Sleep Disorders/Non restful sleep
QUESTION: Hello there. I have sleep apnea that I am being successfully treated with CPAP therapy. During sleep study my AHI index looks good and appears to be successfully treated. My normal oxygen sat during sleep has a mean of about 93 to 94 percent but does occasionally range down to the lower 90s to a low of 88 for a brief time. I do not feel that I get restful, restorative sleep. When I look at my numbers, it appears that my respiration rate is all out whack. My wife has been complaining that during sleep I take many short and shallow breaths. The data I have collected from my CPAP shows an average of about 45 breaths per minute. I am 55 years old, am a non smoker, am 6 foot tall and weigh about 195. I ride a road bike and a mountain bike regularly. I think I am in above average physical shape. What could be accounting for the high respiratory count? It makes sense to me that I may not be able to get deep rest when my body is working so hard breathing. Any help or insight would be appreciated. The sleep specialists only seem to be concerned with hypopneas and apneas.
ANSWER: Your cpap pressure undoubtedly has to be lowered. I suggest you call your sleep specialist and tell him you are literally fighting with the machine to breathe, and that you want the pressures lowered. Only he can call the company and give them a script or you the script and have the therapist come out and change the pressures on the machine. Unless you have some other underlying lung or heart trouble, you need to see your pulmonary doctor and tell him the trouble you are having. Everyone reacts differently to what the doctor prescribes and only you can tell him how the rates he sets is affecting you. feel free to email again, Karel
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QUESTION: Thanks for your reply Karel. I lowered the pressure on my machine and my APHI and respiration rates dropped dramatically! Without effecting my oxygen sat. From that I can surmise that my body is getting more recuperative rest. I have another question. My normal oxygen saturation at rest hovers around 94 percent. Is that number ok? Seems to be the same when I sleep.
A. you must call the doctor to see if he wants to lower the pressure. The therapist is supposed to come out and do it. so please make sure you tell him which pressure you lowered and how much. You also should get a script from him for the new pressures and then submit it to the company. Only because if something goes wrong with the machine. legally the company has to know what the parameters are. Its just to cover their hides and yours because if something goes wrong , then they will say you touched the machine. If the doctor says its allright then at least call the company and tell them that you got the script to change the pressures from the doctor, tell them the doctor did it. Next 94% is not great. It should be 97. You might want to let the doctor order you oxygen to pump into the machine for you to wear during the night. Please there are different pressures to change. I don't have clinician guides with me, as each machine is different , so please call the md, tell him what you changed if there is any others you should change with it. also ask him about the o2 pumped thru the machine. feel free to email again Karel also when you increase or decrease pressures sometimes rates need changing which is why the doctor gives you the script, yo call the company that delivered the machine and they send a therapist or the therapist talks you thru it over the phone to change the correct parameters. I only want to make sure its properly set since this is controlling your breathing at night. and I don't want to have you the pressures you lowered it to be the wrong ones.