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Cheyne stokes and periodic breathing, what can you tell me?
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kameeleun Offline

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Post: #1
Cheyne stokes and periodic breathing, what can you tell me?
Hi all, I posted this in a reply somewhere but I was hoping to ask a follow up and thought I should start a new thread.

Okay, here's a night from last week, before my full face mask:

[Image: itMQWy2.jpg]
[Image: EH0eOx7.jpg]
[Image: RUfdrqa.jpg]
[Image: 9fWzNOv.jpg]

This seems to be a nightly pattern I see, but I only have flow rate data from oct 22nd onward (my machine only saves it for a week apparently).

The user flag 1 is 50% reduction for 10s (which I'm also not sure why the machine isn't just flagging these as hypopnea).

Sorry I'm bombarding the board with my questions lately, I'm a little lost and overwhelmed.

Basically, I've been trying to look into why I have such lousy daytime sleepiness despite my consistently low AHI (which is what lead to learning about sleepyhead and all this).

I've had basic bloodwork done, like thyroid, iron, things you look at for fatigue and they're all fine. I've been to the ENT and dentist to look into physical obstructions in my airway, all clear. That was all when I was still under the impression the issue was obstructive sleep apnea. What is my first step in investigating central apnea? I don't have congestive heart failure, and I'm not a big opium addict so that's mostly all google has to contribute. What tests should I even be asking my doctor for? I've been trying to approach this like "if you hear hoofbeats you should think horses not zebras" but besides heart failure and drugs everything seems to be zebras. Are there any other horses?
11-06-2015 10:49 AM
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ramblingasian Offline

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Post: #2
RE: Cheyne stokes and periodic breathing, what can you tell me?
Compared to what others have posted on this and other boards that show CSR, your graphs don't look anything like it.

You probably want to talk to your doctor about your sleep though.
11-06-2015 11:23 AM
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PaytonA Offline
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Post: #3
RE: Cheyne stokes and periodic breathing, what can you tell me?
What is your leak rate? How much of the time are you in the large leak area?
11-06-2015 11:50 AM
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kameeleun Offline

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Post: #4
RE: Cheyne stokes and periodic breathing, what can you tell me?
(11-06-2015 11:50 AM)PaytonA Wrote:  What is your leak rate? How much of the time are you in the large leak area?

My leak rate is always low, and I never have any large leaks just small ones. Before my full face mask I was suspicious of this, but now I kinda believe it. Here is the whole night again with the leak rate at the bottom now. I rescaled the axis for leaks to 9 to make it more visible.

[Image: T2Bg0ng.jpg]
(11-06-2015 11:23 AM)ramblingasian Wrote:  Compared to what others have posted on this and other boards that show CSR, your graphs don't look anything like it.

You probably want to talk to your doctor about your sleep though.

Can you link me to those posts? I just googled, and I searched the forum, but had trouble finding good comparisons.
(This post was last modified: 11-06-2015 12:41 PM by kameeleun.)
11-06-2015 12:34 PM
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justMongo Offline

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Post: #5
RE: Cheyne stokes and periodic breathing, what can you tell me?
Some questions for kameeleun:
How long have you been on PAP therapy?
Which S9 do you have? (Look by the start button)
Are you using EPR?

Suggestion: Google, pressure induced central apnea.

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.
11-06-2015 12:57 PM
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kameeleun Offline

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Post: #6
RE: Cheyne stokes and periodic breathing, what can you tell me?
(11-06-2015 12:57 PM)justMongo Wrote:  Some questions for kameeleun:
How long have you been on PAP therapy?
Which S9 do you have? (Look by the start button)
Are you using EPR?

Suggestion: Google, pressure induced central apnea.

It's an S9 Elite, what does that mean? I've been on CPAP for four years, always this machine but I have previously been at different pressures. The first time I've switched masks was this past monday, that's why I picked this day from before I switched masks.

Now that you mention it, I remember now that I was using EPR that night. I had been feeling like my pressure was too high and had read about EPR, so I tried it out a few nights while I waited for the sleep doctor's office to get back to me, but didn't feel like it was making a difference. Now I'm on a fixed 6 pressure, but the pattern is still there. Sorry, I meant to choose a day from before my mask change because I didn't want to add variables, but I forgot about trying out EPR. I can post more screen shots from a day I didn't use EPR, if that's helpful let me know.
11-06-2015 01:20 PM
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ramblingasian Offline

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Post: #7
RE: Cheyne stokes and periodic breathing, what can you tell me?
(11-06-2015 12:34 PM)kameeleun Wrote:  Can you link me to those posts? I just googled, and I searched the forum, but had trouble finding good comparisons.

This is a thread on another forum where someone has a much more noticeable form of periodic breathing.

http://freecpapadvice.com/forum/viewtopic.php?f=10&p=10852
11-06-2015 01:28 PM
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kameeleun Offline

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Post: #8
RE: Cheyne stokes and periodic breathing, what can you tell me?
(11-06-2015 01:28 PM)ramblingasian Wrote:  
(11-06-2015 12:34 PM)kameeleun Wrote:  Can you link me to those posts? I just googled, and I searched the forum, but had trouble finding good comparisons.

This is a thread on another forum where someone has a much more noticeable form of periodic breathing.

http://freecpapadvice.com/forum/viewtopic.php?f=10&p=10852

Thank you! I've never found a thread where anyone agreed the person had it, this is very helpful. That looks exactly like the picture on wikipedia, I guess I thought it was a little more variable.

I definitely do not have whatever that person has. So is what I have normal? I had a really hard time finding non-cheyne-stokes periodic breathing information using google, and I have a lot of these ups and downs with hypopnea instead of apnea. I think the up and down might be why a lot of the hypopnea aren't scored by the machine too, unless there's some additional criteria beyond 50% reduction for 10s (which is what resmeds site says).

Here's a closeup of another night, maybe it's showing what I mean better:
[Image: L1ggUxs.jpg]
Let me know if you want more screenshots, or if you want to see different variables too.
(This post was last modified: 11-06-2015 02:07 PM by kameeleun.)
11-06-2015 02:03 PM
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OpalRose Offline

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Post: #9
RE: Cheyne stokes and periodic breathing, what can you tell me?
kameeleum,
There are a few threads listed at the bottom of this thread that may be related.

This has nothing to do with your question, but may help in posting a graph.

You can leave off the right side bar, and get rid of the calendar and pie chart.
Leave the info under the pie chart.

OpalRose
(This post was last modified: 11-06-2015 07:03 PM by OpalRose.)
11-06-2015 07:02 PM
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StoopidMonkey81 Offline

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Post: #10
RE: Cheyne stokes and periodic breathing, what can you tell me?
(11-06-2015 10:49 AM)kameeleun Wrote:  [Image: EH0eOx7.jpg]

So just to reiterate, if I notice a wavy waxing/waning breathing pattern like the one depicted in the graph above, but breathing does NOT stop or result in a CA in between periods, then it's not Cheyne-Stokes? I've seen a few of those on my SH charts myself, and I'm wondering if I can safely ignore them.
12-01-2015 08:50 AM
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