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+--- Thread: looks like i have cheyne stokes.. (/Thread-looks-like-i-have-cheyne-stokes)
looks like i have cheyne stokes.. - trailrunner - 01-14-2021
new to OSCAR. looks like I have CSR.... :
freaking out sorta. looks like i get this 2 - 3 times a month. so its not consistent.
not sure if anyone has CSR but I'm wondering what this all means, and what I can do.
thanks for any experiences or suggestions.
RE: looks like i have cheyne stokes.. - Crimson Nape - 01-14-2021
That was a poor choice for a descriptor name by Resmed. You need more than breathing patterns to diagnose CSR. It is really periodic breathing. Several members here experience this problem. Don't fret over it. It seems to be localized and not spread out throughout your sleep session. Your breathing builds up to a hyperventilation condition and washes the CO2 out of your system, causing the breathe response to cease. Once your CO2 builds back up, you start breathing again but now are trying to make up for the O2 that got depleted. This is just a guess, but you could have been having a dream that was causing you anxiety.
RE: looks like i have cheyne stokes.. - trailrunner - 01-14-2021
Thanks Crimson. Ya I scanned thru previous posts about CSR and noticed my flow rate pattern matched exactly this pattern as posted in a previous post: i.imgur.com/Po5bH2o.jpg
I need to research periodic breathing, (again i'm new to OSCAR and deep diving into my stats) and how to prevent this or change things...
thanks again for the words Crimson.
RE: looks like i have cheyne stokes.. - Sleeprider - 01-14-2021
That is a CSR pattern. If you have health problems that you are aware of, let us know. Otherwise, call your doctor and discuss this. Overall, the extent of this is very short, and is may be an anomaly just to keep an eye on. If it becomes more persistent. a different therapy may be appropriate. Let's assume you are in otherwise good health, and just need time to adapt to CPAP. Reduce EPR to 1 and it's likely this won't repeat. I have more to say, but need to take a break. Any questions?
RE: looks like i have cheyne stokes.. - trailrunner - 01-14-2021
Thanks for replying. health is so-so. overweight, high blood pressure on beta blockers.. but i can do daily activities, walk about 2 miles with major hills.
i've seen this pattern about 3-4 times now in the past 3 months. so its not daily. and it tends to be 20mins or less. i've been on CPAP for 6 years so not new to CPAP..
how do i adjust the EPR? and what does that do?
RE: looks like i have cheyne stokes.. - Sleeprider - 01-14-2021
Keeping in mind, carbon dioxide drives, respiration, part of the problem with this breathing pattern is a repetitive cycle of hypocapnea and hypercapnea from an imbalance of CO2 in the blood. This becomes a feedback loop as it progresses resulting the the very even cyclic pattern, as hypoventilation leads to hyperventilation, then hypo and hyper, until the cycle breaks. The mechanism involves more complex chemical feedback, but that is the basics of respiratory drive. We can reduce that effect by not using "pressure support" (PS) which is the difference between inhale and exhale pressure, where higher differences tend to enhance the flushing of CO2. Right now, you are using EPR 3, which is the same as PS 3. Your median pressure is 9.3/6.3 (inhale/exhale or IPAP/EPAP). So you have pressure support. To change that setting, just enter the clinical setting menu, scroll down to comfort and find the EPR setting. It is currently 3, set it to 1. This little tutorial describes how to access the clinical menu to access that setting by pressing the home button and control knob at the same time. https://www.apneaboard.com/resmed-airsense-10-aircurve-10-setup-info
It's not time to push the panic button. This pattern was only 15 minutes on one night. It can be considered a problem when it becomes a trend and even more prevalent in your results.
RE: looks like i have cheyne stokes.. - SarcasticDave94 - 01-14-2021
EPR is exhale pressure relief, literally on exhale the pressure drops by 1, 2, or 3 cmH2O, same measure as that for therapy pressures. It should be found in the comfort settings, will have duration including full time, which is what I'd set, then set the value, try full-time 2.
If it's not under comfort then it's in clinical menu. In that case hold Home and Dial in at the same time for about 5 seconds and you're in clinical.
RE: looks like i have cheyne stokes.. - trailrunner - 01-15-2021
last nights OSCAR....much much better. but like i said before the CSR comes randomly. but hoping the EPR setting helps in the long run. also used flonase before bed, def helped. i may continue that at night we'll see.
RE: looks like i have cheyne stokes.. - Sleeprider - 01-15-2021
That's great! You absolutely responded to the reduced EPR and this shows your CSR episode was actually a result of the ventilation resulting in you being at and above your apneic threshold, and in a feedback loop. So, no health problems, you just don't tolerate pressure support or EPR well. As you note, looking a the longer term will confirm.
RE: looks like i have cheyne stokes.. - trailrunner - 01-15-2021
thanks sleeprider!!
and thank you for the tip on EPR, i never knew that existed! i also confirmed the change with my sleep dr. and they gave me the go ahead
'many thanks!