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Cheyne Stokes Respiration
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SaldusMiegas Offline

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Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: P-10, F&P Simplus
Humidifier: integrated
CPAP Pressure: Rx:14, Set:Auto 8.0-15.0
CPAP Software: ResScan SleepyHead

Other Comments: Woot! P-10 pillows plus Ruby chinstrap for side-sleeping mouth breathers

Sex: Male
Location: Virginia

Post: #1
Cheyne Stokes Respiration
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

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02-07-2016 01:47 PM
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Sleeprider Online
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #2
RE: Cheyne Stokes Respiration
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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02-07-2016 02:24 PM
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SaldusMiegas Offline

Advisory Members

Posts: 227
Joined: Apr 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: P-10, F&P Simplus
Humidifier: integrated
CPAP Pressure: Rx:14, Set:Auto 8.0-15.0
CPAP Software: ResScan SleepyHead

Other Comments: Woot! P-10 pillows plus Ruby chinstrap for side-sleeping mouth breathers

Sex: Male
Location: Virginia

Post: #3
RE: Cheyne Stokes Respiration
Thanks Sleeprider.

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

Thanks for the reassurance and perspective.

Saldus Miegas
02-07-2016 02:29 PM
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Mosquitobait Offline

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Other Comments: RLS and Bradycardia

Sex: Female
Location: Minneapolis

Post: #4
RE: Cheyne Stokes Respiration
NOT that I think this is what happened to you, but would a stroke event show up as a CSR?
02-07-2016 02:36 PM
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bwexler Offline

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Machine: PRS 1 BiPAP autoSV Advanced, with Heated Tube humidifier
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CPAP Software: SleepyHead EncorePro

Other Comments: CMS 50i with Software for SpO2

Sex: Male
Location: San Marcos, CA, USA

Post: #5
RE: Cheyne Stokes Respiration
Based on this one example I would suspect sleep wake junk and disregard it unless and until it becomes a recurrent event.
02-07-2016 03:11 PM
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vsheline Offline

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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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: #6
RE: Cheyne Stokes Respiration
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.

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: 02-07-2016 03:38 PM by vsheline.)
02-07-2016 03:38 PM
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0rangebear Offline

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Machine: ResMed AirSence 10
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CPAP Software: ResScan SleepyHead

Other Comments: Ramp off

Sex: Male
Location: Brighton Colorado

Post: #7
Question RE: Cheyne Stokes Respiration
(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
02-07-2016 04:00 PM
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SideSleeper Online

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Sex: Female
Location: Western Oregon, USA

Post: #8
RE: Cheyne Stokes Respiration
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.
02-07-2016 04:19 PM
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Sleeprider Online
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Posts: 3,307
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #9
RE: Cheyne Stokes Respiration
(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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02-08-2016 11:00 AM
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0rangebear Offline

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Posts: 340
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Machine: ResMed AirSence 10
Mask Type: Other
Mask Make & Model: Amara View
Humidifier: HumidAire (Built-in)
CPAP Pressure: APAP 12.8-15 EPR 3 (cmH2O)
CPAP Software: ResScan SleepyHead

Other Comments: Ramp off

Sex: Male
Location: Brighton Colorado

Post: #10
RE: Cheyne Stokes Respiration
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]



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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 ...

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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.
02-12-2016 01:40 PM
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