Rapid breathing on Bipap

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landscape

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Has anyone experienced 'rapid breathing' with a Bipap? Almost as soon as my husband goes to sleep he starts taking tiny breaths at about one per second. This goes on for about 30 seconds and then he'll take normal breaths for a while. Then the cycle is repeated. During the rapid breathing episodes there is no apparent chest expansion when I put my hand on his chest.

I've taped the sounds and discussed them with the respiratory therapist but everyone is at a loss as to why they occur or how to solve the problem. It is unlikely to be the machine because, for administrative reasons, the machine has been changed to a different make & model within the last few days.

The inspiratory pressure has been increased to 18 recently but that hasn't made any difference.

He is not using the Bipap during the day.
 

Al

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My wife's never mentioned that but I'll ask her later.
AL.
 

MarshaF

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My husband does the same thing - rapid breathing followed by breathing at a regular, steady rate. We are still pretty new to the BIPAP and at first I thought there was a problem with the mask. It does not occur in any regular pattern. Also, on occasion he sounds like he is honking. Haven't figured that one out either.

Marsha
 

landscape

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It's weird isn't it? The rapid breathing I mean. Is your husband's neck affected? I'm going to try to see if supporting his neck makes any difference at all. Are those little breaths about one every second? And does his chest expand when he's doing it? Is he aware it is happening?

The honking/whistling/trumpet sounds are leaks from the mask. I thought at first that I should tighten the straps but the Respiratory Therapist said that makes things worse. There should be a cushion of air at the interface of mask & face. We are now on the third mask and although it's been not too bad for sound the pressure was increased yesterday and we are back to the horn & tuba concert. Sure makes for sleep deprivation.
 

Al

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I asked Lee and she hasn't noticed the short breaths. There is a fine line between the mask being too loose and too tight. It does take quite a bit of experimenting.
AL.
 

CindyM

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I am one of those rare folks who would rahter have it tight. Can't stand the air whistling around my face. I'd rather be closed in, I guess. :-D Cindy
 

landscape

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Last night was a better night . To counteract the position of my husband's neck during the day (bent way forward without the collar--and bent forward even with it) we have been using rather a flat pillow. With the mask I think his head is positioned even flatter, closer to the 'stargazer' position.

Last night I changed the pillow and made sure he had more of a 'chin tuck' . Whether it was this or just chance but he only had a few instances (that I heard) of this rapid breathing and it was only one or two breaths not a whole string of 30 and more.

When I elevated the head of the bed in previous nights it seemed to make it worse but I now think that's because he slips down towards the edge of the pillow.

I have a problem with the sounds because tigthening the straps on the mask causes skin breakdown on his nose and the bony parts of his face. (He's lost a great deal of weight). My current answer is, once he is sleeping well, to take one of our wireless call bells and sleep in the next room. The sounds don't seem to wake him and he can call me when he needs--and I can get some sleep myself!
 

newtown

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I have been on BIPap for 4 years. Is the sound due to air leaking out of his mouth? I have to use a chin strap to keep my mouth closed.
:mrgreen:
 

janf

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I've Heard The Honking Sound I Make And Its Not The Mask Its Me Being Noisey. Jan
 

CindyM

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LOL, Jan- My kids used to complain about my snoring and they were down the hall and behind closed doors! Cindy
 

NvrGiveUp

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backup rate?

Hi landscape,

My partner T also has had tiny rapid breaths (or what seem to be breaths). After a few (maybe 5 seconds) she will have a big chest rise and "normal" breathing afterwards for a while, and it is a cycle. At first I had no idea what this was, I thought the machine was messed up. When I described it to the respiratory therapist she told me that this was happening because T wasn't really breathing. She told me that T was probably taking really shallow breaths,and the big breath was the result of the backup rate kicking in and forcing a regular breath. Before the most recent machine (a couple weeks), T was using a bipap that assists your breath in only after the patient initializes it. There was no "backup rate" on it, so if she didn't breathe or the machine didn't register a shallow breath, no assistance would be given. Now, because of her decreased lung function, she is using the type of bipap that will kick in if it doesn't sense a breath for a given period of time (hers is after 5 seconds). After seeing the strange "little" breaths followed by a big breath, I became very glad that her doc switched her over to this type of machine since it evidently was really needed. She has been getting better rest as well. Good luck and God bless...
Pam
PS A "sleep study" can also tune the bipap to the right setting, not sure if this is standard practice for all pulmonologists, but it should be. At first T didn't have one and they kind of "guessed" what to set it at. Luckilly she eventually did get one after being on the new machine a couple "long" uncomfortable nights. It really helped to get the settings where they should be.
 

CindyM

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Thanks Pam for what is great information. I love it when this board serves this role! BTW, are you and T all packed for your trip? I saw that Mike offered his tips for travel-I was going to tell you that he is the "go to" guy for that sort of thing but he beat me to the punch! Cindy
 

landscape

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Thanks. NvrGiveUp, for the info. I'm glad to hear from others who have experienced this.

Although the repositioining of my husband's neck improved his breathing, we were back to the tiny breaths last night. Not nearly as bad as before, this time only about 3 tiny breaths before he takes a normal breath. But still, it worries me.

I think you are absolutely right, during these periods he is not breathing. He did have a sleep study and it did show he has periods of apnea in addition to his other problems.

The prescription from the pulmonologist as a result of the study was a pressure of 18 for the inspiration and 12 for the expiration. But the respiratory therapists talked with the dr. as they felt he did not have the strength to breath out against that much pressure. So it was left as 4 for the expiratory.

The machine does have a back up rate but it doesn't seem to be overcoming the problem. They also changed something else on the machine that should prevent these tiny breaths.

Re: the noises. He uses a full face mask because he can't keep his mouth closed during sleep. Air escapes between face and mask and the result is the same as if you blew air through a trumpet. When he is almost asleep he yawns a lot, this moves the mask on his face and sets up the situation for leaks. If he is super-tired and goes to sleep right away we don't seem to have as much trouble with the mask leaking. In addition he has tried to tear the mask off in his sleep!

I'll see what kind of a night we have tonight and then call the RT in the morning again.
 
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