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Cheyne Stokes Respiration
#1
CPAP therapy has been going well and stable for many months without any adjustments. So I haven't been importing the data as often as I used to do.

This morning I just imported about 51 days of data from the SD card and discovered there was one day on Jan 3 where I had a CSR report of 3.03% of the time. There was one episode around 7am which lasted 15 minutes and 28 seconds. During that time there were a number of CAs on the chart.

I have been on CPAP therapy for about ten months now, and never had any CSR reported before nor since.

My question... is CSR something that needs to show a pattern before becoming concerned or is one occurrence enough to raise a red flag?

If one occurrence is significant, then what should I do about it?

thanks,

Saldus Miegas

[Image: kN7tY9k.png]
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#2
Sleepyhead labels all periodic breathing as Cheyne-Stokes. It is extremely unlikely you had CSR, but Periodic Breathing (PB) is pretty common. An isolated occurrence is not a cause for concern. You would need to zoom in on the flow line during the CSR to see the shape of the waveform and patterned breathing to know more.

I would forget about it unless is is a very prevalent feature, and you say it's not. I would also re-label the CSR to PB using File/Preferences, and edit the event titles and abbreviations.
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#3
Thanks Sleeprider.

Most searches for CSR lead to places I don't want to be.

Thanks for the reassurance and perspective.

Saldus Miegas
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#4
NOT that I think this is what happened to you, but would a stroke event show up as a CSR?
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#5
Based on this one example I would suspect sleep wake junk and disregard it unless and until it becomes a recurrent event.
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#6
Hi Saldus,

ASV machines can treat/prevent CSR-like breathing pattern, but I think no insurance company is likely to cover an ASV machine if this type of night happens only once a year or once a month, but I'm not sure.

USA Medicare guidelines require CAI to be at least 5 (it was on that one night) and CAI needs to be greater than Obstructive Apneas (it was on that one night) and if the CAI is less than 10 or 15 then there may be other requirements. I think Medicare may require the data to have been taken in a sleep lab, so data from your machine might not be enough proof, but again I'm not sure. Coverage would depend on the guidelines of the particular insurance company.

The pattern may have been caused by something you ate or a medication you took.

I think no reason to be alarmed, but I would show this report to your cardiologist and your other doctors. (Do add a closeup of the longest cluster, with about 10 minutes filling the whole horizontal scale, showing Leak and Flow and High Rate Pressure and either Minute Ventilation or Tidal Volume.


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#7
Question 
(02-07-2016, 03:11 PM)bwexler Wrote: Based on this one example I would suspect sleep wake junk and disregard it unless and until it becomes a recurrent event.

What is sleep walk Junk
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#8
I'd be a heck of a lot more concerned about the CAs than the CSR. I get a lot of CSR readings from SH but they seldom show the characteristic waveform. I carefully check the length of the CA's every day to make certain they are not long ones--mine usually are under 20 seconds--not good but that isn't going to kill me. I have known heart problems. I'm logging my results from SH every day so I can quickly find the bad ones to print out and take to my sleep and cardio docs after I get mobile after my knee surgery.
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#9
(02-07-2016, 04:00 PM)0rangebear Wrote:
(02-07-2016, 03:11 PM)bwexler Wrote: Based on this one example I would suspect sleep wake junk and disregard it unless and until it becomes a recurrent event.

What is sleep walk Junk

Orangebear, we frequently see clusters of CA and even periodic breathing during arousals or at periods of sleep onset and waking. For lack of anything better to label it, some of us call it sleep/wake/junk (SWJ). The events may not be real apnea or periodic breathing, but instead may be from partial arousal, movement and just "stuff" that happens when you conscious brain hands off breathing to the autonomic system.

This is a bit technical, but it explains SWJ in more scientific terms: https://books.google.com/books?id=lrEHxR...et&f=false
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#10
What is sleep walk Junk
[/quote]

Orangebear, we frequently see clusters of CA and even periodic breathing during arousals or at periods of sleep onset and waking. For lack of anything better to label it, some of us call it sleep/wake/junk (SWJ). The events may not be real apnea or periodic breathing, but instead may be from partial arousal, movement and just "stuff" that happens when you conscious brain hands off breathing to the autonomic system.

This is a bit technical, but it explains SWJ in more scientific terms: https://books.google.com/books?id=lrEHxR...et&f=false
[/quote]



see my other posts
Thread: Newbie
Post: RE: Newbie
I have been using this machine for 40 days now my compliance is 33 out of 40. shortest time is 4.5 hours longest is 7. However I was awake for more than 2 hours on 7 hours use day. I am using sleepy ...

0rangebear Software Support Forum 7 253 Yesterday, 06:18 PM
Thread: Are there any APAP Machines that record SLEEP HOURS
Post: RE: Are there any APAP Machines that record SLEEP...

I actually have the opposite problem. When I lay awake unable


Could I be looking at sleep wake junk here
when I go to sleep quickly and turn the device off immediately upon waking, I have an API <7 but if I linger going to sleep or keep the mask on after walking it skyrockets. I have seed as many as 81 event in the first hour and 262 event in the last hour when I believe I was mostly awake but trying to sleep.




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