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Is This Cheyne-Stokes Respiration?
#1
My periodic breathing is on the increase and the last two nights has been over 14%. As someone who has had a heart issue (triple bypass in 2013) I am concerned that this might be CSR. Before I go racing off to the doctor, could the experts on this forum look at one of my PB events and tell me if the waveform indicates possible CSR and the possible onset of congestive heart failure.

https://imageshack.com/i/pnfnErNYp
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#2
To determine if it CSR or a different type of PB, we really need to see the flow over a couple of cycles of waxing and waning, which will take a few minutes. You've zoomed in too far.

CSR shows a smooth reduction in flow followed by a central apnea, followed by a smooth increase in flow. All this repeated over and over. If the apnea episode is followed by a sharp recovery breath, then that is not CSR.

>>Disclaimer: I'm an engineer not a medical professional. Take my advice for what it's worth<<
DeepBreathing
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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.
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#3
(05-13-2017, 10:37 PM)holden4th Wrote: My periodic breathing is on the increase and the last two nights has been over 14%. As someone who has had a heart issue (triple bypass in 2013) I am concerned that this might be CSR. Before I go racing off to the doctor, could the experts on this forum look at one of my PB events and tell me if the waveform indicates possible CSR and the possible onset of congestive heart failure.

https://imageshack.com/i/pnfnErNYp

Hi holden4th,

I think "true" CSR is the CSR breathing pattern which occurs even without CPAP. Also, it is fairly common that living or traveling in a high altitude can cause central apneas, which disappear after returning to a lower altitude.

The short period you posted shows smoothly waxing and waning of the Flow. This may be Periodic Breathing but is not CSR-like unless there are periods of longer than 10 seconds of no breathing between the gradual starts and stops.

My heart rate is chronically slow, which I think may be a contributing cause of my own occasional CSR-like breathing pattern.  Heart failure is not the only reason for CSR-like breathing patterns.

Regarding heart failure, though, the note below was copied from http://www.medicinenet.com/script/main/m...1930#page3

It should also be noted that in patients with underlying heart disease, taking certain medications can lead to the development or worsening of congestive heart failure. This is especially true for those drugs that can cause sodium retention or affect the power of the heart muscle. Examples of such medications are the commonly used nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen (Motrin and others) and naproxen(Aleve and others) as well as certain steroids, some medication for type 2 diabetes, for example, rosiglitazone (Avandia) or pioglitazone (Actos), and some calcium channel blockers (CCBs).
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.
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#4
(05-13-2017, 10:54 PM)DeepBreathing Wrote: To determine if it CSR or a different type of PB, we really need to see the flow over a couple of cycles of waxing and waning, which will take a few minutes. You've zoomed in too far.

CSR shows a smooth reduction in flow followed by a central apnea, followed by a smooth increase in flow. All this repeated over and over. If the apnea episode is followed by a sharp recovery breath, then that is not CSR.

>>Disclaimer: I'm an engineer not a medical professional. Take my advice for what it's worth<<

Is this a better time frame?

https://imageshack.com/i/pnS9qvzop
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#5
(05-14-2017, 01:53 AM)holden4th Wrote: Is this a better time frame?

https://imageshack.com/i/pnS9qvzop

Looks to me like PB, not CSR.
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.
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#6
I agree, this does not resemble CSR. I have an example you can consider:

[Image: EQz81TPh.png]
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#7
Given your cardiac history, you should be monitored by a cardiologist.
I don't know how things work in Oz; but an annual echocardiogram would seem appropriate.
(I too am an engineer -- so, unless you are a missile or a satellite, take what I say with a grain of salt.)
With an echo, the wall motion of the heart, the valve action and the ejection fraction can be estimated.

I have a friend who was in congestive heart failure several years ago. He became unable to lie down without coughing.
His ejection fraction was down to 30%. Today he is doing well with a LVEF of 70%. No surgery, just medications and a huge change in lifestyle.

It's my understanding that CSR is not a symptom of CF. There is a warning out that use of an ASV in certain patients with CF may be contraindicated. CSR originates in the brain. A modulation of the central ventilator drive -- a sort of oscillation of the PaCO2 trigger for respiration.
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.
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#8
mongo, for some unknown reason, holden is self treating. public hospital healthcare in australia, is free. The newly acquired bipap may even be causing the erratic breathing patterns.
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#9
(05-13-2017, 10:37 PM)holden4th Wrote: My periodic breathing is on the increase and the last two nights has been over 14%. As someone who has had a heart issue (triple bypass in 2013) I am concerned that this might be CSR. Before I go racing off to the doctor, could the experts on this forum look at one of my PB events and tell me if the waveform indicates possible CSR and the possible onset of congestive heart failure.

https://imageshack.com/i/pnfnErNYp

like we said in the other forum

see a doctor for heart questions not rely on some RAD machine 

PB is not a precursor of anything that i am aware of
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#10
Good info on CSR from the Resmed site:  http://www.resmed.com/us/en/blog/diagnos...ation.html

CSR is often linked to congestive heart failure--discussed in this article.
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