Cheyne Stokes Respiration ?

[Mal777]

[attachment=17960]Hi 
I have been having heart rhythm issues, and got this Oscar report a couple of nights ago. Any adjustments to my machine likely to help 
Any input appreciated

Mal

[Sleeprider]

Pour a drink and celebrate. You don't have CSR. We call this sleep-wake-junk (SWJ) and it is all at the end of the night. For now, don't change anything except turning off ramp, and disregard the events.

[Gideon]

Welcome to AB

That is NOT CSR!! It is Periodic Breathing.

You may be able to reduce EPR and reduce your centrals.
For you I suggest reducing EPR slowly since your centrals are not that bad.
Your changes need to be based on how you feel. Acceptable adjustments start with no adjustments.

You need to identify which settings you feel best at.

EPR = 3 (current settings)
EPR = 2
EPR = 1
EPR = 0 or OFF

Each reduction should reduce centrals and increase obstructive events.

[Mal777]

Thanks so much Sleeprider and Bonjour.
I'd never heard of CSR and a quick google of it had my anxiety levels skyrocket.

kind regards
Mal

[Mal777]

Last night I got another episode of Cheyne Stokes......this time not at the end of the night. Is it anything to be concerned about?
Thanks again for your assistance

[ApneaQuestions]

I am a relative newbie so I hope that the Gurus will correct me or confirm.

Did you notice that your leak rate has a strong correlation with these green areas?

I can't help but wonder if those leaks are confusing the data and this might be a false alarm.
Or maybe it's the leak rates that are showing up as false leaks?

I only know enough to be dangerous at this point so let's see what others say.

[Sleeprider]

The pattern is periodic breathing with a slow attenuation of respiratory volume to a short period of zero flow followed by abrupt recovery breathing. I have never seen such short periodic episode that nothing gets flagged as CA or OA. This is not CSR but it is a pretty rough transition to sleep. Going back to Bonjour's last post, I think you need to consider reducing the EPR, but once again this is not what we know as CSR, in fact there isn't even an apnea in here.

[Gideon]

There is a correlation to the leaks, but the leaks are fairly small and the PB is fairly big.  

This is NOT CSR, it is a 30 minute series of periodic breathing.  The decrease in breathing is similar to CSR but the breath initiation is not and that looks more obstructive than central.  

Consistently seeing this pattern warrants a discussion with your sleep doctor.

[ApneaQuestions]

There is a correlation to the leaks, but the leaks are fairly small and the PB is fairly big.  

This is NOT CSR, it is a 30 minute series of periodic breathing.  The decrease in breathing is similar to CSR but the breath initiation is not and that looks more obstructive than central.  

Consistently seeing this pattern warrants a discussion with your sleep doctor.

Not wanting to hijack the thread but this is another great learning opportunity for me (and maybe for others).

Is it fair to assume that the periodic breathing is so powerful that the mask is leaking during the strong breaths and the periodic breathing is therefore causing the leaks?
That hypothesis could go some way to explaining the strong correlation.

[Mal777]

Thanks for the repies.....very helpful

Some other things I should mention
1) I take stilnox, so will try to stop it from tonight in case that is contributing, however since starting Cpap therapy on 19/7/19 I have not seen this Cheyne Stokes (despite regularly taking stilnox) Could Stilnox cause issues?
2) My mask is the Resmed F20, and I havent changed the cushion fo since 1/11/19 (6 weeks) so will do so tonight
3) Also will reduce EPR to 1 tonight, and to 0 in a few nights all being well

If CSR continues I will see a sleep physician