Is this Cheyne-Stokes?

[Coberson75]

Hello, I am posting this on behalf of my spouse who is too busy to deep dive into CPAP data himself. We both took at-home sleep tests in February 2024 and began using CPAPs in March 2024. I got a lot of help from this board for my issues and so I'm hoping you guys can help out with his issues.

He was diagnosed with moderate apnea consisting of 24.9 AHIs (24.3 hypopneas and 0.6 obstructive apneas). The pressure on the machine was originally set from 4.0 - 20.0 with no EPR and with a ramp, which he did not tolerate well. I changed his pressure to 9.0 - 13.0 with EPR 3 and no ramp after some trial and error. (When the min was too low, he got OAs, and when the max was too high, he would wake up often and got bad mouth leaks. He thought higher EPR made it more comfortable.) These setting have been better than the initial settings, but he still feels less than happy with the therapy, and the numbers aren't always great. He also tried out different masks and so far the N20 has been his favorite, but it's not perfect. 

For both of us, the CPAP hasn't erased the fatigue that brought us into the doctor in the first place, but we do notice other benefits and so we do our best to stick with it. I've been meaning for a while to post on his behalf to ask how to make his therapy better, but the focus on CPAP got back-burnered for a while and I haven't examined the OSCAR data for many months. 

Today I finally did a big OSCAR upload and was frightened to see several recent incidences of what ResMed identifies as Cheynes-Stokes respiration. I'm attaching screenshots along with data from the sleep study. 

Is this real Cheyne-Stokes respiration? What does it mean? Should we be worried? Is there anything else about the data that jumps out? 

Thank you so much. 
           

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[quiescence at last]

I would say this is not really C.S. especially if he doesn't have other signs of heart failure. The waxing and waning does signal that your regulatory control mechanisms are not correcting breathing rates and volume quickly enough to avoid these clear airway apneas. Some have found that the higher the EPR setting, the more likely this phenomenon occurs.

If this were my chart, I would trial at EPR of 2 for a few nights and compare.

QAL

[Jay51]

I agree with QAL.  Lowering your EPR (or possibly even turning it off after trying 2 and 1 fulltime) might completely get rid of these events that are most likely wrongly flagged as CSR.  You can always show these exact OSCAR charts to your Dr.'s.  Here is some more reading on CSR from our wiki:         

• Cheyne-Stokes respiration
  

[Coberson75]

Thank you both so much, it’s a relief to hear that this can arise from treatment. I changed the EPR to 2 and will keep a closer eye on the OSCAR data to see if it goes away.