Cheyne Stokes respiration - first time seeing it

[sleepychar]

I have been on CPAP for just going on 7 months now, adjusting fairly well so far. Sleeping better, feeling better. For the most part waking up only once a night for bathroom trip vs pre-CPAP and early days on CPAP when I was waking up every hour or hour and a half. AHI is frequently/usually below 1, occasional large leaks but most of the time under the 24L for the Resmed Autoset for Her limit. This morning's SleepyHead report, though, showed a 20 minute stretch of Cheyne Stokes respiration for the first time. This occurred about a half hour after going to sleep, or masking-up, as it took a short time before actually falling asleep. I have searched posts and so I have seen that it may or may not be something to worry about. Since this was the first occurrence, I am not too freaked out yet... but it does bother me that it lasted for what seems to me a longish time. Of course this had to happen just a few days after my 6th month check-up with pulmonologist so I didn't get to ask him about it. So here I am, sharing with the group, looking for a little reassurance or advice, trying to decide if I should call the doctor for another consult. Right now I'm telling myself not to worry since this has only happened one time so far... but is a 20 minute stretch of Cheyne Stokes unusual?

[Julie]

Why do you think it's 'Cheyne-Stokes' rather than just what's called sleep-wake junk (some 'centrals' or clear airway events many of us have on drifting off or just before wakening?

[sleepychar]

Thanks for your response, Julie...

Only because that's how SleepyHead categorized it - and it's the first time I have seen it shown that way in SleepyHead - and it was for a solid 20 minute period whereas when I have seen centrals listed in my SleepyHead reports, they are generally isolated and lasting only 10-15 seconds each... maybe it is only sleep-wake junk... I would like to think so... I am only mildly concerned at this point but concerned enough to post about it.

[Pugsy]

Have you compared the actual flow rate that your machine is flagging as CSR with the example of CSR shown in the provider manual?
Zoom in on the flow rate (using SleepyHead) and see if it looks like this below.....and were there any flagged events showing up during this time that has been flagged?

I have not seen any examples of CSR flagged breathing from an AirSense 10 machine. I don't know if it is known to flag minor Periodic Breathing as CSR or if it isolating full blown for sure CSR. Can you share a zoomed in image of the flow rate that is being flagged? Need to zoom in though...can't see the individual breaths well enough unless you zoom in so that you can see each breath like in the image below.
I would really like to see an example of what ResMed flags.

[sleepychar]

Pugsy, I am trying to post SleepyHead chart but after I put SleepyHead into full screen mode, per tnet instructions I was reviewing, SleepyHead is now completely frozen. I have entered a separate post on that topic, hoping to get some advice on how to resolve that. I'm thinking I may need to uninstall and re-install SleepyHead. Will I lose all my previous data if I do that? Anyway, I'm currently waiting for advice and will post chart as soon as I can... Thanks

[Pugsy]

No, you won't lose any data because everything is still on the SD card.

That full screen thing is a known bug in SH...I wish that particular instruction was removed from tnet site.
The report doesn't have to be in full screen to see things well enough but it sure causes headaches.

Try creating a new user profile first....and give me some time because you aren't the first to have this happen and there are various "fixes" that have worked and mentioned on the forum in the past.
I just gotta find them and I am short on time at the moment.

[sleepychar]

I am searching previous posts myself as well... so far I found that PaleRider suggested F11 and that worked for someone but it did not work for me. I don't think I can create a new profile because I can't get into any aspect of SleepyHead other than a view of the full screen. I noticed a post from one user who said they had uninstalled/reinstalled SleepyHead and it did not resolve the problem for them. I will see if there are any other suggestions before I try the uninstall/reinstall myself...

[Pugsy]

If you uninstall...there's a SleepyHead folder in your MyDocuments folder that won't be removed with the uninstall and that's where all the old data and selections are stored and that might be why uninstall didn't fix the problem for some people because any new install will draw from that folder.
One would have to manually remove that folder also. So bear that in mind if you end up with a reinstall and the problem still doesn't get resolved.

[dorilu]

I posted an image of Cheyne Stokes respiratation that was reported as such on my Airsense 10, back in Oct. Pugsy replied that it looked like real CSR and real centrals to her.

Re: Newbie's AHI higher than at sleep study

Postby Pugsy on Thu Oct 27, 2016 12:45 pm

Got it..thank you. Looks like real CSR and real centrals to me.


It was an episode lasting 26 min. I had not had it before nor have I ever had it reported since so I'm assuming (hoping) that it is not of any significance. I tried to paste the actual close up image here but couldn't get it to. It's on pg 2 of my thread.

[Pugsy]

I posted an image of Cheyne Stokes respiratation that was reported as such on my Airsense 10, back in Oct. Pugsy replied that it looked like real CSR and real centrals to her.

I had forgotten about yours.

I would still like to see SleepyChar's though. Yours had a bunch of centrals associated with the flagging and sleepychar didn't mention a truckload of centrals.

[dorilu]

I am interested in seeing hers as well. I monitor my reports every morning to keep an eye out for any CSR flagging.
The fact that I haven't had any other episode other than the one night could mean that it may have been some error on the part of the machine and that could be the case with SleepyChar as well.

[Rob K]

I have the same problem with full screen mode in Sleepyhead. Sometimes it locks up after pressing the F11 key. I am still able to take a screen shot by pressing F12 and then press the F11 key again to exit full screen mode. Once out of full screen mode then everything works as normal. Not sure if this helps you at all, but figured I'd mention it.

Edit: I just seen you started another thread on this subject and what I mentioned did not work for you. Good luck.

[JimW159]

A few months following a heart attack I noted CSR on SH. When I spoke to my cardiologist the next day he said to track for a few days to see if it continued or was an isolated event. When I first saw the pattern, I immediately homed in on a song:
https://www.youtube.com/watch?v=BmuS5CQlMlo

Fortunately for me, I did not linger too long with the negative prognosis. Rather, I focused on another video that presents the situation from the viewpoint of a PAPer.
https://www.youtube.com/watch?v=RdzgAA861Yw

[sleepychar]

Thanks for your comments, Jim W. I confess, I am a little bit worried about my heart. I don't have a personal history of heart disease but there is a serious family history of it and just recently some very minor symptoms have come up. I am of a certain age (72 years old) where these things start to be of concern. I discussed those minor recent symptoms with my primary care doctor not that long ago. An EKG didn't show anything untoward and the symptoms I described were "atypical" and we decided were from a musculo-skeletal source and we decided against a cardiac follow-up. I don't want to go into panic mode from one episode which may or may not be true Cheyne Stokes respirations but it is a worry in the back of my mind - maybe not all that far back...

[sleepychar]

Here (I hope) is screenshot of Cheyne Stokes from SleepyHead: