Central sleep apnea periodic breathing

[Sleeprider]

Sleepyhead software improperly labels periodic breathing as CSR.

Out of my curiosity, what makes you sure that Sleepyhead improperly labels periodic breathing as CSR.

Best Regards,

PaytonA

I haven't downloaded a copy recently, but the default label for that graph was CSR when I got in April. Mark was alerted to the problem, and it is one of many things on the list to be changed if he ever issues another release..

[vsheline]

Where is it said that the apnea in CSR must be central apnea?

See the list of possible causes. Obstruction is not included in the list.
http://patient.info/doctor/cheyne-stokes...espiration

For more detail:
https://en.m.wikipedia.org/wiki/Cheyne–S...espiration

[mollete]

Where is it said that the apnea in CSR must be central apnea?

Good point!

Actually, what Bill and John said was:

In the Dublin Hospital Reports and Communications in Medicine and Surgery 2: 216-223, 1818, John Cheyne (1777-1836), professor in Dublin, reported "A Case of Apoplexy in which the Fleshy Part of the Heart was Converted into Fat":

"For several days his breathing was irregular; it would entirely cease for a quarter of a minute, then it would become perceptible, though very low, then by degrees it became heaving and quick, and then it would gradually cease again; this revolution in the state of his breathing occupied about a minute, during which there were about thirty acts of respiration."

William Stokes (1804-1878), physician to the Meath Hospital, reported his "Observations on Some Cases of Permanently Slow Pulse" in the Dublin Quarterly Journal of Medical Science 2: 73-85 (August 1), 1846. He quotes Cheyne's description of this type of breathing and describes a patient of his own who had similar breathing:

"For more than two months before his death, this singular character of respiration was always present, and so long would the periods of suspension be, that his attendants were frequently in doubt whether he was not actually dead. Then a very feeble, indeed barely perceptible inspiration would take place, followed by another somewhat stronger, until at length high heaving, and even violent breathing was established, which would then subside till the next period of suspension. This was frequently a quarter of a minute in duration..."

[mollete]

I think that you will find that the definition of CSR includes an apnea in the trough. On the other hand patterned breathing has a hypopnea in the same location. So no, I do not think that it is possible to CSR without apneas.

Well! Upon further review, the Scoring Manual says:

Score a respiratory event as Cheyne-Stokes breathing if BOTH of the following are met:

a. There are episodes of ≥3 consecutive central apneas and/or central hypopneas separated by a crescendo and decrescendo change in breathing amplitude with a cycle length of ≥40 seconds.

b. There are ≥5 central apneas and/or central hypopneas per hour of sleep associated with the crescendo/decrescendo breathing pattern recorded over ≥2 hours of monitoring.

[richb]

I think that you will find that the definition of CSR includes an apnea in the trough. On the other hand patterned breathing has a hypopnea in the same location. So no, I do not think that it is possible to CSR without apneas.

Well! Upon further review, the Scoring Manual says:

Score a respiratory event as Cheyne-Stokes breathing if BOTH of the following are met:

a. There are episodes of ≥3 consecutive central apneas and/or central hypopneas separated by a crescendo and decrescendo change in breathing amplitude with a cycle length of ≥40 seconds.

b. There are ≥5 central apneas and/or central hypopneas per hour of sleep associated with the crescendo/decrescendo breathing pattern recorded over ≥2 hours of monitoring.

Many of the research papers that I have read are reluctant to use the label Cheynes Stokes respiration for CA events that are not accompanied by congestive heart failure and or end of life events. There is considerable research on Periodic Breathing associated with High Altitude sickness and Idiopathic Central Apnea that refers to the waveforms that resemble Cheynes Stokes breathing but since it is not associated with CHF and or end of life there is no reference to Cheynes Stokes. There is also very little research and published material on Idiopathic Central Apnea/Periodic Breathing without CHF and or end of life.