Thanks for that reply! I have UARS and never have obstructive events. Literally never. So the EPAP setting is arbitrary for me. Because of my theory that EPAP over 7 cm causes normal tension glaucoma (happy to expound), I try not to go too high on that setting.Respirator99 wrote: ↑Sun Apr 24, 2022 12:58 amI'd be interested in the answer to this. As I said, I have seen the same thing in my traces and it doesn't seem to cause any specific problems. I had a very thorough heart health work-up a couple of years ago and it was sound as a bell, so I don't think it's associated with any heart issues. Central apnea can be largely a neurological problem but again I've had no specific symptoms in that regard.
My understanding is that EPAP primarily controls obstructive events and pressure support helps with central apnea. I read something on the Resmed site a few years ago to the effect that if your PS is high enough (they recommend PSmax = 15) then all central apneas are eliminated and any events that do occur can be regarded as obstructive. Therefore EPAP should be set high enough to reduce the number of obstructives. In my case I have EPAPmin at 5 with PSmin = 3. This gives me the equivalent of P = 8 with EPR = 3 on a conventional CPAP, and that is a comfortable place for me. EPAPmax and PSmax are both at 15, giving a potential IPAPmax of 30 if the stars align, though I don't think it's ever got that high.2. What ASV settings has the most effect on hyperventilation and centrals ? Is it Max PS or Max pressure or EP? I'm thinking Max PS is likely the most impactful. Again, an extensive literature search yielded nothing. But I'm sure this is respiratory therapy 101.
Respiratory Rate of 7 on ASV - UARS x 13 years
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
[img[/img]
I use Apple Watch and I have no significant PO2 drops during these bradypnea periods. I also own a WatchPAT and could wear it for continuous PO2.
But with UARS, I never have obstructive events or significant hypoxemia w/o PAP.
Will upload entire SD card if you like to a Sync account that anyone could download.
Thanks for your ideas!
I've uploaded a zoom in from the 4-20 tracings and another from last night. The red rectangle outlines the low RR episode with perfect flow curves. I'm thinking N3, not REM.Rubicon wrote: ↑Sun Apr 24, 2022 5:35 amCan you load a zoom screen shot of the first episode? The expiratory times don't line up.
That's a weird sleep period.
Feel like uploading the whole SD card to dropbox for dissecting?
Conceivably could be REM-related.
Got an oximeter to simulmonitor with the ASV?
I use Apple Watch and I have no significant PO2 drops during these bradypnea periods. I also own a WatchPAT and could wear it for continuous PO2.
But with UARS, I never have obstructive events or significant hypoxemia w/o PAP.
Will upload entire SD card if you like to a Sync account that anyone could download.
Thanks for your ideas!
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- RR = 7.jpg (895.51 KiB) Viewed 1151 times
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- RR = 7 #2.jpg (958.35 KiB) Viewed 1151 times
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
Do you have a DropBox link I could upload to ?
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
You need to create that at your end.
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.
Make each sensation a little bit stronger.
Experience slips away.
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
By weird sleep period, your bedtime is 4 AM. I mean, there are night owls and there are night owls.
I'd still have to bet REM as the location is about right (first starts at ~90 minutes after sleep onset)(assuming you're sleeping) and it would be unlikely to have a big block of N3 later in the night.
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.
Make each sensation a little bit stronger.
Experience slips away.
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
Very artsy breathing pattern.
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.
Make each sensation a little bit stronger.
Experience slips away.
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
My bedtime is 1:30. I may have fallen asleep w/o PAP then but it on later.Rubicon wrote: ↑Fri Apr 29, 2022 4:02 amBy weird sleep period, your bedtime is 4 AM. I mean, there are night owls and there are night owls.
I'd still have to bet REM as the location is about right (first starts at ~90 minutes after sleep onset)(assuming you're sleeping) and it would be unlikely to have a big block of N3 later in the night.
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
If that’s REM I would be pleasantly surprised, as I have high rates of arousals in REM at PSG. So this would be good therapy.Rubicon wrote: ↑Fri Apr 29, 2022 4:02 amBy weird sleep period, your bedtime is 4 AM. I mean, there are night owls and there are night owls.
I'd still have to bet REM as the location is about right (first starts at ~90 minutes after sleep onset)(assuming you're sleeping) and it would be unlikely to have a big block of N3 later in the night.
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
Definitely not awake. I live in a very quiet area, have black-out curtains on my windows and sleep with earplugs. I've always been a VERY light sleeper with my UARS.klv329 wrote: ↑Sun Apr 24, 2022 4:39 pmFor my asv charts, 12 bpm or a little higher would mean asleep, and 7 bpm would mean not asleep. Rough troughs at 7bpm in the respiratory rate chart come with recollections of awakening, smooth troughs at 7bpm come with no recollections of awakenings. It took awhile to figure out the awakenings were due to loud noises like the fire engine going by or the cell phone left on and a call received. I'm sure acid reflux causes awakenings, too, as well as other physical discomforts.
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
Here's a link if anyone wants to download my Resmed ASV sleep data. 118 MB.
For anyone that takes the time to download and have a look: THANK YOU!
https://ln5.sync.com/dl/2bdf1e0f0/p56xa ... h-7h4ps54a
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.
Make each sensation a little bit stronger.
Experience slips away.
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
In no particular order:MRI_Doc wrote: ↑Sat Apr 23, 2022 8:12 pm
1. Does suddenly dropping from a RR of around 12 to 7 on ASV (with metronome-like, sinusoidal flow tracings) indicate any sort of pathology. I know the left ventricle has an "escape" heart rate of about 40 BPM, which kicks in if there's a total block of electrical activity to the LV. I'm wondering if this RR of 7 is a similar phenomenon. Otherwise, as my minute ventilation is maintained (via gigantic tidal volumes), this seems like some really deep, zen-like sleep (likely N3). An extensive literature search yielded nothing, other than HRV peaks at a RR of about 6-7 (which seems like a good thing). Any thoughts?
2. What ASV settings has the most effect on hyperventilation and centrals ? Is it Max PS or Max pressure or EP? I'm thinking Max PS is likely the most impactful.
Since you shared that you were already sleeping for 3 hours prior to the screenshot I must retract my guess of REM (although since they are still of ~90 minute cycles they could be).
And if it's phasic REM it's definitely probably not.
Since it's now very late in the night N3 is most definitely absolutely probably out.
Yes Max PS is most impactful.
Yes those are massive VTs.
So HF (aka sinus arrhythmia) HRV is good (at least up to the point of it becoming LF HRV).
To be continued...
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.
Make each sensation a little bit stronger.
Experience slips away.
Re: Respiratory Rate of 7 on ASV - UARS x 13 years
I think these Z episodes are a result of an aggressive algorithm, overly aggressive settings and some Resmed calculations.
Resmed uses signal averaging for tidal volume, rate and minute ventilation so those parameters are not as smooth as they appear. If you look at I and E:time it looks like normal breath variation.
The Z-episode in the above example (and most of the others reviewed so far) is actually triggered by an arousal. It should have been left alone, but the ASV PS went crazy and started sending in huge breaths. With respiratory drive now happy your respiratory rate drops to 8 cause that's all you need. This continues until another arousal bails you out (note the MV is gradually falling to try to get back to "normal", but (insert slow metaphor here)).
Resmed uses signal averaging for tidal volume, rate and minute ventilation so those parameters are not as smooth as they appear. If you look at I and E:time it looks like normal breath variation.
The Z-episode in the above example (and most of the others reviewed so far) is actually triggered by an arousal. It should have been left alone, but the ASV PS went crazy and started sending in huge breaths. With respiratory drive now happy your respiratory rate drops to 8 cause that's all you need. This continues until another arousal bails you out (note the MV is gradually falling to try to get back to "normal", but (insert slow metaphor here)).
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.
Make each sensation a little bit stronger.
Experience slips away.