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Cheyne-Stokes Breathing Pattern ??
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Labrat0116 Offline

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Post: #1
Cheyne-Stokes Breathing Pattern ??
Doc says I got it.

Not on my death bed (YET!) but pretty worried about it non-the-less.

Any of you folks (not near death) have Cheyne-Stokes breathing in your apnea episodes ?

What do I need to know about Cheyne-Stokes ?
03-15-2013 11:50 PM
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dcgrafix Offline

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Post: #2
RE: Cheyne-Stokes Breathing Pattern ??
(03-15-2013 11:50 PM)Labrat0116 Wrote:  Doc says I got it.

Not on my death bed (YET!) but pretty worried about it non-the-less.

Any of you folks (not near death) have Cheyne-Stokes breathing in your apnea episodes ?

What do I need to know about Cheyne-Stokes ?

Yes I do show some periods of Cheyne-Stokes breathing in my sleep data & at first I was concerned too so did a search using Google & there are a few different reasons or circumstances why I may & hopefully you as well that may be caused by sleep medications & other medications to relax as in my case (Zopiclone) & a myriad of other meds as well as alcohol before bed.
Any drug that slows down your respiration can be a contributor for Cheyne-Stokes breathing.

Can you give an idea of how often & for how long you show having Cheyne-Stokes breathing in say a night, week & month?

It is something I have worried about too & don't see others mentioning it.

Here is a couple links with info but don't read too much into some of the worst case senerios & get freaked out with out a profesional opinon that your sitiation is caused by the worst possible coss.

"Cheyne-Stokes respiration (CSR) is a form of disordered breathing characterized by recurrent episodes of central apneas or hypopneas, alternating with hyperpneas, during which there is a crescendo-decrescendo pattern of tidal volume."


http://en.wikipedia.org/wiki/Cheyne%E2%80%93Stokes_respiration

http://circ.ahajournals.org/content/99/11/1435.long

http://www.wisegeek.com/what-is-cheyne-stokes-respiration.htm

I havn't been able to find any of the articals I read about how medications & alcholol can cause Cheyne-Stokes respiration symtoms but it is best to consult a profecinal.

I can say that some of the nights that I showed Cheyne-Stokes respiration in my data I had been taking pain killers or muscle relaxes & alcohol.
Well I didn't mean to write a book on something I don't know enough on but I hope it helps.

I would be interested in your experience with Cheyne-Stokes respiration to compare.

Dan
03-16-2013 12:55 AM
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DocWils Offline

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Post: #3
RE: Cheyne-Stokes Breathing Pattern ??
Mixing pain killers, muscle relaxants and alcohol is not really a smart idea (medically speaking) and I don't recommend it. It will certainly create long chain breathing cycles that resemble CSR. At this point unless the data is very alarming I should instead concentrate on the main therapeutic aim of the PAP, and once that is achieved, examine how CSR is progressing. This can take some time, so be patient. Many medications will act as respiratory suppressants or cause respiratory tension, causing CSR like activity, and alcohol, which is a depressant, if either in sufficient amount, or if mixed with certain medications will also bring it about. So part of the method of dealing with it is to examine your daily behaviour and isolate possible causes.

Some cases, as in certain types of athletes and scuba divers of a certain age, a longer breathing pattern is developed that mimics CSR but actually isn't and is not dangerous. I know this one from personal experience, being a skip-breather form years of diving. Opera singers have this problem, too, due to how they by habit cycle air.

Don't panic, relax, start the therapy and see how your compliance over a three to six month period changes your level of CSR. If it hasn't budged much, then look at your lifestyle and examine how that may be affecting your breathing pattern. Actually, like any doc, I will say examine your lifestyle and change it anyway - lose weight, exercise, don't smoke and don't drink booze before bed, don't mix booze and pills, all pretty much stuff you know. I really don't need to tell you theses things, but I will anyway ;-).
03-16-2013 05:18 AM
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Shastzi Offline

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Post: #4
RE: Cheyne-Stokes Breathing Pattern ??
What wilorg said.
See about getting some therapy for that, in hopes if lessening the negative impact on your system.

Good luck!

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
03-16-2013 08:44 AM
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dcgrafix Offline

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Post: #5
RE: Cheyne-Stokes Breathing Pattern ??
(03-15-2013 11:50 PM)Labrat0116 Wrote:  Doc says I got it.

Not on my death bed (YET!) but pretty worried about it non-the-less.

Any of you folks (not near death) have Cheyne-Stokes breathing in your apnea episodes ?

What do I need to know about Cheyne-Stokes ?

Love to hear from you Labrat0116
03-16-2013 09:13 PM
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dcgrafix Offline

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Post: #6
RE: Cheyne-Stokes Breathing Pattern ??
(03-16-2013 05:18 AM)wilorg Wrote:  It will certainly create long chain breathing cycles that resemble CSR.

I see you are using a Philips machine & SleepyHead software.
Have you used EncoreBasic?

I would be interested if you were able to decipher any of the events like CSR
I can get an idea of how bad or good a night was but to understand it all together like patters & what they mean is passed me.

Dan
03-17-2013 12:31 AM
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DocWils Offline

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Post: #7
RE: Cheyne-Stokes Breathing Pattern ??
Haven't used EncoreBasic. Sleepyhead actually gives sufficient data to read these things out, but you do have to know how to put all the information together and understand the flow patterns, etc. CSR isn't altogether uncommon in healthy people too, or rather CSR like breathing - it will often occur around the time of arousal and around the point of switchover from awake to sleeping state. There is another thread where we discussed "panic" waking, where you feel you forgot how to breath and wake up, and that is actually similar to CSR, and common. What is happening in both cases is that the autonomic breathing centres of the brain are adjusting from one state to another, and sometimes it is not an easy adjustment. It is a leading cause of death (and a merciful one) in Alzheimer's patients, as the breathing centres become affected and the command pattern for breathing is "forgotten", causing intervaled breathing. For most people, having the note that you have CSR in our breathing pattern is not really something to panic about. Yes, it is the type of breathing just before death, and was named by blokes who noted it in describing the stages of the death spiral, but it is not happening there - so really, don't panic. The big question for now is whether the overall therapy is doing you any good - if it is, and the CSR is showing up around when you start falling asleep and/or waking up, then you need not worry yet. If it is happening during the sleeping phase and pulling you out of your sleep, then it may require further investigation if it is a nightly occurrence. Watch your tidal volume around the above mentioned points and see if they equate to any events.
03-17-2013 05:43 AM
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dcgrafix Offline

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Post: #8
RE: Cheyne-Stokes Breathing Pattern ??

Thanks for your reply, I will try to figure out & find the transitions you mentioned.

Did you say you were a Doctor with a specialty?
03-17-2013 05:21 PM
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DocWils Offline

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Post: #9
RE: Cheyne-Stokes Breathing Pattern ??
I was a surgeon, and now divide my time between teaching, supervising research projects and being a consulting fellow in internal medicine. Not a sleep specialist, but understanding the information is probably a bit easier for me - my language, so to speak. I was diagnosed with SA last spring, wasn't surprised, suspected it for a few years (a decade, really, but the first time I took a test, a decade ago, it was negative), never had the time to settle down for a study until last spring, when I more or less marched into the sleep clinic at the Unispital (not my hospital, but it is the one with the sleep clinic) and told them to give me something to test me at home and I had no intention of doing an overnight there. Luckily, it was enough to make a clean diagnosis (as the sleep doc said to me, "hardly rocket science, eh?") so I went on a CPAP the next day and haven't looked back. Of course, I did give a good ten days over to research on all of it, and sussed it pretty quickly, because so much of it is related to my areas of medicine, and we learn most of this in school, even back in the days of dinosaurs that I hail from. The science isn't very new, just the technology to make things better. And that technology is improving all the time, so never despair, in ten years we'll be kitted out with neater, smaller and quieter devices, and new therapies are being tested now all the time.
(This post was last modified: 03-17-2013 07:39 PM by DocWils.)
03-17-2013 06:58 PM
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archangle Offline
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Post: #10
RE: Cheyne-Stokes Breathing Pattern ??
The Philips Respironics PRS1 machines are very quick to flag something as "PB-Periodic Breathing." CSR (Cheyne-Stokes Respiration) is sort of the more serious level of PB.

Many times, if you look at something flagged as "PB" by a PRS1 machine nothing much is happening that you should be concerned about. You could also have something life threatening.

When I see "PB" flagged in the results, what it means to me is "you need to look at the airflow waveforms and other data in this area. It's a bit like finding out that someone snores. It means you should probably be checked for sleep apnea. You might not have apnea at all, or you may be about to die from it.

This is not a fault of the machine, in my opinion. The machine isn't smart enough to conclusively decide what's important or unimportant in terms of severity of PB, so it flags it as something you should look at when you look at the results.

Unfortunately, people tend to either ignore all PB or panic unnecessarily. You really do need to look at the airflow waveforms and other data.

Even if you do have "real" periodic breathing, it may not mean anything. Instead of breathing steadily, the feedback mechanism in your nervous system and respiratory system are sort of "hunting" for the right level. If it's bad enough, your O2/CO2 levels and other things can reach harmful levels. It's also possible that things vary up and down a bit, but do no harm to your body.

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03-18-2013 06:54 AM
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