Cheyne-Stokes 4 cases recently

[marcinpiskala]

       

Good evening, my mother has been using Resmed For Her for 2 years. Recently I found 4 cases of Cheyne-Stokes respiration shown by Oscar. They lasted 14-19 mins. 

Could you please help me analyse if they are real? I know that Resmed sometimes incorectly reports CSR. However, I do not have experience in CSR and I am not sure how to recognize if the pattern is real or fake. 

It really concerns me and I would be very, very grateful for your help. Please find the example of one episode. I have attached 2 screens: a bigger picture and zoomed one. Please help. 

Regards, Marcin

[Jay51]

Hello Marcin, 

While it is true that the vast majority of Cheyne-Stokes Respirations that show up on OSCAR charts are not real true CSR, there are a few instances that could be legitimate.  

A few questions may help determine your course of action as well as some additional reading on CSR from our wiki.  

1.  How old is your mother?  The older a person is, usually the more likely CSR could be real.  

2.  Does she have a Cardiologist?  Or Pulmonologist?  They both helped me learn some things about CSR as well.  

3.  Does she have heart failure or any other heart related issues?  The vast majority of true CSR tend to appear with people in heart failure.  

Just a comment as well:  Most false CSR happen briefly (usually brief or only a few minutes).  Since the CSR flagged lasted for 20 minutes, it raises a little suspicion.  

Here is some more reading from our wiki on CSR:  And the "Associated Conditions" section highlights some other causes of CSR besides heart failure:  

• Cheyne-Stokes respiration
  

[marcinpiskala]

thank you for the answer! Answering your questions:
1) She is 73 years old
2) Yes, she has both and additionaly neurologist.
3) no. Never.
I have attached 2nd eposide - 8.04.2025. It lasted 12 mins. I am concerned as this has never happened during last 2 years.
When she was in a hospital from 15.04.2025 - 1.05.2025 (pulmonology/rehabilitation), saturation measurement took place every day in the morning (always 96-99). She had good results of spirometry as well. No headache, no heart pains. The only problem was terrible pain of her left arm, shoulder (probably tear of muscle). She has been treated and recovered.

I am wondering if the pattern of her CSR (attachements) can be recognized as real? I have read that particular sequences of respiration and apneas (patterns) may determine if CSR is fake or real.

thank you

[Jay51]

Thank you for that information.  Hopefully these are not real, true CSR.  From looking at these charts, they kind of resemble the crescendo-decrescendo pattern of real CA's (even though she only has a few CA's in the long term sequence).  

A great plan would be to show these charts to all of her Dr.'s at her next appointments.  They can help determine if these are real CSR or not.  And more importantly they could attempt to provide treatment if necessary as well.

[marcinpiskala]

thank you. I am going to talk to the doctor. Unfortunately he does not want to look at my charts from Oscar, possibly does not treat as reliable enough
I have attached CSR number 3 and 4. They do not last very long, only: 15 and 19 mins. Some leaks are visible for 3 may in the time when CSR appeared. Could you also have a look please.

Thanks!

[Jay51]

Leaks can contribute to CA's; but CSR is more of a consistent pattern.  CSR have shown up on several OSCAR charts already (although each looks slightly different - but they each last pretty long duration wise).  

Great job trying to show these OSCAR charts with CSR to your Dr.  At least you are making the Dr. aware of it.  Try to show your mother's other Dr.'s these charts as well.  By telling them about it, it should surely help.  It couldn't hurt.

[kwhenrykerr]

Not being trained with what you are showing the doctor may cause a rejection. Not great but it happens.