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CHEYNE-STOKES
#1
How serious is cheyne-stokes respiration and when is it important to seek medical attention?

My device has indicated 1 episode on May 4, 2016 [AHI 13.61 CSR 3.66% 9:02:36 (1094)]

2 episodes on July 5, 2016 [AHI 11.93 CSR 15.06% 10:04:06 (2598) 11:14:26 (1767)

2 episodes on July 6, 2016 [AHI 10.27 CSR 11.39% 04:42:08 (1674) 07:04:32 (1493)

I do not seem tired, I do throw PVCs, and PACs.

Any comments, suggestions would be welcomed.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#2
Your AHI's are kind of high. One thing I'd like to know is, are your apneas mostly obstructed or clear?
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#3
In my non-medical opinion, as long as you are being followed by a cardiologist, I would not be concerned.
Remind me how long you've been on PAP? I was told that people who have had untreated apnea for a long time can lose (or diminish) their central respiratory drive. CSR is an oscillation of respiratory drive: Both in terms of tidal volume and pH (as controlled by CO2).
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
(07-07-2016, 07:48 PM)Snowleopard28 Wrote: Your AHI's are kind of high. One thing I'd like to know is, are your apneas mostly obstructed or clear?

MAY 4 - 1 CA (12); 14 O (10-17); H 98 (10)
JULY 5 - 3 CA (10-17); 6 O (10-14; H 87 (10)
JULY 6 - 0 CA; 5 O (10-13); H 71 (10)

(07-07-2016, 10:04 PM)justMongo Wrote: In my non-medical opinion, as long as you are being followed by a cardiologist, I would not be concerned.
Remind me how long you've been on PAP? I was told that people who have had untreated apnea for a long time can lose (or diminish) their central respiratory drive. CSR is an oscillation of respiratory drive: Both in terms of tidal volume and pH (as controlled by CO2).

SINCE 2008 ON CPAP STARTED APAP 3/21/16 WITH THE AIRSENSE
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#5
Your clear airway events are low but your obstructed events seem a bit high. As for your hypos, wow.
IMHO Maybe trying to dial in your settings and more time will help. Of course you might be a candidate for an ASV machine. Unless you suffer from some degree of heart failure. You mentioned the problem with arrhythmia's If your cheyne-stokes is because of your heart, is up to you and your cardiologist whether it's safe for you to use an ASV machine. Most people here are aware of the Resmed study on ASV machines and CHF. If you're not, just google that and you'll see.
There are folks on this forum with more knowledge about this than me. I'm sure they'll chime in soon.

Snowleopard
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#6
(07-08-2016, 02:59 AM)Snowleopard28 Wrote: Your clear airway events are low but your obstructed events seem a bit high. As for your hypos, wow.
IMHO Maybe trying to dial in your settings and more time will help. Of course you might be a candidate for an ASV machine. Unless you suffer from some degree of heart failure. You mentioned the problem with arrhythmia's If your cheyne-stokes is because of your heart, is up to you and your cardiologist whether it's safe for you to use an ASV machine. Most people here are aware of the Resmed study on ASV machines and CHF. If you're not, just google that and you'll see.
There are folks on this forum with more knowledge about this than me. I'm sure they'll chime in soon.

Snowleopard

Thanks. No known CHF. The cardiologist, pulmonologist, and sleep doctor have the reports via fax. We will see what happens. Will advise. These are my worst AHIs -- normally I have an average of 4.3 AHI for the last 60 days with a 4.1 Hypopnea. (This includes the last stinkers) And, thanks again.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#7
I have lots of cheyne stokes......up to 6 per night. I also have PVCs and PACs and my AHI fluctuates wildly. One night a 3 and the next night a 17. So my sleep study is lunch of the draw if it's a good night or bad night. Can't get answers.
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#8
(07-07-2016, 04:37 PM)srlevine1 Wrote: How serious is cheyne-stokes respiration and when is it important to seek medical attention?

My device has indicated 1 episode on May 4, 2016 [AHI 13.61 CSR 3.66% 9:02:36 (1094)]

2 episodes on July 5, 2016 [AHI 11.93 CSR 15.06% 10:04:06 (2598) 11:14:26 (1767)

2 episodes on July 6, 2016 [AHI 10.27 CSR 11.39% 04:42:08 (1674) 07:04:32 (1493)

I do not seem tired, I do throw PVCs, and PACs.

Any comments, suggestions would be welcomed.

If you'd like to post data showing a close-up of the flow rate during a CSR event, we could probably offer more constructive suggestions. Do not assume that your machine properly diagnoses CSR. Most events flagged as CSR are a form a periodic breathing, and the medical importance of the events ranges from benign to "see a doctor" depending on duration, frequency and severity. It's really not possible to interpret the summary. Most reported events are actually periodic breathing and may even be caused by sleep/wake transitions.

If you have abundant CSR, central apnea and other non-obstructive events, a CPAP may not be the correct machine for your needs. On the other hand, these problems sometimes diminish over time on their own as users adapt to CPAP therapy.

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#9
(07-07-2016, 04:37 PM)srlevine1 Wrote: How serious is cheyne-stokes respiration and when is it important to seek medical attention?

My device has indicated 1 episode on May 4, 2016 [AHI 13.61 CSR 3.66% 9:02:36 (1094)]

2 episodes on July 5, 2016 [AHI 11.93 CSR 15.06% 10:04:06 (2598) 11:14:26 (1767)

2 episodes on July 6, 2016 [AHI 10.27 CSR 11.39% 04:42:08 (1674) 07:04:32 (1493)

I do not seem tired, I do throw PVCs, and PACs.

Any comments, suggestions would be welcomed.

UPDATE: Cheyne-Stokes Respiration is suggestive of congestive heart failure (liquid build-up) as well as kidney issues etc. In my case, I went to the cardiologist and my BNP suggests that I have undiagnosed/untreated CHF. So it appears that watching the numbers can be extremely beneficial. --steve
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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