Respiration concerns

[Bigmike52]

My Tidal Volume is constantly very low and I can't seem to get an answer from my sleep doctor or cardiologist as what needs to be done to increase it to more common numbers. I know an average male should be around 500 to 600L, but I am about 340L on a pillow mask and 440L on a FFM. Can losing weight or breathing exercises increase my volume. I am a 72 year old male recently retired and due to arthritis it's extremely hard to exercise. Any information would be greatly appreciated.

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[bombayone]

My Tidal Volume is constantly very low and I can't seem to get an answer from my sleep doctor or cardiologist as what needs to be done to increase it to more common numbers. I know an average male should be around 500 to 600L, but I am about 340L on a pillow mask and 440L on a FFM. Can losing weight or breathing exercises increase my volume. I am a 72 year old male recently retired and due to arthritis it's extremely hard to exercise. Any information would be greatly appreciated.

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Normal tidal volume for a healthy young adult is about 500ml. Considering that you are not young and the lack of your physicians’ concern, I would not be concerned if you are feeling well and generally healthy beyond arthritis. For your general well being maintaining appropriate weight and moderate exercise are beneficial. Many excercises are adaptable to and beneficial for arthritic conditions.

[rick blaine]

Hi Bigmike52,

You posted back in September 2018, asking pretty much the same question.

And I replied to you about the possibility that visceral fat – the fat between organs in the abdomen – might be pushing your diaphragm up, and thus reducing your maximum lung volume.

It's a possibility. A simple chest x-ray would confirm. And if this is the case then, when you ask: "Can losing weight or breathing exercises increase my [tidal] volume?" the answer is: "It could well do – why don't you try it and see?"

Also, tidal volume on its own isn't a critical number. What the key indicator is, is minute ventilation. And on the chart above, your median is 7.25 litres per minute – which suggests you are getting enough air – although that is made up of: 340cc median tidal volume – which is on the low side – and a median resp rate of 20.80 – which is on the high side.

For comparison, a good number for minute ventilation for a male of average height and build at rest is 6 litres per minute – made up of tv 400 cc and resp rate of 15.

In your case, you mention that the FFM gives you 440. If so, then you should, IMO, go with that.

An additional reason for going with the FFM is that, if your tv goes up to 440, your resp rate should come down (for the same minute vent). And that's a good thing. A high resp rate means more CO2 is being blown off than doctors like.

So I would say: use your FFM ... as well as: lose weight.

[Goofproof]

Your doctor could have your lung function tested, if you are really concerned,He ran the test on me twice I considered it a waste of time in my case. Jim

[palerider]

My Tidal Volume is constantly very low and I can't seem to get an answer from my sleep doctor or cardiologist as what needs to be done to increase it to more common numbers. I know an average male should be around 500 to 600L, but I am about 340L on a pillow mask and 440L on a FFM. Can losing weight or breathing exercises increase my volume. I am a 72 year old male recently retired and due to arthritis it's extremely hard to exercise. Any information would be greatly appreciated.

Why are you concerned about it?

Are your oxygen levels low?

But, if you want a higher TV, then buy a Resmed AirCurve 10 Vauto and dial up the PS.

[Bigmike52]

Thanks to all who responded. rick blaine I have been trying to lose weight as that is the cause of most medical problems to begin with. No doubt I will have to use the FFM 20 and let go of the P10. Palerider, I fly solo on all Cpap machines and supplies. I live in a state where we are rated worst in the US for healthcare and one of the highest obesity levels. I am very fortunate to have the equipment I have, much less try to come up with an $1800 Air Curve, not that Medicare wouldn't cover it but because the DME's in this area will not waste their time on Medicare patients. I moved here to be closer to my family but unfortunately at the expense of my health.

Bombayone I am not it good health. I have had 2 heart attacks, triple heart bypass, diabetes, glaucoma and recently survived prostate cancer now sleep apnia for the past two years. Palerider asked "why are you worried about it?" Moving forward I won't! Goofproof, my doctor did request my cardiologist send him copies of any testing going forward. He's the same doctor that pronounced me "cured" last October when I showed him my sleepyhead report showing my AHI is mostly <1.00. When a "sleep" doctor is NOT concerned about a patient sleeping less than 5 hours a night, or anything else on the chart other than AHI, then I have to feel like you goofproof. "It's a waste of time"

[bombayone]

Big Mike:

Thanks for the additional detail. I hope that your health improves. I wish you well.

[palerider]

Palerider, I fly solo on all Cpap machines and supplies. I live in a state where we are rated worst in the US for healthcare and one of the highest obesity levels. I am very fortunate to have the equipment I have, much less try to come up with an $1800 Air Curve, not that Medicare wouldn't cover it but because the DME's in this area will not waste their time on Medicare patients. I moved here to be closer to my family but unfortunately at the expense of my health.

Mississippi?

I'd suggest picking up an inexpensive oximeter, like the CMS50D (if you just want to see oxygen levels during the day) or a CMS50F (if you want to monitor overnight) and check your O2 levels. This should help you to feel better about your ventilation.

If you do decide you need a machine with higher PS, a used S9 VPAP Auto would cost much less, (it's what I have) or you could get a used AC10 Vauto, ... keep an eye out, they show up not infrequently here in the forum, or there's always secondwindcpap.com, .... or craigslist. (all of my machines have come, directly or indirectly through craigslist).

Palerider asked "why are you worried about it?"

Please note, I wasn't being dismissive, I was trying to find out if you had a particular concern, or if it was just "hey, I'm not 'average', (which often isn't something to be concerned about).

[ajack]

Who ever put you on min 10 got the number right. I doubt it is anything to do with your apnea.
Respiration of 20 is within norms, but a bit high. For whatever reason, your body finds it easier to breathe 20 times at 340, (leaky nasal mask, better with FFM) than roughly 12 times at 500 a minute. The obvious answer is to use a FFM or sort out the nasal. It may impact a bit on respiration.

If your doctor agrees it is suitable, as suggested, a BPAP can increase your volume and reduce your breaths. The recording spo2 cms50 is a good idea, to put your mind at rest.

Have you googled it?
https://www.medscape.com/viewarticle/712242

[Bigmike52]

Palerider: Mississippi? No Arkansas. (we keep trying to see which one is #50 and some of the surveys and my experiences picked us this year) Thanks for the advise on the Co2 and S9 VPAP. I will keep my eyes open for that machine. I did have a concern as I read it could be leading up to possible congestive heart failure. When I developed cardio problems I was a patient of the Cleveland Clinic. I am afraid here it may be Goobers Heart Clinic & Auto Repair. (doesn't quite have the ring of the Cleveland Clinic) Thanks for clarifying as I didn't think you were being "dismissive" but rather straight to the point.

[Bigmike52]

ajack, thanks for your concerns. My lowest AHI reading always comes from the P10 pillows, but gives me the lowest TV readings. I just bought 3 supposedly new pillows but have major leaks from them. I will start tonight strictly with the F20 and hopefully this will be the better solution for me. The pillows always have given me the lowest AHI number, but that doesn't make it the best mask.

[palerider]

Goobers Heart Clinic & Auto Repair.

Hey now, I hear Goober does great work... just make sure that when you go in for a valve job, he doesn't confuse the valves for your v8 and your heart... otherwise you'll end up setting off the metal detectors at the airport every single time.

[ajack]

ajack, thanks for your concerns. My lowest AHI reading always comes from the P10 pillows, but gives me the lowest TV readings. I just bought 3 supposedly new pillows but have major leaks from them. I will start tonight strictly with the F20 and hopefully this will be the better solution for me. The pillows always have given me the lowest AHI number, but that doesn't make it the best mask.

It's more than probable that the leaky nasal is missing events, that the FFM is catching.