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[Health] Periodic Breathing or CSR - Cheyne-Stokes Respiration

Does anyone know much about Periodic Breathing or CSR - Cheyne-Stokes Respiration?

I get this every now & again & don't know it it is common or is it something I should be worried about?

Most of what I read is that it indicates very shallow breathing & known to be common in someone's last breaths before dieing.


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DC-- I have found some info on Cheyne-Stokes in an internal medicine text. It describes the condition as one in which there are alternating periods of apnea and hyperpnea. The pt. often lies motionless for 15 to 20 seconds and then begins to breathe shallowly at first, then with increasing amplitude, and finally shallow again. Respirations during this period are regular in time. Conditions where this condition is seen include normal individuals living at high altitude, chronic hypoxia, brain damage from trauma, cerebral hemorrhage and congestive heart failure.
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Cheyne-Stokes respiration is an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea. The pattern repeats, with each cycle usually taking 30 seconds to 2 minutes. It is an oscillation of ventilation between apnea and hyperpnea with a crescendo-diminuendo pattern, and is associated with changing serum partial pressures of oxygen and carbon dioxide.

Cheyne-Stokes respiration and periodic breathing are the two regions on a spectrum of severity of oscillatory tidal volume. The distinction lies in what we observe happening at the trough of ventilation: if there is apnea, we describe it as Cheyne-Stokes respiration (since apnea is a prominent feature in their original description); if there is only hypopnea (abnormally small but not absent breaths) then we call it periodic breathing. Physiologically and mathematically, the phenomena are less different than they appear, because breaths that are smaller than the anatomical dead space do not actually ventilate the lung and so - from the point of view of gas concentrations in an alveolus - the nadir of hypopnea in periodic breathing may be indistinguishable from apnea.

These phenomena can occur during wakefulness or during sleep, where they are called the Central sleep apnea syndrome (CSAS).

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Thanks Dawei & zonk for such detailed information, It is more than I expected.
I have done some research just after I got EncoreBasic but in the beginning it was so much information to absorb being at that time I was very new to anything to do with sleep apnea & CPAP in general.

Then the CSR seemed to go away for a while & I kind of dismissed it but after the 3rd time seeing it again I thought that there must people here that may know more than I was finding on Google & you did.

This definitely scars me & keep learning more & more things that I do not remember that I apparently did or talked about that might of been the same day or a few days & the more I am reminded or described I can't remember but I may remember details 3 minutes before or after but what happened in between is gone.

I will need to do more thinking on the because I have had other nights with much longer lengths of CSR
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The PRS1 machines are rather "eager" to flag breathing as periodic breathing. Before you get too carried away, look at the actual airflow waveforms to see if it's just some minor variation or something to worry about.

I think the proper meaning of "PB" in the data is an indication to look at the airflow waveform further.

Also, look at how much of the night you're flagged as having PB.

There are some serious medical conditions that will cause PB/CSR. Don't be too quick to jump to conclusions because the CPAP machine flags "PB."
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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(11-02-2012, 01:11 PM)dcgrafix Wrote: https://dl.dropbox.com/u/104178268/Sleep...tion-1.jpg


I'm not a doctor, and I'm not your doctor, but let's stop beating around the bush. You're still breathing just fine even during the PB events. The machine is just being over eager to point out possible problems to be looked at.

Unless your breathing decreases a whole lot more in the "valleys" or you start doing PB for a lot more of the night, it's meaningless. I'm doubtful that there's anything at all going on in those graphs in terms of actual high/low blood CO2/O2 concentration.

Look up the graphs on the web to see what breathing looks like in REAL CSR.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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Thanks archangle
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