Cheynes-Stokes Respiration

[máirtín]

This is something that showed up on all my sleep studies.
I have a general idea of what it is but I would like more information.
Googling the term mostly produces results that link it to heart disease.
What is the mechanism that produces this pattern and how is it treated?

[JDS74]

This is something that showed up on all my sleep studies.
I have a general idea of what it is but I would like more information.
Googling the term mostly produces results that link it to heart disease.
What is the mechanism that produces this pattern and how is it treated?

I think the most common cause is heart disease followed by certain lung and pancreas conditions.
All of these are serious and need to be excluded and/or treated.

That said, perhaps you suffer from what is called idiopathic Cheyne-Stokes Respiration. That's doctor speak for they don't have a clue as to the cause.

In my case, I've had a 24 hour Holter monitor EKG, an echocardiogram, numerous cardiac stress tests, etc. All are well within normal range for someone my age. The issue is whether or not it causes desaturation of your O2 levels enough to be worrisome. An overnight oximetry test will probably resolve that issue.

If it is a problem, then one of the Adaptive Servo Ventilator CPAP machines may be in you future. I have read they give some level of relief for this condition. I don't have one yet as my CPAP treatment using a Philips BiPap machine seems to be controlling my apneas fairly well.

Here is a link to a Wikipedia article that is well written and should give you the basics of what the docs are talking about.
You could also ask them to run off a strip on your respirations from one of the studies so you could see your actual performance.

http://en.wikipedia.org/wiki/Cheyne-Stokes_respiration

[Audge]

Just wondering if it is actually Cheynes-Stokes or, perhaps, central apnea. I have ComplexSA so I have central apnea episodes as well as obstructive apnea episodes. My heart tests were also fine but sometimes my brain drops the ball and forgets to tell my body to breathe which is, as I have been told, the central apnea. My test indicated for the night 92 central episodes and 244 obstructive episodes and 6 hypopneas....they told me I am severe. Not debating your testing but just wondered if it's central apnea. Otherwise, yup, I would get the ticker checked out.

[M.D.Hosehead]

Depends upon how much (how frequent and how long) CS and whether there is O2 desaturation. So overnight oximetry is what you need to do now. As you've discovered, people can and do have CS without disease in any major organ. However, if you desaturate during the CS episodes, gradual heart/brain damage could occur and you may need a different machine to prevent that.

[SenjiMom]

HI

I'm a new member here and I also work in healthcare. I'm a Respiratory Therapist.

Cheyne-Stokes Respiration is an abnormal pattern of respiration that is often seen in central sleep apnea and neurologic conditions like traumatic brain injuries. It is also associated with heart failure. If I understand it correctly, the reason for the delay in the respirations (apneas) has to do with blood flow to the brain tissue. In patients with heart failure, the delay in flow via the circle of willis (the system of arteries that provide blood to the brain) creates a lag in the communication that occurs. Our brains know when to breathe based on CO2 levels. If blood flow is impaired, delay in recognition of CO2 levels, brain isn't triggered to breathe, so apneas are seen.

I actually learned this in observing a Trauma ICU patient who we were trying to figure out why they were "Cheyne-stoking". congestive heart failure was the answer, was a trick since the patient was at the hospital for a trauma.

I'm not sure of your diagnosis but if you have OSA, you probably know about overlap syndrome. This is the common occurence of overlap of OSA & CHF (congestive heart failure) in pts. You might want to speak with your doctor about getting an Echocardiogram (ECHO). Or if you have CSA, then maybe not such a concern.

best of luck
Jen

[máirtín]

Thanks everyone for the great information.
Just so you know: Dx of OSA, CSA, CSR, mixed apnea. I'm using the latest whizz bang product for CSA and CSR - the Resmed VPAP ASV.
I also have PVC/bigeminy - lots of extra beats all the time but especially when I lie down. Other than that I have no known heart issues - I've had the halter monitor and get an annual Echocardiogram.

During my sleep studies my O2 saturation never dropped below 90%.