Spikes in Tidal Volume

[john5757]

Would this be a cause of concern with the spikes?

[JDS74]

There is a phenomenon during sleep called sighing.

The person periodically takes a single deep breath and then exhales followed by resumption of normal breathing pattern.

This is apparently a common phenomenon with no sleep disturbance significance or so my neurologist/sleep specialist thinks. I see it frequently in my waveform data.

[avi123]

Is it this phenomena:

Nocturnal moaning and groaning-catathrenia or nocturnal vocalizations

http://www.ncbi.nlm.nih.gov/pubmed/21380609

[JDS74]

Interesting but I don't think so. The "sighing" thing is a single inhale-exhale cycle that, for me, lasts aprox. 4 seconds corresponding to my sleep breathing rate of 15 BPM.

[avi123]

James, I see a similar graph of Tidal Volume spiking with this James (age 36!):



Source:

http://www.apneasupport.org/post191044.html?style=2


Also, CSR:

[avi123]

IMO, the treatment for the Tidal Volume Hyper Ventilation (spikes) is in additional O(2) supply.


Reference:


CONCLUSION:

The data demonstrate that using a titration protocol with CPAP and then PAP with O(2) effectively eliminates CSA in individuals with underlying comorbid conditions and prescription opioid use. Comparative studies with other therapeutic modalities are required.


http://www.ncbi.nlm.nih.gov/pubmed/23066368

[john5757]

avi123

So you saying that having a large number of spikes is the body trying to get enough 0² and keeps resetting the blood CO² levels? I read that hyperventilation is not the best way to increase o² levels as normal steady breathing?

[JDS74]

IMO, the treatment for the Tidal Volume Hyper Ventilation (spikes) is in additional O(2) supply.

Reference:

CONCLUSION:

The data demonstrate that using a titration protocol with CPAP and then PAP with O(2) effectively eliminates CSA in individuals with underlying comorbid conditions and prescription opioid use. Comparative studies with other therapeutic modalities are required.

http://www.ncbi.nlm.nih.gov/pubmed/23066368

avi123:

I seemed to miss something in the referenced article. It seems to be discussing people with CSA and with comorbid conditions and doesn't seem to have anything to do with tidal volume spikes in respirations.

O(2) supplementation may very well help with the tidal volume spikes but this article doesn't indicate such a connection.

[john5757]

I know that some spikes are normal but if you get many of them at 4 to 5 times the normal rate I think that the body is trying to tell me something. Sighing as one poster mention is more of a emotional or anxiety response when you are in deep sleep? Not sure that is really the case here. I am going to see my new sleep doctor this week.

[avi123]

James and John, I am relating to the two modalities to treat the hyperventilations (spikes in the Tidal Volume graph) that are mentioned in my above links to reports, in this thread:

1) "Either positive pressure therapy (PAP) or supplemental oxygen (O(2)) may stabilize respiration in CSA by reducing ventilatory chemoresponsiveness",

Treatment of central sleep apnea in U.S. veterans.

Chowdhuri S, Ghabsha A, Sinha P, Kadri M, Narula S, Badr MS.


and

2) Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).

Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).

Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.

[john5757]

AVI123

The first study says to add supplemental O² may help stabilize respiration

The second says to add CO² re-breathing may help with respiratory instability.

While I am not a medical expert it seems that the two studies statements contradict with each other, in other words does not make much sense to me.

[avi123]

John yes, they are the opposite but we need to find which one is the needed one, or possibly both.

Check this:

http://www.normalbreathing.com/CO2-breath-control.php

Breath control in the sick: increased role of O2

Older man breathing oxygen Control of breathing of sick people is done, in addition to CO2, by current blood O2 concentrations. The urge for oxygen gets stronger with the advance of many diseases.

The control of the breathing of sick people is accomplished by blood and brain CO2 concentrations and O2 drive, which becomes stronger with progression of chronic diseases and increasing cell hypoxia due to increased respiration (elevated minute ventilation).

In severely sick people, O2 can become the main factor in regulation of respiration.

The change in air composition during human evolution and evolution of animals on the Earth was the key factor that led to appearance of chronic diseases. This is because hyperventilation was beneficial for creatures living in primitive air with very low O2 content and high CO2 content 1-2 millions of years ago, but overbreathing destroys health now.


Also:

Pathophysiology of Central Sleep Apnea

http://emedicine.medscape.com/article/3 ... view#a0104

[Todzo]

AVI123

The first study says to add supplemental O² may help stabilize respiration

The second says to add CO² re-breathing may help with respiratory instability.

While I am not a medical expert it seems that the two studies statements contradict with each other, in other words does not make much sense to me.

One group posits that as the blood moves toward a hypocapnic state it tends to hyper-sensitize the peripheral chemoreceptors. In other words blowing off too much CO2 causes the resultant blood chemistry to make the carotid bodies more sensitive to deoxygenated blood cells and so produces a larger breathing signal than is appropriate for the current metabolism levels.

The larger breathing signal then further reduces the blood CO2 levels which reduces the flow of blood to the brain and separates the central from peripheral chemoreceptors. The control of breathing therefore becomes very unstable.

Well now, if you add O2 to the incoming air then the proposed hyper-sensitized state of the peripheral chemoreceptors would have much less effect. That is, it takes less breathing to satisfy what the chemoreceptors would be happy with. Say they normally want to see “no more than 4% deoxygenated blood cells in the blood on the way to the brain” (sensing at the carotid bodies). Then they become hyper-sensitized and so want to see “no more than 2% deoxygenated blood cells in the blood on the way to the brain”. If you are using supplemental O2 you can meet that criteria with a lot less breathing. Less breathing results in better CO2 maintenance.

Perhaps the peripheral chemoreceptors become hyper-sensitive due to excessive central nervous system activity or stress hormone levels. Whatever the source supplemental O2 would quiet things down.

Supplemental O2 seems to initially work to stabilize breathing but seems to become less effective over time. I have found the re-breathing approach is consistently effective. That said, I use it only as necessary (2-3 months a year).

[mollete]

You're getting colder...

[Todzo]

AVI123

The first study says to add supplemental O² may help stabilize respiration

The second says to add CO² re-breathing may help with respiratory instability.

While I am not a medical expert it seems that the two studies statements contradict with each other, in other words does not make much sense to me.

One group posits that as the blood moves toward a hypocapnic state it tends to hyper-sensitize the peripheral chemoreceptors. In other words blowing off too much CO2 causes the resultant blood chemistry to make the carotid bodies more sensitive to deoxygenated blood cells and so produces a larger breathing signal than is appropriate for the current metabolism levels.

The larger breathing signal then further reduces the blood CO2 levels which reduces the flow of blood to the brain and separates the central from peripheral chemoreceptors. The control of breathing therefore becomes very unstable.

Well now, if you add O2 to the incoming air then the proposed hyper-sensitized state of the peripheral chemoreceptors would have much less effect. That is, it takes less breathing to satisfy what the chemoreceptors would be happy with. Say they normally want to see “no more than 4% deoxygenated blood cells in the blood on the way to the brain” (sensing at the carotid bodies). Then they become hyper-sensitized and so want to see “no more than 2% deoxygenated blood cells in the blood on the way to the brain”. If you are using supplemental O2 you can meet that criteria with a lot less breathing. Less breathing results in better CO2 maintenance.

Perhaps the peripheral chemoreceptors become hyper-sensitive due to excessive central nervous system activity or stress hormone levels. Whatever the source supplemental O2 would quiet things down.

Supplemental O2 seems to initially work to stabilize breathing but seems to become less effective over time. I have found the re-breathing approach is consistently effective. That said, I use it only as necessary (2-3 months a year).

I think it would also be good to add that adding supplemental O2 or CO2 (re-breathing or otherwise) are steps likely to have side effects. Today I will be spending some quality time with my machine during the day to help breathing reflexes with the machine while breathing quietly become more established in my reflexes. I will also be doing some aerobic steps and may well do some 85% of maximum heart rate work to help my breathing reflexes in general. I will also do some meditation and prayer.

I think that there are many things we can do to add to our health that do not involve pharmaceuticals or mechanical splints and that we should concentrate on those things.