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Cheyne-Stokes/Periodic Breathing?
#1
Im learning a great deal perusing the boards here and the info Im gleaning is fantastic! I have a question. I have been on APAP for three days now. Last nite was the first nite I managed to sleep all nite with the system on me. I loaded the data into Sleepy head and I saw several episodes of CSR. Total time on the bottom graph by pressures was 3.80 minutes at 10cm, which us my max pressure (6-10). CA, which I assume to be Centrals were zero. My AHI during th max pressure times was 10.44. My AHI for the nite was 5.71. Is this something to be concerned about. (Im a worrywart anyway)..
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#2
(12-12-2015, 07:25 PM)GTOdude Wrote: Im learning a great deal perusing the boards here and the info Im gleaning is fantastic! I have a question. I have been on APAP for three days now. Last nite was the first nite I managed to sleep all nite with the system on me. I loaded the data into Sleepy head and I saw several episodes of CSR. Total time on the bottom graph by pressures was 3.80 minutes at 10cm, which us my max pressure (6-10). CA, which I assume to be Centrals were zero. My AHI during th max pressure times was 10.44. My AHI for the nite was 5.71. Is this something to be concerned about. (Im a worrywart anyway)..

First, getting a full night's sleep on your third night with APAP is fantastic. I wouldn't worry about your slightly high AHI or the episodes you mention unless you're still that way after a month or so. Then it would be time to check your progress and perhaps adjust your settings. You are making a great start, don't worry about anything else for awhile.

Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
Your brain is not the boss.
Our forefathers took drugs.
He's no fun he fell right over.
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#3
The "by pressure" chart was a bit of an experiment by the author of SleepyHead and I'm not sure it was ever finished properly. So while it can be interesting I wouldn't place too much reliance in it.

Cheyne Stokes breathing is associated with congestive heart failure. You are seeing a cardiologist regularly, so I assume this has already been investigated and/or ruled out? More likely, it's just a few minutes of irregular breathing which the machine has incorrectly flagged. So long as these are scattered events I wouldn't worry, but if they become frequent then perhaps best to get your doc to look at it.

Your AHI = 5.7 is OK but you should really get it below that. The aim to to get a good night's restful sleep. The AHI is one indicator that you've achieved that aim - with a 5.7 you're getting close but still have a way to go. Having said that, every night is different and it's trends over time which are important, not individual nightly results.
DeepBreathing
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#4
(12-12-2015, 08:01 PM)DeepBreathing Wrote: Cheyne Stokes breathing is associated with congestive heart failure. You are seeing a cardiologist regularly, so I assume this has already been investigated and/or ruled out? More likely, it's just a few minutes of irregular breathing which the machine has incorrectly flagged.

Hi GTOdude,

It is common that patients first starting in CPAP therapy will see some Central Apnea and/or Periodic Breathing which gradually disappears in a few weeks or months, as we adapt to breathing under pressure.

If your Central Apnea index was zero then the "CSR" which your machine flagged could not have been true Cheyne-Stokes Respiration.

The events flagged as "CSR" may have been a little Periodic Breathing, nothing to worry about at all unless these continue to keep your AHI above 5 for weeks or months AND are causing excessive daytime sleepiness or other symptoms. SleepyHead lumps PB under the category CSR, but these are different. PB does not include CA, and true CSR does.

Moreover, I think that "CPAP induced" CSR-like breathing pattern (which does include CA events) may be an example of CPAP-induced Central or Complex Sleep Apnea (if the average number of CA per hour of sleep is more than 5) but still would not indicate true CSR, because in true CSR the breathing pattern would occur on its own without being caused by CPAP therapy. CSR which is seen during a diagnostic sleep study while not being treated by CPAP would be true CSR.

In the Flow waveform, if you zoom in to look very closely at 1 or 2 minutes during what SH has flagged as "CSR" you would be able to see what SH was reacting to.





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