hi all, just wandered if there is a correct breathing procedure when using a non rebreather mask. Do i just breathe normally or deep breathes, regards shaun

That seems to be personal preference or trial and error. Many swear by the hyperventilation method, as fast and deep as you can.

What works best for me is I empty my lungs completely, then breathe in as deeply as I can with the 02, hold it up to 30 seconds, repeat! Hoping it proves the magic for you it has been for me!

Joe

Hi Shaun. I agree with Joe that it differs for each individual.
I need to hyperventilate the o2 to knock down a hit, but I find it also takes less time if I can calm myself down while aborting a CH with o2.

thanks for the replys, it seems to be working for me at the moment but i am only getting very mild hits at the moment, just hope it does the job when the bad ones come along, regards shaun

That's awesome news Shaun....hope it continues! :)

Joe

I've noticed that a lot of the folks who are really successful with their O2 use around here do hyperventilate.

Something I've taken to is concentrating on emptying the lungs really completely, which takes kind of a "double exhale" for me.

My (bonehead?) theory on that, is that if I wanna take in 100% O2, I better get the existing Co2 outa there.

I second that! Emptying the lungs makes O2 kick-in much faster. My first post to this board BTW.

I prefer the breath in, breath out method. :D

Personally when first getting to the O2 I find myself hyperventilating and then as I get control over it slowing by breathing down and breathing more deeply and exhaling more thoroughly.  Initially I am unable to breath in a more controlled manner.

You will need to find what works for you.  There is no set answer, and no "right" way or "wrong" way with it.

Jerry

hi all, been on 02 for a week now and it is the best thing thats happened to me in a long time. i am getting 2-4 attacks during the night, 10-15 mins later i am back in bed. i have not needed any imagran inj or any other meds, it took me 10 years to finally get 02 prescribed my advice to others is  do not take no for an answer from the clueless docs, regards shaun

Adding on... I may clear out my lungs by hyperventilating common air, but when I settle into breating O² with a torch handle I sit calmly and turn on the O² knob to breath in, turn the knob off to save O², and hold my breath around 10 seconds counting silently. Then exhale slowly and repeat.

I find I wear myself out holding my breath for 30 seconds or longer. I can swim under water and hold my breath doing that once, for about 90 seconds, but that wears me out too.

Hey Shaun,

Good question and it looks like you've received a good set of answers.  Glad to hear oxygen therapy is working well.

Most folks understand oxygen therapy well enough to know we need to breathe enough oxygen to saturate our hemoglobin to 100% and achieve hyperoxia (an excess of oxygen in the arterial blood).

What isn't fully understood is while it's important to achieve hyperoxia as an abortive for cluster headaches, it's equally important to reduce CO2 levels below normal (hypocapnia) in order to achieve aborts even faster and more reliably.

The only way to reduce CO2 levels below normal is to hyperventilate...  Breath faster and/or more deeply than normal.

If you think of hyperventilation in terms of minute-volume (the volume of air inhaled in one minute) instead of flow rate or respiration rate, this gets a little easier to understand. 

As you're sitting there at rest and reading this post, you're likely to have a minute volume of 9 liters (That's based on a Respiration Rate of 13 and tidal volume of 0.7 liters). That's the minute volume needed to keep CO2 in the normal range if you're breathing air or 100% oxygen.

It only takes a slight increase in physical activity to cause the minute volume to climb to 15 liters...  And if you're doing the cluster two-step cha-cha or pacing in circles, or seated bouncing your legs up and down and rocking hunched over your knees, or sitting in a fetal position while pounding on your head, the minute volume is likely near 20 liters...  Again, that's just to keep your CO2 level in the normal range breathing normal air or 100% oxygen.

In order to pump out CO2 faster than you're generating it through normal metabolism plus the metabolism associated with the increased physical activity, you need a minute volume of lung ventilation greater than 20 liters. 

The higher the minute volume, the faster you pump out CO2 and the sooner you pump it below the normal level tp achieve hypocapnia.  This is why an oxygen flow rate of 25 liters/minute (a minute volume of 25) is the minimum flow rate that supports effective hyperventilation and why higher flow rates pump CO2 out even faster.

There are a number of breathing techniques that can be used in hyperventilating, and the more effective of these in aborting cluster headaches involves the basics of exchanging as much exhaled breath as possible with 100% oxygen.

When you look at the mechanics of hyperventilation you need to consider the average adult lungs hold a volume of 5 liters. 

The maximum tidal volume of air or 100% oxygen inhaled or exhaled with one breath is 3 liters.  That leaves 2 liters of residual breath basically trapped in the lungs at all times...

That makes the most effective hyperventilation technique one that attempts to squeeze as much of the residual lung volume into exhaled breath as possible. This also removes the most Nitrogen as fast as possible.  Ventilating the lungs with 100% oxygen to the greatest extent removes the inert Nitrogen and also dilutes the residual lung volume to remove the most CO2.

I've done some tests that show inhaling to the maximum extent possible followed by a forceful exhale to the maximum extent possible followed by an abdominal crunch like you're doing a sit up and doing a coughing maneuver holding it for at least a two- or three-count. 

Coughing constricts the intercostal muscles in the ribcage and also forces the diaphragm up into the chest cavity to reduce lung inflation more than normal. 

If I do this correctly I'll hear a wheezing sound during the three count.  BTW, I've had my wife try this and she wheezes just like me and she has never smoked...

As soon as I've squeezed out as much breath as possible, I repeat the procedure again inhaling as deeply and as fast as possible.

The mantra I use is "Squeeze till I wheeze."

This works for me at a flow rate of 25 liters/minute and even better at a flow rate of 40 liters/minute.  If I do this correctly, 4 to 5 times, I start feeling the symptoms of respiratory alkalosis.  This is called paresthesia...  That's a sensation of slight dizziness combined with a tingling of the fingertips and the back of my neck.

If you follow my logic, if I'm feeling paresthesia, I'm hyperventilating.  And If I keep up that level of lung ventilation, I know I'm going to get the fastest abort possible...

Hope this helps.

Take care,

V/R, Batch

Thanks Pete, you explained it very well. :)