (99.5% leak rate is 0). And virtually no apnea events being detected (1-2 per night!).  Feeling oh so much better. However, I do have one nasty issue thats a mystery. Around four nights per week, I have a significant drop in respiratory rate from 15 ish, to 8 ish, and it stays down for 20-30 minutes! It wakes me up when it starts, and I cant go back to sleep until it resolves. I can manually measure RR while I lay there awake, and it agrees with Oscar graph. Any thoughts, or pointers to an expert, would be appreciated.

[Gideon]

Please post both a full night view of your detailed daily charts
plus
3-minute views of both your 15 bpm rate and your 8 bpm rate.

Need to see the 15 min zoomed view and expect to only be able to see the difference in the 8 min rate.

[Sleeprider]

Just to add to Gideon's comment, it is not unusual to see some periods of lower respiration rate, but it is normally associated with higher tidal volume. Slow, deep breaths tend to result in the same minute vent as normal shallower breaths in sleep. You will be able to see how this shift in respiration rate affects respiratory volume by looking at the tidal volume and minute vent charts. For what it's worth, there are no settings available on your Airsense 10 that can influence or change the respiration rate, so we can only look for possible respiratory resistance (flow limitation) an other factors. It may just be an artifact of REM sleep stage.

[Lfmichel]

Thanks Sleeprider. Sounds like I over-reacted to RR being in the single digits. Everything I read indicated that RR so low were a concern, so I may have read too much into that.  You are correct, tidal volume went up during these relatively long periods of low RR (see below). So, maybe just coincidence that when I have these waking episodes (which can occur at any time of the night) that they happen to have low RR proceeding? Maybe just generic insomnia? They tend to resemble a CA to some extent with the trigger stopped breathing not hitting the 10 second detection threshold. The difference being my CAs have just a few seconds of low RR, where these waking episodes have 10-30 minutes of low RR. Thanks for your replies. 

   

[Sleeprider]

We would not want to see RR at low values throughout the night, but it's not unusual at all for some periods of low deep breathing to occur. Minutvent is the best indicator of changes in respiratory insufficiency as it reflects the product of both respiration rate and tidal volume. Long-term dips in minute vent are more likely to be reflected in SpO2 if you were using a pulse-oximeter. We do see an increase in CA events when respiration rates drop to low levels and the breathing cycle approaches 10-seconds. At 8 BPM your breathing cycle is still 7.5 seconds on average, but that can easily go to 10-seconds after a larger breath or sigh. Having this detailed data can reveal many idiosyncrasies that may be concerning, but that probably go unnoticed except for the data.