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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
borgready
 
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Difficulty Recovering From fast breathing using Bipap/Cpap

Postby borgready on Fri Jan 04, 2013 5:04 am

I have noticed that I have a hard time recovering from faster than normal (idle) breathing rates and I was wondering if this is just me or it is the setup of using the cpap/bipap system that has limations on the breathing rate that the mask can handle. I use a full face mask that covers the mouth and nose. I am not sure how this air flow works but I will assume that there is a certain amount of air that is breathed over and over again before it escapes the mask through the air outlet ports. This might allow a build up of CO2 to occur if a persons breathing/air consumption rate was increased. There is a set air flow rate that goes through the mask at all times and you have to take all your air from that air flow. So my guess is that if your air comsuption is more than can be delivered through the mask, then you end up re-breathing air and that increases the CO2 levels. This would then make it more difficult to recover from fast breathing. How close am I on this idea?

I do know that once I take the mask off that I can recover from fast breathing much easier. Maybe this is from stopping the dreaming or maybe its from taking the mask off so that I can get enough fresh air. I am not sure on that. I will assume that I have had a central apnea and that air deficit results in faster breathing as CO2 levels in the blood increase. There is probably a dream factor that is occuring too that accelerates the breathing and heart rate(air consumption). I am usually in some craze dream and starting to get panicked I guess. The dream is one of those crazy chase type dreams that make you feel like your running or chasing something or being chased. You get the fast breathing and fast heart rates. It has not transformed into a death dream yet so I will assume that O2 is not too low. Usually when O2 gets too low the death dream will freak me out and kick me out of dreaming.

Post your experiences with fast breathing and crazy dreams and do you have difficulty getting enough air while using cpap/bipap. Also let me know anything about my idea of the breathing set up of cpap/bipap and the breathing limitions imposed by the mask.

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Julie
 
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Re: Difficulty Recovering From fast breathing using Bipap/Cpap

Postby Julie on Fri Jan 04, 2013 7:50 am

Look up paroxysmal nocturnal dyspnea ... you might find some answers there, or else ask your MD about it.

borgready
 
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Re: Difficulty Recovering From fast breathing using Bipap/Cpap

Postby borgready on Fri Jan 04, 2013 1:48 pm

I looked up paroxysmal nocturnal dyspnea.

If you are starting to get heart failure, does this show up in your inability to get enough air when your breathing demands go up from say after having an apnea. Then by removing the cpap/bipap your able to get your breath back easily. From what I read you would not be able to get your breath back lying down you would have to set up. I can get my breath back from just taking off the cpap/bipap for 15 minutes while laying down and then when everthing goes back to normal I can put the cpap/bipap back on and not have any problems. Yeah I know, this is when you mess up and fall back to sleep not wearing cpap and get really messed up. I have heard of people tearing their mask off and not really waking up. I think I done that one a few times as well.

Is my assumption correct that using cpap/bipap puts a significant load on the heart and lungs and makes it difficult to recover in situations like after having an apnea where your hearts working capacity has been reduced? That would be a reason why people feel the need to tear the mask off while asleep because they can't get enough air.

Anybody know of any studies where they figured out a way to track the hearts working capacity at a reduced oxgen level? So they might say that your heart loses 20% of its working capapcity at a SpO2 of 85. Adrenaline I guess gets you out of that rut where you heart gets weaker from not having enough oxygen during an apnea. I'm making some big assumptions so feel free to correct anything. I do believe that that using adrenaline when the Sp02 level has been reduced takes a toll on the hearts working capacity. I know it has taken me several hour to recover after a bad apnea episodes. Even after several hours, you still don't feel like jumping around that much even though you think everthing is back to normal. Its not. I have found out by going out and doing some activity that your hearts working capactity is reduced so that your heart starts giving off tell tale trouble signs that its done more than it should. If you ignore those signs that the heart is tiring, then you do damage of some sort and feel real bad afterwards. I guess this is when people have heart attacks. They push push push. Got to do this or that. Then the next thing you know your in real trouble. I think each apnea that requires you to trigger adrenaline to get things going does permanent damage of sort. I would like to hear the technical medical jargon on the transformation that occurs in the heart if anyone knows it. It must do damage of sort to the internal workings of the muscle cells.

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kteague
 
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Re: Difficulty Recovering From fast breathing using Bipap/Cpap

Postby kteague on Fri Jan 04, 2013 3:25 pm

BiPAP settings are totally out of my realm of knowledge, so this is more a question than an answer, but seems I remember reading that there is a setting that changes the length of time between breaths. I just remember someone years ago on here saying they felt like their exhales were cut short with a forced inhale too soon, and settings were discussed to give them more exhale time. If this is totally unrelated to your scenario, please forgive the interruption and return to regularly scheduled programming. :D

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Julie
 
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Re: Difficulty Recovering From fast breathing using Bipap/Cpap

Postby Julie on Fri Jan 04, 2013 4:12 pm

And please don't think I was saying that you do have PND, it just was something I thought you might look at and see if you could relate to it. Your doctor would be the one to make the call on that or anything else... I'm also not familiar with bipaps so can't advise you there at all.

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Todzo
 
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Re: Difficulty Recovering From fast breathing using Bipap/Cpap

Postby Todzo on Fri Jan 04, 2013 4:27 pm

Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21206741
May any shills trolls sockpuppets or astroturfers at cpaptalk.com be like chaff before the wind!

borgready
 
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Re: Difficulty Recovering From fast breathing using Bipap/Cpap

Postby borgready on Fri Jan 04, 2013 10:11 pm

I have my bipap set on synchronous so that it triggers pressure change as you start to breath in and changes again as you stop and start to breath out. It will do breaths as fast as you can take them. The flow rate being delivered through the mask is about 30 to 40 l/min. Breaths per minute runs about 13 to 20 averaging about 15. I am not familiar with the engineering of these machines but it would be interesting to see the calcluation methods that would be used to give a person the right amount of air. Those vent holes in a mask determine the flow of air through the mask. So I guess there has to be a serveral times more air flowing through the mask than what a person takes in on each breath to keep up with mixing and removing the exhaled air.

Bio medical engineers do respiratory engineering.

Here is one paper that looks at respiratory engineering.
http://www.artjohnson.umd.edu/respirators/designofrespdev-dave-shade-art-johnson.pdf

Post any other articles you might come across related to respiratory engineering.

I think Julie has it right with paroxysmal nocturnal dyspnea. A weakened heart is not going to pump very well and breathing against cpap increases the work load of the heart. As an example blow out of your mouth and create a good bit of air pressure in your cheek. Your heart rate will slow and you can feel the beat more as though the heart is laboring more. Then do the opposite. Inhale while creating a vaccum in your cheeks and your heart rate goes up and it doesn't feel as though the heart labors as much. I don't know how low O2 and high CO2 affects the heart workload. A high CO2 buildup in the blood will make your heart rate go up and your respiratory rate and effort go up but I am not sure how it affects the blood pressure going to the lungs.

It might make sense to wake up when you come out of a dream and your heart rate and breathing rate is up rather than lie there for awhile dozing in and out of sleep waiting for your heart rate to come down and your blood chemistry to come back to normal. I notice that there is a cycling effect that occurs after a bad apnea. You go from breathing to not breathing and it will usually gets worse(longer apneas). You end up having apneas every few minutes. I have an alarm that sounds off if you have an apnea. That feature should be on all machines so you can correct what ever is going wrong when it happens. So if you see a string of apneas when you look at your data after having a bad night then you know you should have woken up to break the cycle that occurs. I found that taking calcium an hour or two before bed helps in dealing with hypopneas. I guess the calcium helps stabilize the blood chemisty that gets out of wack from a bad apnea or series of apneas.


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