Distinguish between Cheyne-stokes and Periodic Breathing

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dataq1
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Distinguish between Cheyne-stokes and Periodic Breathing

Post by dataq1 » Mon Jan 10, 2022 9:53 pm

Resmed appears to label a pattern of breathing as" Cheyne-stokes".
Respironics appears to label a very similar pattern as "Periodic Breathing"
Is there a distinction/difference between between the patterns?

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Julie
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by Julie » Tue Jan 11, 2022 9:28 am

Definitely - the former is more serious... have you googled them?

dataq1
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by dataq1 » Tue Jan 11, 2022 12:50 pm

Julie wrote:
Tue Jan 11, 2022 9:28 am
the former is more serious... have you googled them?
and scary!
Yes, I have googled but with unsatisfactory results.
What I'm looking for is the differences in the pattern. What Resmed labels Cheyne-stokes, looks remarkably like what Respironics labels Periodic Breathing.

What I'm trying to capture is if there is a difference in the breathing pattern that distinguishes between the two, what is the "thing" that distinguishes Cheyne-stokes from Periodic Breathing?

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Julie
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by Julie » Tue Jan 11, 2022 4:23 pm

Bumping for you...

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palerider
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by palerider » Tue Jan 11, 2022 5:52 pm

Julie wrote:
Tue Jan 11, 2022 4:23 pm
Bumping for you...
People that know the answer have been down that waste of time road already, bump all you like.
Get OSCAR and come chat on IRC: #cpaptalk on irc.libera.chat

Accounts to put on the foe list: dataq1, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They're often post misleading, timewasting stuff.

dataq1
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by dataq1 » Tue Jan 11, 2022 6:20 pm

palerider wrote:
Tue Jan 11, 2022 5:52 pm
People that know the answer have been down that waste of time road already, bump all you like.
Thanks for your helpful input
Now. back on topic....

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Respirator99
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by Respirator99 » Tue Jan 11, 2022 7:07 pm

True Cheyne Stokes Respiration consists of a smooth waxing and waning of the air flow, with a central apnea occurring at every low flow. It's a problem if it persists for more than a short period and may be indicative of heart failure. The medical definition includes a requirement that the waxing & waning persists for 45 minutes or more.

The machines typically report any repeated patterns, even if they are not true CSR. For instance a repeated series of obstructive apnea caused by sleeping position will be labelled as CSR or PB.
Resmed Aircurve 10 CS Pacewave (ASV)

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dataq1
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by dataq1 » Tue Jan 11, 2022 9:51 pm

Respirator99 wrote:
Tue Jan 11, 2022 7:07 pm
True Cheyne Stokes Respiration consists of a smooth waxing and waning of the air flow, with a central apnea occurring at every low flow.
Does it make a difference if the low flow rate terminates in a obstructive versus central?
Respirator99 wrote:
Tue Jan 11, 2022 7:07 pm
The machines typically report any repeated patterns, even if they are not true CSR. For instance a repeated series of obstructive apnea caused by sleeping position will be labelled as CSR or PB.
The patterns I'm looking at are about 5 waxing breaths followed by 5 waning breaths followed by period of about 10 seconds of apnea (either CA or OA) then the pattern repeats sometimes for 30-45 minutes. Respironics labels this as Periodic Breathing, while Resmed labels it as (the scarier) CSR.

Are you saying that the two may be synonymous ?

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Respirator99
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by Respirator99 » Tue Jan 11, 2022 10:23 pm

Does it make a difference if the low flow rate terminates in a obstructive versus central?
Yes, true CSR involves central apneas. Repeated obstructive apneas (if correctly flagged) constitute PB, but are not CSR.
Are you saying that the two may be synonymous ?
Not exactly. All CSR is periodic breathing but not all PB is CSR. I think Resmed are wrong to label it all as CSR - it should be called PB unless it meets the strict criteria for Cheyne Stokes Respiration.

Edit to add: It would help if you could post an Oscar chart showing the events you describe.
Resmed Aircurve 10 CS Pacewave (ASV)

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dataq1
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by dataq1 » Wed Jan 12, 2022 1:38 pm

Respirator99 wrote:
Tue Jan 11, 2022 10:23 pm
Edit to add: It would help if you could post an Oscar chart showing the events you describe.
CSR example.jpg
CSR example.jpg (25.19 KiB) Viewed 155 times
If I understand you correctly, this would be a fair exemplar of CSR?
On the other hand if the CAs were identified as OAs, then it would NOT be CSR, but Periodic Breathing.

Incidentally this snippet is taken from an episode that persisted for ~40 minutes, terminated by an full awakening.

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Respirator99
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by Respirator99 » Thu Jan 13, 2022 12:14 am

That's pretty close to "classic" CSR as I understand it. The fact it persists for 40 minutes is possibly indicative of an underlying problem, especially if this is a frequent occurrence. If that was my chart I'd be off to the doctor, just to rule out anything nasty.
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Morbius
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by Morbius » Sat Jan 15, 2022 7:28 am

dataq1 wrote:
Wed Jan 12, 2022 1:38 pm
If I understand you correctly, this would be a fair exemplar of CSR?
Doubt it. Cycle is too short.
On the other hand if the CAs were identified as OAs, then it would NOT be CSR, but Periodic Breathing.
No. If they're OAs, then it's OA.

dataq1
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by dataq1 » Sat Jan 15, 2022 7:50 am

Morbius wrote:
Sat Jan 15, 2022 7:28 am
Doubt it. Cycle is too short.
When you say cycle time I assume that you mean the time interval between peak of wax to the next peak of wax. Is that what you mean?
What would the cycle time be for a classic CSR?
Any references for that criteria?

So is it your opinion is that Resmed is probably wrong to label this pattern as CSR?

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Morbius
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by Morbius » Sat Jan 15, 2022 8:24 am

dataq1 wrote:
Sat Jan 15, 2022 7:50 am
When you say cycle time I assume that you mean the time interval between peak of wax to the next peak of wax. Is that what you mean?
Yes.
What would the cycle time be for a classic CSR?
>40 seconds, typically 45-90 seconds. I think that sample just misses.
Any references for that criteria?
AASM Scoring Rules
So is it your opinion is that Resmed is probably wrong to label this pattern as CSR?
ResMed can do whatever they please.

dataq1
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Re: Distinguish between Cheyne-stokes and Periodic Breathing

Post by dataq1 » Sat Jan 15, 2022 8:30 am

Morbius wrote:
Sat Jan 15, 2022 7:28 am
No. If they're OAs, then it's OA.
My question is about the labeling of the pattern, CSR versus PB. If the wax/wane cycle must terminate in a Central ?