Respiatory rate increase

I have been using CPAP or a Resmed Aircurve 10 for the past eight months.

From the very first I could tell my respiration rate was faster on the machine. I think this is part of what has felt uncomfortable for me using it.

My AHI from the sleep study was 72. I am currently running between 6 and 9. Better but still not where I need to be. I have been very slowly increasing my pressure getting my body used to the setting. I had been having pain from the forced breathing at the higher pressures. So I backed off and I'm increasing 2cm about every weeks.

So regarding respiration; My respiration median number on the machine was about 11 when I started. I felt like it was pushing me to breath more shallow and faster breaths from the very start. That has always been the case. Now my respiration median number is almost 13.

I have a very large lung capacity. I play games with my adult daughters singing or making sounds which are essentially a lung capacity competition. I can usually last in one breath what my daughters manage in two full breaths.

So today, I thought I would try to measure my respiration rate naturally. I had my daughter count the number of times I inhaled and exhaled for a ten minute period while resting. Not sleeping which should be ever slower. While resting I respirated 70 times in a ten minute period. That's 7 per minute. The machine has me inhaling and exhaling nearly twice what my body would prefer to do on it's own.

For me, the machine has NEVER made me feel like I had a more restful night's sleep. Just the opposite is true. I wake and often get up early just because I am tired of breathing and keeping up with what the machine demands from me.

Am I right in thinking this is less than ideal? Is there an adjustment I can make to the machine that will allow it to let me take bigger breaths?
Thank you,

Jeff

Several thoughts, Jeff.

Respiration patterns may differ from waking states to sleeping states, and within sleep, they may differ from one sleep stage to another. So your daytime respiration rate is not necessarily a "natural" benchmark for your sleeping RR, and changes in your median RR during sleep may reflect changes in how much time you're spending in the different sleep stages.

It looks like your median tidal volume (amount of air moved during one breath) has gone down a little bit over time while your RR has gone up a little bit, with your median minute ventilation (amount of air moved during one minute) fairly stable. These changes look pretty unremarkable to me, though of course if they concern you, you should talk with your doctor.

You've used two machines with different capacities, and I don't know the extent to which that, plus changes in your settings, may have affected your RR, TV, and MV.

Your machine should not be giving you the sensation of being forced to breathe faster than you want to. Could you look in the clinical menu and see what the trigger, cycle, and Ti settings you are using?

What is most striking to me is that your obstructive apnea is not yet adequately addressed. I recommend increasing your minimum pressure to 13 and your maximum to 20 as a first step. Given the clustering of events, you may have a positional issue, specifically tucking your chin down toward your chest, which makes it easier for obstructive events to occur. Please try using a soft cervical collar to see whether that makes a difference.

When you post your next chart, could you make a few changes? Please move the mask-pressure graph out of your screen shot. Please include the graph for flow limitations and the respiration-rate graph. You can squeeze the graphs into a single screen shot by grabbing the gray bars that separate them and pushing them up. Also, please turn off the calendar so we can see more information in the left panel. (Click on the triangle next to today's date.)

I'd also be interested in seeing a one-minute zoomed-in view of some period when you're sure you were asleep and weren't having an event.

I'll try one more time.

I have only used one machine. I have been using CPAP or a Resmed Aircurve 10 for the past eight months.

I know folks are here mostly to help. That is a very good thing. I really appreciate it.

But MY question is about the respiratory rate. I know my AHIs are too high. I am working on that. But that is not what my question is about. It's about respiration.

Since I started CPAP, I sleep fine. Before I used CPAP, I slept better. With CPAP I wake worn out. I NEVER awakened worn out pre-Cpap even though my AHI for my sleep study was 72. I obviously had/have issues. Yet even pushing my events down to an average of 7 or 8 per hour, I awaken every morning with a very tired breathing system. My ribs and diaphragm are worn out every morning.

Please consider this. My waking resting respiratory rate is 7 per minute. My machine pushes me not to breath at 12-13 per minute.

Here is a thread where another person explained the same respiration issue a number of years ago here. viewtopic.php?f=1&t=11458&p=263806#p263099 I have read where others have described what they felt was the machine pushing them to hyperventilate. Hyperventilate is probably just the wrong term for the same thing I experience. There is no oxygen saturation. Just rapid short natural breaths all night long.

I wish to slow the machine down. I do not breath at a mean average of 12-16 respirations per minute.

Is there a way to make the machine allow me to breath at the rate my body wants to breath at? Or al least give me more time to respirate at a more natural rate for me?

Get your provider/clinical manual for your machine and look at potentially experimenting with the Ti min and Ti max as well as trigger settings to see if it will do what you want.
Those are the only settings that "might" and I stress the "might" part ....do what you want.
Don't ask me which one or how much....I have no idea. Sorry. Making a guess...I would start with Ti max.

Pugsy wrote: ↑

Mon Apr 05, 2021 11:20 am

Get your provider/clinical manual for your machine and look at potentially experimenting with the Ti min and Ti max as well as trigger settings to see if it will do what you want.
Those are the only settings that "might" and I stress the "might" part ....do what you want.
Don't ask me which one or how much....I have no idea. Sorry. Making a guess...I would start with Ti max.

Thank you!