Cheyne Stokes Respiration

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Hosehead4ever
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Cheyne Stokes Respiration

Post by Hosehead4ever » Sun Feb 01, 2015 11:02 am

Is there a level at which this type of breathing becomes worrisome?

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Pugsy
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Re: Cheyne Stokes Respiration

Post by Pugsy » Sun Feb 01, 2015 11:21 am

I have never seen any documentation as to how much CSR is a problem like we see with other statistics.
There's a lot to consider besides just a % of time in CSR...with general health being important.
I have no heart issues so if I had 5 to 10% of the night in CSR show up occasionally it wouldn't be nearly as scary to me as if I had it show up and I knew I had some sort of heart issue like congestive heart failure.

What I would do if I saw over 10 % of the time in CSR consistently every night...I would at least ask my doctor about it.
And that's assuming it was true CSR and not just mild Periodic breathing.

Random brief CSR flags...real or not I don't know that it is a cause for worry but if a person is concerned...by all means run it by their doctor.
Prolonged consistent CSR with accompanying high central count....needs to be evaluated by the doctor sooner than later because it can mean Complex Sleep Apnea has materialized.... and one or two centrals per hour is far from a high central count. I am talking high central count of 5 or more per hour that is prolonged and frequent.
I once had 17 centrals in 17 minutes and it looked an awful lot like true CSR...but it only happened once...I wasn't alarmed by it but if I had seen that happen often...then I would be concerned.

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Hosehead4ever
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Re: Cheyne Stokes Respiration

Post by Hosehead4ever » Sun Feb 01, 2015 1:43 pm

Thanks. That all makes sense. Mine hasn't been quite to 2% so I'm not worried. I just noticed it was something that had been happening consistently and didn't know anything about it.

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archangle
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Re: Cheyne Stokes Respiration

Post by archangle » Sun Feb 01, 2015 5:52 pm

One problem is that what PRS1 machines flag as "periodic breathing" may not be very severe at all. I haven't seen how mild PB/CSR can be before and AirSense 10 machine will flag it.

While some very serious medical conditions can cause CSR, CPAP induces PB/CSR in some people and it doesn't necessarily man anything.

Even if you were in PB/CSR all night long on a PRS1 machine, it may not mean anything at all, because it can be a very mild waxing and waning of the airflow. It could also be a sign of serious central apnea, or some unrelated serious medical condition.

Like all central apnea, you need to look at the airflow and see how long, how completely, and how often you stop breathing.

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Pugsy
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Re: Cheyne Stokes Respiration

Post by Pugsy » Sun Feb 01, 2015 6:37 pm

Here's a couple of examples when the PR S1 flags PB and it isn't anything near like real CSR despite SleepyHead putting that name on it. It isn't CSR. It's just plain ordinary PB that means not much of anything exciting at all. Now if it looked like the image below from ResMed and had some centrals in it then I would sit up and take more notice if I was seeing it very often or very prolonged.

Image

Image

and here is the flow pattern with real CSR that I snagged from the AirSense manual since the new Resmed AirSense machines will now flag CSR. I haven't seen any examples from the new machine yet to see how much of a leeway there is in actual air flow wave form.

Image

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palerider
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Re: Cheyne Stokes Respiration

Post by palerider » Sun Feb 01, 2015 8:13 pm

Pugsy wrote:Here's a couple of examples when the PR S1 flags PB and it isn't anything near like real CSR despite SleepyHead putting that name on it. It isn't CSR.
I've put "fix the label on that flag" on mark's list of things to do with the next version

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Pugsy
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Re: Cheyne Stokes Respiration

Post by Pugsy » Sun Feb 01, 2015 8:17 pm

palerider wrote: I've put "fix the label on that flag" on mark's list of things to do with the next version
Good. It has always been a bit of a bother to me to have to keep explaining that PB is NOT always CSR and trying to alleviate someone in panic mode when they see 5 minutes of PB that is not CSR and they are ready to go to the ER or cardiologist immediately because they read up on what causes CSR.

I think maybe Mark really had some CSR looking PB when he was using his PR S1 and designing Sleepyhead...so that was on his mind and not realizing that not everyone had the ugly reports he was having back then.
Knowing his issues it wouldn't have surprised me if they were the real deal.

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palerider
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Re: Cheyne Stokes Respiration

Post by palerider » Sun Feb 01, 2015 8:48 pm

Pugsy wrote:
palerider wrote: I've put "fix the label on that flag" on mark's list of things to do with the next version
Good. It has always been a bit of a bother to me to have to keep explaining that PB is NOT always CSR and trying to alleviate someone in panic mode when they see 5 minutes of PB that is not CSR and they are ready to go to the ER or cardiologist immediately because they read up on what causes CSR.

I think maybe Mark really had some CSR looking PB when he was using his PR S1 and designing Sleepyhead...so that was on his mind and not realizing that not everyone had the ugly reports he was having back then.
Knowing his issues it wouldn't have surprised me if they were the real deal.
I thought it said "PB" until the as10 came out, with it actually saying it'd flag CSR, then he changed the label for both.. *shakes fist*

I might be mis-remembering... long nights talking to crazy aussies will do that to a guy.

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Pugsy
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Re: Cheyne Stokes Respiration

Post by Pugsy » Sun Feb 01, 2015 9:20 pm

palerider wrote: I thought it said "PB" until the as10 came out, with it actually saying it'd flag CSR, then he changed the label for both.. *shakes fist*
I don't remember when it was changed to just CSR but I have a report in the 0.9.3.0 version showing where it was shown as PB/CSR. I thought the change was prior to when the AirSense came out but I don't remember and I don't have PR S1 reports available in the older Sleepyhead versions to confirm (I haven't kept all of the various versions or if I did they only have S9 data in them).

He needs to go back and go to the PB/CSR name...IMHO. Maybe won't cause so many panic attacks.

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Hosehead4ever
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Re: Cheyne Stokes Respiration

Post by Hosehead4ever » Sun Feb 01, 2015 10:04 pm

Pugsy, the graphs were very helpful. I looked at the breathing graph on SH and sometimes it looks like that Resmed graph, but usually not. I am not alarmed any more.

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