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Cheyne-Stokes/Periodic Breathing?
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GTOdude Offline

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Posts: 94
Joined: Dec 2015

Machine: RemStar Auto APAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFIT P10
Humidifier: Unsure
CPAP Pressure: 7-14
CPAP Software: SleepyHead EncoreBasic

Other Comments: Other Dx: cabg x3 '94. Hypothyroid '15 and other maladies.

Sex: Male
Location: Central Valley, Left Coast

Post: #1
Cheyne-Stokes/Periodic Breathing?
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)..
12-12-2015 07:25 PM
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eseedhouse Offline

Advisory Members

Posts: 879
Joined: Dec 2014

Machine: ResMed Airsense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: SimPlus
Humidifier: ResMed
CPAP Pressure: 7-10
CPAP Software: SleepyHead

Other Comments: Also on supplemental O2 at 3L/min. while sleeping.

Sex: Male
Location: Victoria, British Columbia

Post: #2
RE: Cheyne-Stokes/Periodic Breathing?
(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

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

Actually you know, it is what it isn't.
12-12-2015 07:51 PM
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DeepBreathing Offline
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Posts: 2,295
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #3
RE: Cheyne-Stokes/Periodic Breathing?
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
Apnea Board Moderator
www.ApneaBoard.com


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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.
12-12-2015 08:01 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #4
RE: Cheyne-Stokes/Periodic Breathing?
(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.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-13-2015 06:01 PM by vsheline.)
12-13-2015 05:27 PM
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