[Symptoms] Flowrate pattern

[Juanito]

Can anyone explain to me what kind of sleep pattern is shown in the attached image? I never had anything like this happen to me before.

[retired_guy]

I believe that's something called "Cheyne-Stokes" breathing. What it suggests to me for you to do is talk with your Doc about this. Take the picture with you when you go. It could simply be something transient or environmental, but it could also be an indicator of something else you would want treated.

[Juanito]

I believe that's something called "Cheyne-Stokes" breathing. What it suggests to me for you to do is talk with your Doc about this. Take the picture with you when you go. It could simply be something transient or environmental, but it could also be an indicator of something else you would want treated.

Thank you very much. I think I will wait and see if it happens again. If it does I will set up an appointment with my doctor.

[justMongo]

I'm not sure there's anything that can be done about CSR. We had at least on person on the board who exhibits CSR -- perhaps they can shed some light on it.

[archangle]

Look up Cheynes Stokes Respiration and periodic breathing.

There are some serious medical conditions that can cause CSR, but it can also not be that serious.

On CPAP, sometimes the airflow will flush out the CO2 from your bloodstream too much. There is also an effect on the feedback in your respiratory system from the lungs inflating more completely. Both of these phenomena cause your respiratory drive to be temporarily reduced and your breathing may slow down or stop. Eventually, CO2 builds up and O2 drops and your respiratory drive goes up and you breathe again.

The urge to breathe is more dependent on CO2 than it is on low O2.

Before you panic about it too much, look at the airflow waveforms and think about how long your breathing has stopped or reduced.

My impression is that most sleep doctors don't worry that much about periodic breathing or CSR while doing CPAP unless it gets bad.

You can probably reduce it by lower CPAP pressures, but that may not be necessary. It may increase your obstructive apneas as well. Sometimes you have to balance the CA/CSR/PB vs. obstructive apnea. If it's bad, you may need an ASV machine to handle the central apnea aspect of it.

If your clear airway index is that low, it's probably not a big deal, as long as you're not having really long clear airway apenas.

[Juanito]

I'm not sure there's anything that can be done about CSR. We had at least on person on the board who exhibits CSR -- perhaps they can shed some light on it.

I have a seizure disorder and, after looking up details about CSR, I concluded I simply had a seizure while sleeping. I then knew what to do and won't be seeking more advice. Last night I was back to my normal breathing patterns. Thanks for your informative guidance.

[Galactus]

I'm not sure there's anything that can be done about CSR. We had at least on person on the board who exhibits CSR -- perhaps they can shed some light on it.

I have a seizure disorder and, after looking up details about CSR, I concluded I simply had a seizure while sleeping. I then knew what to do and won't be seeking more advice. Last night I was back to my normal breathing patterns. Thanks for your informative guidance.

Just a thought, you might post what you are doing, so in the event someone comes along at a later date looking for advice on a similar matter your solution might be utilized by them as well.

[archangle]

I'm not sure there's anything that can be done about CSR. We had at least on person on the board who exhibits CSR -- perhaps they can shed some light on it.

I have a seizure disorder and, after looking up details about CSR, I concluded I simply had a seizure while sleeping. I then knew what to do and won't be seeking more advice. Last night I was back to my normal breathing patterns. Thanks for your informative guidance.

Don't be too sure it's a seizure. That's a very common pattern for many CPAP'ers.

[Juanito]

Don't be too sure it's a seizure. That's a very common pattern for many CPAP'ers.

I looked back through my flowrate graphs from the time I received my ResMed S9 and don't find anything like the pattern I posted (at least not for such a long time). So the pattern is unusual for me. It has not recurred, perhaps because I took my seizure meds or perhaps because it was not going to return. Anyway, I'm not concerned. Thanks, everybody, for your responses.

[wolson]

Archangel's post above is excellent.

This is an excellent synopsis of everything that I have read about it in the medical literature. I also have CSB and don't have a clue yet what is causing it. My guess is that the APAP has uncovered it and it may as the above author suggested be due to hypocapnia brought on by the machine.

Thank you.

Walter W. Olson. Ph.D., P.E.
Professor Emeritus