Cheyne Stokes Respiration

Peacenana · Post by **Peacenana** » Sat Oct 10, 2020 6:39 am

Hi all,
Checking my OSCAR data from last night (I have been tracking mask leaks), I saw for the first time a period of Cheyne Stokes Respiration. It lasted for about 20 minutes. Is this something to be concerned about? What causes it?
Thanks!!

Miss Emerita · Post by **Miss Emerita** » Sat Oct 10, 2020 11:12 am

CSR is a very specific type of periodic breathing. It's a shame the label "CSR" is used, because all the machine can tell is that there's a bit of periodic breathing. It can't tell whether it's CSR or not. Occasional short intervals of non-CSR periodic breathing are nothing to worry about.

To put your mind at rest, you could post a 10-minute zoomed-in segment from within the green zone, capturing some events in there, if there are any.

Peacenana · Post by **Peacenana** » Sat Oct 10, 2020 11:47 am

Thank you, Miss Emerita. I am posting what I think you are asking for. Does this help?

Miss Emerita · Post by **Miss Emerita** » Sat Oct 10, 2020 1:15 pm

To my eye, that doesn't look like CSR. CSR has a distinctive waxing/waning curve to the flow-rate pattern. Here is an example from Pugsy.

CSR.jpg

But it'd be great if someone with more expertise could opine.

palerider · Post by **palerider** » Sat Oct 10, 2020 2:17 pm

There's some waxing and waning, but it's not CSR.

Miss Emerita · Post by **Miss Emerita** » Sat Oct 10, 2020 4:37 pm

Peacenana, palerider knows what he’s talking about, so you should feel reassured. If you start seeing a lot of this, just come back to this thread to look into it again.

Peacenana · Post by **Peacenana** » Sat Oct 10, 2020 5:30 pm

Thank you both so much. The truth is I don't even know what CRS is but from what you are saying I should be glad not to have it. I will definitely keep an eye out and let you know if it continues.

Pugsy · Post by **Pugsy** » Sat Oct 10, 2020 6:35 pm

Periodic Breathing is a waxing and waning of the flow rate. CSR or Cheyne Stokes Respiration is a form of periodic breathing but not the only form of PB. CSR is worrisome when it is chocked full of central apneas and has a very definite pattern and we see a lot of it.

Obviously this segment of PB isn't chocked full of central apneas and I suspect if zoomed in more closely it would looked more like this

than like this

You have zoomed out a little too much for good details of the flow rate but the overall pattern looks like it's leaning more towards awake breathing irregularities. Doesn't look like asleep breathing to my eye. The flow rate pattern is simply way too irregular.

At any rate...sometimes we just breathe weird and it doesn't mean much and unless you see a lot of apneas flagged in the middle of PB flagged breathing I don't worry about it. I wish that they had stuck to the PB flagging name instead of CSR because most of the time the PB isn't anything bad and obviously CSR seems to scare the heck out of people and most of the time it's not real CSR and instead what I call plain PB and means nothing of great importance. Not all PB is equal to CSR anyway and in fact most of the time it's not CSR.

Peacenana · Post by **Peacenana** » Sun Oct 11, 2020 6:46 pm

Pugsy, et. al.,
I took your advice and zoomed in further to a segment of the PB that was labelled CSR by my machine. Does this help? Luckily, there was none of this in my sleep data from last night. Should I check with my doctor?
Thanks for all the good information.

Pugsy · Post by **Pugsy** » Sun Oct 11, 2020 7:11 pm

That flow rate looks nothing like real CSR. It's what I have always called plain jane periodic breathing and it just happens sometimes.
To my eye it doesn't look like you were sound asleep for some reason or other and other than we wonder why not asleep....awake breathing irregularities don't mean much. You have to be asleep for it to matter.

I wouldn't worry about it if it were me unless you start seeing an awful lot of it and you see that very definite CSR pattern above and it's full of central apnea flags.

Now I always tell people that if it really bugs them and worries them...by all means alert your doctor but there isn't any urgent need to do so at this time. So if you would sleep better alerting your doctor the you might give him a call but I am betting he will say don't worry about it unless you start seeing a lot of it with a bunch of apneas packed in there with it.

Heck, one time I had 17 centrals in 17 minutes and it really did look like CSR but I was on a machine back then that didn't flag PB...
But it only happened once and never again...so I just shrugged my shoulders and moved on.
Most of my PB/CSR flagged breathing has been related to awake breathing irregularities and unless we are asleep it simply doesn't matter.

Peacenana · Post by **Peacenana** » Mon Oct 12, 2020 6:23 am

Pugsy, that is a relief! Weird that the machine records it as CSR, and I don't recall being awake during that time. Oh well. Thanks again.

Pugsy · Post by **Pugsy** » Mon Oct 12, 2020 8:39 am

Think of it this way. The machine may flag it as CSR because of waxing and waning and the whole idea is to alert for a potential problem.
It gets reviewed by a doctor or whomever and discarded as no big deal. That's better than it happening and no one knows there is a potential problem.

I wish it had been called periodic breathing instead of CSR because there are many more forms of PB but they didn't ask my opinion.

CSR is but one of many forms of periodic breathing and periodic breathing really isn't a big deal unless it has the CSR very specific pattern and a lot of central apneas are packed in it. The central apneas are more important than the waxing and waning which constitutes PB.

As for not remember being awake or semi awake...we don't always remember being awake and in fact there are normal wake ups that are brief and we won't remember them. Or maybe it wasn't related to being awake...maybe you had a really good dream or a really bad dream and it changed your respiration a bit.

I do understand the initial panic though...they see CSR and look it up on the internet and think "OMG something is wrong with my heart"....and even if it is real CSR it doesn't mean there is necessarily a heart problem but again it's better to investigate and rule out a problem than have a potential problem just be totally ignored.

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