Inquiring about PB/CSR

[Starlette]

Post: Freaking Out by Resister

I read the thread stated above.

Wikipedia states: Cheyne-Stokes respiration is an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea. The pattern repeats, with each cycle usually taking 30 seconds to 2 minutes....

So, if I'm understand correctly by Resister's thread and this definition, the concern lies in the time duration and occurrence, correct?
If correct, do I then have something to be concerned about then? I took my data from the last 2.5 weeks.
Also, I didn't document the numbers in parentheses.

Starlette

[Pugsy]

Go back to those dates and zoom in close on the green areas to see what the pattern looks like.

I see PB flagged for short durations of 2 minutes to maybe 4 minutes and when I go look at the actual waveform...doesn't even come close to a typical CSR pattern. Sometimes a maybe come close. Most of the time it is obvious that it is not anything like CSR.

The Respironics definition of Periodic Breathing is " a Respironics data feature defined as a persistent waning and waxing breathing pattrn which repeats itself between 30 and 100 seconds. The nadir of the breathing pattern is characterized by at least a 40% reduction in airflow from an established baseline flow. The pattern must be present for several minutes before it can be identified as periodic breathing. No therapy adjustments are made in response to periodic breathing."

I already gave one example in Resistor's thread of an obvious false positive. That was an old one. I had this one below flagged 3 nights ago.
One single short lived PB flag. 205 seconds...about 3 1/2 minutes.


This is what real CSR pattern looks like. Easy to see that there is an obvious difference. I don't have a longer one to give someone a better look. Maybe someone else has a better image.

[JohnBFisher]

Starlette, you wonder if you should worry about the PB/CSR indications in your data. I would put it this way ... If you see signs of some periodic breathing on a regular basis (as you do), then I would answer another question before going to see my doctor.

If you have (as I do, such as my weight and other issues) other risk factors for cardiovascular problems, then I would recommend you chatting with your primary care specialist. They then might want to do an EKG to see if there are any issues they can see. Depending on the various tests that your PCP does, they might want to refer you onto a cardiologist. If you are otherwise healthy, it might be the type of thing you should ask during your next physical.

If you saw the signs of PB/CSR every evening and for more than a few minutes at a time (which I did not see from the data you provided), then in your shoes, I would definitely visit my PCP for an opinion. Otherwise, at a lower number of events and lower duration, it is something to watch.

Again, this is just how I would react if I were in your shoes. I hope my explanations make sense.

[Starlette]

Thank you Pugsy & John for responding.

I went back to every PB/CSR from last night to 01/22/11. Here are the photos.
Every one looks like 02/02/12, 01/22/2012 & 01/24/2012 are the only ones that are different.

@ John - I already have my next physical scheduled for 04/2012. I'll be sure and bring this up to my PCP.
As for the EKG and Cardiologist, I saw them back in 2005.

Starlette

[Paula J]

I have some PB every night, anywhere from 2% up to 14%. They last anywhere from 2 min. to 10 min. During the PB, sometimes I will have a CA or OA or Hypopnea event or several events. I have talked to my Pulmonologist (sleep doctor) about this and he says not to worry about it......that it is just another type of breathing! I have even shown him some of the wave length graphs. Last week, I went to my cardiologist for my annual checkup ( I have some mild leakage in a heart valve that he keeps an eye on). I told him about the PB and he said it shouldn't be anything to worry about. My echocardiogram and EKG were normal (for me). Even with both of them saying not to worry about it, it still bothers me.

[Kairosgrammy]

I'm sure you helped the original poster but I wanted you to know, you also helped me. I will now go home and look at the events I have flagged. They don't happen every night but I do get the clear airway and PB/CSR readings fairly often. I worry about them but I figure I'm just over worrying. Now I know what to look for. Thanks.

Go back to those dates and zoom in close on the green areas to see what the pattern looks like.

This is what real CSR pattern looks like. Easy to see that there is an obvious difference. I don't have a longer one to give someone a better look. Maybe someone else has a better image.

[Pugsy]

I had 2 short lived episodes of PB flagged last night. They totaled less than 1%. Again nowhere near looking like CSR. It's obvious that the pattern is a bit waxing and waning but nothing like true CSR pattern.

Though the whole report from last night was horrible looking....AHI 5.67 whoopie...nearly 2 of that was ClearAirway Index. Despite ugly report and minor headache (which could be my neck because my neck hurts with the cold damp rainy weather we are having) I feel quite decent. I will post about it over on the Bella Loops thread.

[JohnBFisher]

... I have some PB every night, anywhere from 2% up to 14%. ... Even with both of them saying not to worry about it, it still bothers me. ...

I can understand why. However, I would go with what your doctors are saying. Of course, in your shoes, I would try to reduce any cardiovascular risk factors. The more you can reduce the load on your cardiovascular system (lower BP, lower weight, lower blood glucose, etc) the better it will be for you and your heart.

And you are a good example of why we suggest chatting with your doctor about something like this. While it can be perfectly normal and not a sign of problems, it should be monitored.

[Gabe]

Is PB and CSR one and the same? It is listed together in the data (left side) in Sleepyhead. I was over 5% on the PB/CSR data last night. There have been a lot of nights over 2%. Should I be concerned,then? How did Starlette make her PB/CSR chart for 2.5 weeks?

Quote John Fisher:
If you saw the signs of PB/CSR every evening and for more than a few minutes at a time (which I did not see from the data you provided), then in your shoes, I would definitely visit my PCP for an opinion. Otherwise, at a lower number of events and lower duration, it is something to watch.

Again, this is just how I would react if I were in your shoes. I hope my explanations make sense.[/quote]

[Starlette]

Going down for a nap Gabe. I'll explain later on today.

Starlette

[cpaptex]

Starlette here's my pattern from Feb 4th,



I have days where it's like this over and over for 15-30 minutes. And days when nothing happens. They always happen when my CAs get a bit out of control. I'm concerned about the frequency of the events. It is not usually for just a minute.

[Starlette]

So then, I would take it your SH demonstrates what would be classified as CSRs. That looks scary. Yes hope you are keeping an eye on that.

@ Gabe - I gathered my chart info from the last 2.5 week from SH. Every time I showed PB/CSR I documented it, the percentage and the duration.
I'm understanding now is more about the rhythm.

Thank for posting Cpaptex, makes sense now.

Starlette

[Gabe]

Thanks Starlette, but I don't know how to document it and put it in the format that you did.

[Starlette]

Look up above at 1/22/12 attached photo. Click "events", then click "Periodic Breathing" that is where I got the time down.
To get the picture to blow up, place your pointer over the green bar to highlight, that is how you get it in detail.
I just used a Word table is all. After viewing Cpaptex's data, watching Gabe's video on his thread, "PB/CSR Scary" and jamiswolf's comment on Gabe's thread, I have a better understanding of this.

Thank you.

[Pugsy]

Starlette....I am betting Gabe was referring to your Word Table graph for presenting the data.
I just imagine he has no clue how to use that feature (neither do I ) to document his patterns of PB breathing data.