Respiratory Rate

[caffeinatedcfo]

I have a question regarding Respiratory Rate in Sleepy Head.

If it is showing a nice and steady pattern I'm guessing this means I'm peacefully sleeping. Large uneven spikes I'm guessing I'm awake? Or running from Zombies?

Any thoughts?

[Sir NoddinOff]

To tell when I'm actually sleeping I look at my Respiration Rate, plus my Tidal Volume line, plus my Minute Ventilation line, then correlate them to my software's timeline (the hourly horizontal axis at the bottom). Unfortunately, I can't tell you what your ideal sleep flow line rates in these three categories are because everybody is different, however I can say that when you know you were asleep inspect those three aforementioned flow lines, memorize the patterns, then overlay that data with your precise known sleep times. I realize this sounds hard to do but it's not really that tough. Over several nights, a strong pattern will emerge if you are careful in your observations. You will also be able to spot transitions from wakefulness to real sleep and vice versa, which is actually the easiest part. This critical inspection process is the key to understanding your body/brain entry into the four recognized sleep stages, and as a bonus it lets you drop from your calculations all the minutes/hours you were awake (Tip: these sleep transition periods all look a lot rougher, choppy even). It's very cool to see it all play out at night, as long as you feel good enough in the morning to enjoy it. Summary: Keep records of the things I mentioned above for a week or so... you will begin to see distinct waveform patterns emerge contrasting wakefulness vs sleep.

I intend to write these techniques up in more detail (maybe a video) and will update this post when possible.

[JDS74]

I use the waveform data to do the same thing. Perhaps you could get the equivalent Resmed software and get a similar view. I don't easily see sleep stage but I can see partial arousals, wakenings, and steady sleep.

[Pugsy]

My thoughts in the tutorial thread as your response to the question there.

[caffeinatedcfo]

Thanks everyone.

Pretty much the same pattern every night, except I'm keeping track of conscious awakenings now.

Most of my time since April has been:
1. 3-4 hrs sleep
2. brief awakening
3. 3-4 hrs sleep
4. up for good

Lately I've been sleeping a couple hrs at a time ... max! My physical state is degenerating accordingly and I'm trying to figure things out. It's also taking me longer to fall asleep. I'm normally out within minutes, but lately it's been taking at least a 1/2 hour.

No new meds, no congestion, exercise routine was ongoing but is now starting to backpedal due to the above. Only thing different is that it's fall here in NY.

I'm going to try straight cpap 10cm tonight to see if that helps, but my pressures haven't been changing much lately and AHI has been < 1 as usual.

[caffeinatedcfo]

Here's last night:


Hopefully I'll find after tonight that the pressure increases are causing the mouth-breathing, and if I'm lucky, the awakenings.

[RandyJ]

The pressure increases seem so minimal... Less than 2cm...

One arousal halfway through the night, at the end of a sleep cycle, does not seem like it would have an adverse effect on anything.

Maybe someone can see something I don't...

[Pugsy]

I wonder if the leaks are a potential disturbing factor for overall sleep quality. They wouldn't explain the arousals early on though...minimal to zero leaks for the first half of the night .
Multiple wake ups and trouble getting to sleep and staying asleep will sure make a person feel like crap the next day though.
What does your flow limitation line graph look like?

[caffeinatedcfo]

What does your flow limitation line graph look like?

Ooops, missed it round one:

[RandyJ]

Are you taking melatonin or started/changed any meds or vitamins or other supplements since before April?

[Pugsy]

Well we can mark Flow limitations off the list of possible culprits...yours is very boring.

Any change in how you feel ...aches and pains?

[caffeinatedcfo]

Are you taking melatonin or started/changed any meds or vitamins or other supplements since before April?

No. I hardly slept before April. After switching to nasal pillows 4/22 I started sleeping great with just the one awakening. My physical and mental health improved dramatically over the spring and summer. I've lost 15 lbs since June and added running to my exercise routine.

The only thing I've changed the last couple of weeks is I increased my daily protein intake by 20-30g (I wasn't getting enough for my new activity level).

Pugsy - yes aches in knees and shins sometimes (not constant). Not enough to require meds. Coldness of fingers and toes has returned as well as some stiffness on the right side of neck. Doc is running labs again but we expect them to be normal as they were last year. Circulation is not a culprit.

[Pugsy]

Low level discomfort can affect sleep quality. You might keep an eye out for nights with maybe a little more aches and pains than usual. Doesn't always have to be bad enough to warrant some sort of pain medication. You might try a little aspirin or tylenol or NSAID (whatever your preference is) before bedtime just to see. I know that with the much cooler weather my own aches and pains have increased to more than the usual amount.

I know we like to try to put these reports under the microscope to see if we can spot something going wrong with our therapy that might explain the not feeling so great and sometimes we can spot stuff but sometimes we just can't.
There's just so much more to getting the best quality sleep and feeling the benefits than what we can see on these reports.
I wish it were that easy but unfortunately it isn't often that easy.

[Todzo]

My physical and mental health improved dramatically over the spring and summer.

I do much better in the summer. Now I am wondering if that may be because the sun is out (and I am out in the sun) and the extra vitamin D is helping me.

I've lost 15 lbs since June and added running to my exercise routine. … aches in knees and shins sometimes (not constant). Not enough to require meds. Coldness of fingers and toes has returned as well as some stiffness on the right side of neck.

Your data shows times of unstable breathing which are likely causing arousals. The times where you are breathing more likely affects your blood chemistry to a point where circulation to the extremities is decreased .. “Coldness of fingers and toes”. Last winter I learned if I was breathing too much during exercise I would get pain in my “knees and shins” (arthritis in my case trying to get in) – AND – that reducing my breathing volume (I use a pulse oximeter to see that I do no go lower than 95% with this if low exertion or 96% if high exertion - @2500') DOES INDEED make the pain go away during light to moderate exercise.

It appears that this fall I am discovering that supplementing vitamin D helps keep my nighttime breathing more stable and makes breathing in a eucapnic way during the daytime much easier. It is not that I tend to breath heavy all the time, it is that I become “over responsive” to my environment. A bit of excitement or upset would all that would be necessary to throw my breathing off. Now it takes much more to do that.

Those who are working with the D3 hormone (A.K.A. Vitamin D3) (e.g. Dr. Stasha Gominak (note: she deals specifically with sleep and OSA), Michael F. Holick, Ph.D., M.D., Vitamin D Council) seem to be finding that the very low side of the “normal” range of 30-100 ng/L produces a range of symptoms including OSA, pain, and infection.

I think you should have your vitamin D3 levels checked and consider supplementation if they are less than 60.

[caffeinatedcfo]

Thanks all. I didn't think about vit D. I haven't been doing as much in the yard on weekends like I used to in the spring and summer. Also, when I do I am in pants and sweatshirt vs shorts and tee, so less skin area for absorption.

I know my cpap therapy is fine - it has to be something else.