Respiration rate - please help

Hello - I posted several weeks ago and received no replies. I am hoping a fresh post with a different screenshot will help. I have been on CPAP since June. Every night, my respiration rate goes up as soon as I put the machine on. My normal, resting respiration rate during the day is about 8 BPM. My median, per sleepyhead, while I sleep is now 20. Needless to say, I am noticing no benefits to CPAP. My AHI is usually below 1. My sleep MD (a neurologist), adjusted the pressure from 5-20, to 5-10. I don't know why. I never went above 8 anyway.

Consequence: my asthma is off the charts right now. It has changed my breathing. I don't feel any better on the CPAP.

I would sincerely appreciate ANY feedback.

Thank you.

Fiji wrote: ↑

Sun Aug 05, 2018 8:51 am

Hello - I posted several weeks ago and received no replies. I am hoping a fresh post with a different screenshot will help. I have been on CPAP since June. Every night, my respiration rate goes up as soon as I put the machine on. My normal, resting respiration rate during the day is about 8 BPM. My median, per sleepyhead, while I sleep is now 20. Needless to say, I am noticing no benefits to CPAP. My AHI is usually below 1. My sleep MD (a neurologist), adjusted the pressure from 5-20, to 5-10. I don't know why. I never went above 8 anyway.

Consequence: my asthma is off the charts right now. It has changed my breathing. I don't feel any better on the CPAP.

Maybe it is, maybe it isn't. SH has been known to get the RR wrong in the past, but without seeing breath shapes, (a couple minutes worth) there's no way to know.

Also, your pressure is almost certainly too low, and changing from 5-20 to 5-10 is meaningless, and shows a lack of knowledge on your doctors part.

Actually you did receive one reply but you didn't follow up.
viewtopic.php?f=1&t=172224&p=1258794#p1258794

I saw your original post and the response and was waiting for you to post more information before I said anything because what you posted wasn't particularly helpful. I saw no need to go posting another request and I had nothing to offer at the time.

You might start with the basics...gotta start somewhere.
viewtopic/t158560/How-to-post-images-for-review.html
The respiration graph itself ..all by itself...pretty useless.

If you feel your asthma is worse then you need to be having another chat with your doctor because cpap should not be making daytime breathing (asthma or no asthma) worse.

Pugsy wrote: ↑

Sun Aug 05, 2018 9:12 am

Actually you did receive one reply but you didn't follow up.
viewtopic.php?f=1&t=172224&p=1258794#p1258794

I saw your original post and the response and was waiting for you to post more information before I said anything because what you posted wasn't particularly helpful. I saw no need to go posting another request and I had nothing to offer at the time.

You might start with the basics...gotta start somewhere.
viewtopic/t158560/How-to-post-images-for-review.html
The respiration graph itself ..all by itself...pretty useless.

If you feel your asthma is worse then you need to be having another chat with your doctor because cpap should not be making daytime breathing (asthma or no asthma) worse.

Wow. Ouch. Message received.

palerider wrote: ↑

Sun Aug 05, 2018 8:55 am

Fiji wrote: ↑

Sun Aug 05, 2018 8:51 am

Hello - I posted several weeks ago and received no replies. I am hoping a fresh post with a different screenshot will help. I have been on CPAP since June. Every night, my respiration rate goes up as soon as I put the machine on. My normal, resting respiration rate during the day is about 8 BPM. My median, per sleepyhead, while I sleep is now 20. Needless to say, I am noticing no benefits to CPAP. My AHI is usually below 1. My sleep MD (a neurologist), adjusted the pressure from 5-20, to 5-10. I don't know why. I never went above 8 anyway.

Consequence: my asthma is off the charts right now. It has changed my breathing. I don't feel any better on the CPAP.

Maybe it is, maybe it isn't. SH has been known to get the RR wrong in the past, but without seeing breath shapes, (a couple minutes worth) there's no way to know.

Also, your pressure is almost certainly too low, and changing from 5-20 to 5-10 is meaningless, and shows a lack of knowledge on your doctors part.

thank you so much for taking the time to reply. I can tell you that I wake up feeling like I have been hyperventilating. The RR was confirmed by a respiratory therapist who could look at the data the machine sends directly to the "powers that be"

I am surprised you say that the pressure is too low since my AHI is routinely under 1. Could you help me understand? I have an appointment with the prescribing MD on Wednesday and the more I can understand the better.

Thanks again for reading and helping!

palerider wrote: ↑

Sun Aug 05, 2018 8:55 am

Fiji wrote: ↑

Sun Aug 05, 2018 8:51 am

Hello - I posted several weeks ago and received no replies. I am hoping a fresh post with a different screenshot will help. I have been on CPAP since June. Every night, my respiration rate goes up as soon as I put the machine on. My normal, resting respiration rate during the day is about 8 BPM. My median, per sleepyhead, while I sleep is now 20. Needless to say, I am noticing no benefits to CPAP. My AHI is usually below 1. My sleep MD (a neurologist), adjusted the pressure from 5-20, to 5-10. I don't know why. I never went above 8 anyway.

Consequence: my asthma is off the charts right now. It has changed my breathing. I don't feel any better on the CPAP.

Maybe it is, maybe it isn't. SH has been known to get the RR wrong in the past, but without seeing breath shapes, (a couple minutes worth) there's no way to know.

Also, your pressure is almost certainly too low, and changing from 5-20 to 5-10 is meaningless, and shows a lack of knowledge on your doctors part.

Hi palerider - I'm attaching additional screenshots. I've been told what I have posted is wrong.

Could you turn off the pie chart so the other part of the statistics will move up into view please?

To turn off the pie chart...Preferences/Appearance tab and just remove the check mark for "show pie chart".

Pugsy wrote: ↑

Sun Aug 05, 2018 6:29 pm

Could you turn off the pie chart so the other part of the statistics will move up into view please?

To turn off the pie chart...Preferences/Appearance tab and just remove the check mark for "show pie chart".

For the life of me, I cannot find a "preferences/appearances tab". I looked under "view", I did a help search and couldn't find it. What I could do, was take another screenshot

Preferences is under "File" in the upper left corner next to view.
Appearance is one of the tabs in preferences you can click on.
Preferences lets you customize SleepyHead a bit...various tabs with various choices for customization.

But taking another screen shot works also. I wanted to see what the max RR was.

Curious...what was your AHI without cpap prior to starting therapy and are you on any medications of any kind, if so, what?

Also when you say you aren't "any better" can you be more specific as to what the unwanted symptoms you are having might be that you want gone?
What symptoms are you having that having got any better?

Fiji wrote: ↑

Sun Aug 05, 2018 6:12 pm

Hi palerider - I'm attaching additional screenshots. I've been told what I have posted is wrong.

What we generally need is shown on this web page: https://sleep.tnet.com/resources/sleepyhead/shorganize

Try and make your stuff look just like that (minus the pie chart).

however, to see what your RR actually looks like, pick a smooth section, and zoom in (up arrow) until there's about 2 minutes worth of breathing on the flow chart.... then send that screen shot that, please.

Fiji wrote: ↑

Sun Aug 05, 2018 5:53 pm

palerider wrote: ↑

Sun Aug 05, 2018 8:55 am

Fiji wrote: ↑

Sun Aug 05, 2018 8:51 am

My AHI is usually below 1. My sleep MD (a neurologist), adjusted the pressure from 5-20, to 5-10. I don't know why. I never went above 8 anyway.

Also, your pressure is almost certainly too low, and changing from 5-20 to 5-10 is meaningless, and shows a lack of knowledge on your doctors part.

I am surprised you say that the pressure is too low since my AHI is routinely under 1. Could you help me understand? I have an appointment with the prescribing MD on Wednesday and the more I can understand the better.

The vast majority of people get nothing out of a pressure of 5. Your machine is slow to respond, and thus needs to have the minimum pressure set high enough to head off most breathing disturbances, instead of waiting for them to happen and then responding.

There's more to sleep than just AHI, and raising the pressure some will most likely smooth out some of the disturbances you're having that may be what's detracting from your rest.

Hi Pugsy and Pale Rider --

Thank you both again for your help. Mon/Tue are two of my more brutal work days so I apologize for the delay. My official follow up with my sleep doctor is tomorrow. However, (I work in the medical field) and a colleague emailed a pulmonologist friend of hers on my behalf. His response was, "Most likely she developed CPAP-induced central sleep apnea. That would explain her variable RR at night and worsening gas exchange and asthma symptoms. She should stop using the CPAP today and will need to do a titration study to figure out her optimal positive airway pressure settings she needs to use at home (CPAP vs. BIPAP vs. another mode)."

I will let you know what happens tomorrow, but I want to get the info up in case someone else is on a similar journey.

Fiji wrote: ↑

Tue Aug 07, 2018 4:53 pm

Hi Pugsy and Pale Rider --

Thank you both again for your help. Mon/Tue are two of my more brutal work days so I apologize for the delay.

No apologies necessary.

Fiji wrote: ↑

Tue Aug 07, 2018 4:53 pm

His response was, "Most likely she developed CPAP-induced central sleep apnea. That would explain her variable RR at night and worsening gas exchange and asthma symptoms. She should stop using the CPAP today and will need to do a titration study to figure out her optimal positive airway pressure settings she needs to use at home (CPAP vs. BIPAP vs. another mode)."

I would say that's *highly* unlikely, given that your machine attempts to detect and flag central apneas, and it's not flagging *ANY*.

zero, zip, none, nada. *IF* you were having CSA, or CompSA, then there would be at least some being flagged.

I'd look very suspiciously at the advice from that pulmonologist, who's not even (I'm guessing) seen any data.

palerider wrote: ↑

Tue Aug 07, 2018 5:29 pm

zero, zip, none, nada. *IF* you were having CSA, or CompSA, then there would be at least some being flagged.

boy, am i an old guy? i read that as "CompUSA"!!!

zonker wrote: ↑

Tue Aug 07, 2018 5:37 pm

palerider wrote: ↑

Tue Aug 07, 2018 5:29 pm

zero, zip, none, nada. *IF* you were having CSA, or CompSA, then there would be at least some being flagged.

boy, am i an old guy? i read that as "CompUSA"!!!

So, like, when you started, did you just chisel messages on rocks and throw them at your correspondent?