high respiratory rate

NotMuffy wrote:

Muffy wrote:

zimlich@cox.net wrote:My first sleep study in March of 2008 suggested mild sleep apnea with an AHI of 6 and AHI of 9 in supine position.

In a review of the results, I would also look at the supine-nonsupine breakdown. For instance, if the positional split was 50-50, then the nonsupine AHI would be 3, and then side-sleeping would be a great option.

zimlich@cox.net wrote:A BiPAP machine as I was at a pressure of 18 and still having about 25 AHI an hour.

Certainly a heckuvalot better than AHI 25 with "treatment".

Muffy

Do you think this person is listening to you?

NotMuffy

Not Funny is a better handle !!!

Yes it is clear this person is shy - my guess is not an English speaker & thus uncertain of the comments we (self & Muffy) are making.
Muffy is very direct & better understood as a serious US professional who takes the time to look technically at the situation. That
can be lost if in fact (as I am wondering) that the person is non English or particularly shy & thus is missing the good intent.

Spoofing Muffy as you have done is perhaps unkind & pointless & does nothing to help either of us ?. No ill intent was conveyed ?.

So why ?

DSM

dsm wrote:Not Funny is a better handle !!!

Yes it is clear this person is shy - my guess is not an English speaker & thus uncertain of the comments we (self & Muffy) are making.
Muffy is very direct & better understood as a serious US professional who takes the time to look technically at the situation. That
can be lost if in fact (as I am wondering) that the person is non English or particularly shy & thus is missing the good intent.

Spoofing Muffy as you have done is perhaps unkind & pointless & does nothing to help either of us ?. No ill intent was conveyed ?.

So why ?

DSM

Lord, Give Me Strength...

NM

dsm wrote:my guess is not an English speaker

This poster is clearly a "Newnited States" Southerner (although some people would not consider the Southern Dialect "English" per se). The dialect may be be somewhat tainted by spending a little too much time in the flatlands.

NotMuffy

I don't know if y'all are talking to me anymore or just to each other.
Although my initial diagnosis was "mild" OSA, the excessive daytime sleepiness ruled my life so I opted for treatment with CPAP. The doctor I had then only saw me once every six months and though he said everything was fine he increased my pressure without telling me. I changed to the doctor I have now who sees me every six to eight weeks and talks to me about what's going on with my OSA. Certainly my sleep apnea worsened and I was undertreated for a time. At the present my AHI and AI numbers are reasonable with AI consistently under 5. I have never had insomnia. Now that I have talked to my doctor about the respiratory rate increase on some nights, and because I feel no ill effects I am satisfied at the present. If I start to feel bad I'll move my next appointment up.
I'm a RN with a BSN and though I use common sense and make sure I feel confident in the ability and professionalism of my doctors, I don't nurse or diagnose myself. I do however make my needs known and make sure I get proper attention and treatment.

I did ask for your ideas and I thank each and everyone of you who thought about my questions, asked me questions, and gave me your advice and ideas.
I have been listening to you.
Mary Zimlich

zimlich@cox.net wrote:I don't know if y'all are talking to me anymore or just to each other.

Probably a mix.

I believe an important point to be made is that a case of OSA that appears to get substantially worse with pressure therapy, as your case suggests, could very well be Complex Sleep Apnea Syndrome, described by Thomas et al a few years ago:

http://www.medscape.com/viewarticle/515202

However, if everything's as peachy as a hog covered in thick maple syrup and grits now, then certainly arbitrary dial wingin' would not be in your best interests.

Muffy

Muffy, Thank you for the link; it's beyond my level of understanding as a complete layperson on the subject of OSA. I am taking my machine in to have the data downloaded and now know some further questions to ask my doctor.
I am originally from the heart of Dixie, but have lived in Virginia since 1977.
I have never been flamed in quite your style before and don't understand what you're trying to say to me.
Plain straight forward English minus the colloquilisms might be easier to understand.
From what you've said I realize I should put this in the hands of my doctor, rather than trying to find reason on a discussion group. No offense intended (one thing I do possess is good manners).
That would have been my advice to anyone else who posted the same question. I guess I've been foolish.
I thank you again for your time and the link.

Mary Zimlich

Mary, I hope you'll stick with this message board. I'm a Southerner (Tennessee.) I'm used to Muffy's quirky humor, and appreciate it. And he's used to my accent...for the most part.

Truly, as confusing as some of the back-and-forths can be, there's a lot of good information to be gleaned here.

Do please keep posting your questions. That's how we all learn. You're very, very welcome here.

If it were me, I'd pay especially close attention to what the posters nicknamed -SWS (he hasn't commented in this thread, but do a Search for some of his posts) and Muffy write.

NotMuffy wrote:

dsm wrote:Not Funny is a better handle !!!

Yes it is clear this person is shy - my guess is not an English speaker & thus uncertain of the comments we (self & Muffy) are making.
Muffy is very direct & better understood as a serious US professional who takes the time to look technically at the situation. That
can be lost if in fact (as I am wondering) that the person is non English or particularly shy & thus is missing the good intent.

Spoofing Muffy as you have done is perhaps unkind & pointless & does nothing to help either of us ?. No ill intent was conveyed ?.

So why ?

DSM

Lord, Give Me Strength...

NM

It only dawned on me later that NotMuffy was probably Muffy being Muffy

Sorry for not waking up earlier

DSM

dsm,
Haven't meant to ignore your questions. I might have answered some of them. I'm 57, in fairly good health physically except for a painful right knee and hip. I can walk three miles, no problem.
I have other medical/psych/neurological issues- bipolar, hypothyroid, benign essential tremor, something that looked like early onset dementia currently treated successfully with aricept (some days I just made no sense and got lost, stuff like that), GERD in the past- no problems for a while, continued daytime sleepiness and on Nuvigil. No insomnia, sleep 9-11 hours a night. I'm 5'4" 145 lbs.
I had a sleep study done because excessive daytime sleepiness was ruling my life. I've never really followed my sleep study numbers (except the first two in '08), but not the ones in March of this year. I'm trying to get the dictation now. Im presently using the ResMed VPAP Auto 25 IPAP 22, EPAP 14, PS4 since 11/18/09. My AHI and AI have been mostly on a downward trend with these settings. Eight of the last 10 nights my RR rate has been up to 43-50. Before that it was normal.
I'm going to get my machine data read the first of next week. As a layperson I didn't know whether or not to be concerned as I feel fine. I finally did call my Doctor, hence getting the machine data read.
Thanks for your time and help.

Mary Zimlich

Mary

Thanks for that extra input, it fills out a good perspective of your therapy & is very helpful to any of us wanting to contribute in any way.

DSM

Mary Zimlich wrote:something that looked like early onset dementia currently treated successfully with aricept ...

Aricept also has another interesting effect. In a 2008 study, it cut the AHI of OSA patients in half (in Alzheimer's patients, anyway):

http://chestjournal.chestpubs.org/conte ... l.pdf+html

Muffy

Mary Zimlich wrote:Thank you for the link; it's beyond my level of understanding as a complete layperson on the subject of OSA.

Basically, a significant number of OSA patients (usually estimated to be about 15%) develop central and/or mixed apneas when pressure titration, especially aggressive titration, is performed. In other words, they can get worse instead of better. A more detailed look at your sleep reports (the "long" report, which includes graphs of the nights' events), should shed more light on whether or not you are part of this group. Certainly, the numbers that you originally posted strongly suggest that you fit into this category.

Now again, if everything is going fine, then it wouldn't necessarily make sense to start fiddling with things.

However, a careful review may show that lower pressures can be utilized with the same or better results, and lower pressures, of course, are usually more comfortable.

As an aside, current thinking is that this worsening effect subsides on its own after a period of time, perhaps offering explanation as to why your numbers are improving. Overall, a key piece of information in all this is to see if you have a high percentage of central apneas vs obstructive.

Muffy

rested gal wrote:And he's used to my accent...

My favorite one is

rested gal wrote:DAYYYummmmm!!!

Muffy