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Cheyne Stokes Respiration
#1
Cheyne Stokes Respiration
Hi everyone! I'm new here and new to using CPAP (started 10/31) and just downloaded OSCAR today. I'm a 64 year old female in generally good health and my home sleep study showed an AHI of 16.7 (29.2 supine). Since using CPAP my AHI has consistently been below 5 and often below 2. I'm using an Airsense 11 set on the For Her mode and 4-14 pressure and an F20 full face mask. I purchased the machine privately from someone who only used it 3 times, so I figured out all the settings on my own. I'm seeing my pulmonologist in 2 days, which will be the first time since using the machine. 

My concern is that the last 2 nights my AHI was 10.92 and 13.92 and last night, for the first time, I has a Cheyne Stokes Respiration of 3.64% (all other nights it was 0%). It was just one event that lasted 17 minutes and occurred around 5 hours after I went to sleep (I slept 8 hours). I don't know how to understand what else was going on at that time  (Flow Limit spiked up and down all night but I don't evev know what that is) and I don't know how to upload my report for you all to see. Obviously I will discuss this on Wednesday with my doctor, and I will also have two more nights to see if it happens again, but I was hoping you all could also give me insight on what this could mean. Please let me know if any other info would be helpful. Thanks in advance!
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#2
RE: Cheyne Stokes Respiration
Hi Nadine,

Follow the links in my Signature Line to guide you on Organizing a chart for review.

Use the Attachment Feature to post your chart.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Cheyne Stokes Respiration
Thanks for the reply and the help! Here's my chart from last night.


Attached Files Thumbnail(s)
   
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#4
RE: Cheyne Stokes Respiration
I was looking at your charts and thought to get rid of your OH & H apneas you will need increased pressure to lift the obstruction up to allow air to flow. Your clusters of OH apneas indicate sleeping positional change with neck downwards towards chest possibly closing air way passage . Folks use soft cervical collar to remedy that.
Sleeping on your back position increases obstruction apneas also!
Also your machine ceiling max pressure setting needs to be set higher because its bumping the top of pressure chart at round 12 cmH2o steadily.
There will be other folks along to help and give suggestions.
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#5
RE: Cheyne Stokes Respiration
I'm seeing 3 things:

1. likely a Positional Apnea pattern

2. Settings that's not ideal

3. Flow limits, Hypopnea, OA all elevated

The link to Positional Apnea pattern

https://www.apneaboard.com/wiki/index.ph...onal_Apnea

It's possible you have a thick pillow that's pushing your chin towards your chest and kinking off your airway externally. Might need to try a thinner pillow or a CPAP type.

Settings: I would go 7-15 pressure, allowing EPR 3 full time the chance to work from the beginning. 4 minimum is too low for most adults, and prevents the EPR at the beginning.

This is something you can set yourself. ResMed 11 series access to clinical menu is pushing both blue and purple squares on the screen together for 5 seconds, it'll give a white background look, you're in the clinical area to set pressure, exit when you're finished editing.
Mask Primer

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Cheyne Stokes Respiration
Thank you so much for your reply! I definitely know that I was sleeping with my chin down as I felt that the air was leaking and that seemed to stop the leaks but I didn't realize it was not a good position for the apnea. I was always a back sleeper and have been sleeping on my side with a wedge pillow behind me to keep me from going to my back. I do switch sides often in the middle of the night and end up hugging the wedge pillow when I'm facing it.

Still concerned about the one long (17 minutes) CSR event, if anyone has any input on that. Thanks!
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#7
RE: Cheyne Stokes Respiration
Thanks! My first thank you was to Canuck 2 (don't see how to reply to a specific post or tag someone) and then I saw the response from SarcasticDave94, so thank you also! I will adjust my settings to what you suggested and also try to adjust my pillows. I'm sleeping with two, the top one being memory foam, and most times I'm hanging off the end of the pillow so as not to disturb the seal.
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#8
RE: Cheyne Stokes Respiration
Just my opinion, CSR flags like this might be actually a periodic or variable breathing aspect. Skilled chart gurus might be able to help ID this, but I'm thinking true CSR events will have Central Apnea in the same vicinity, along with a heart condition in your medical history.

I have a PVC heart timing issue, and I'm not thinking I've got CSR.
Mask Primer

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Cheyne Stokes Respiration
CSR by definition have to contain all CA's.  By lining up your CSR on your OSCAR chart, they line up with many consecutive OA's (a large cluster).  So this can't be real CSR.  The vast majority of CSR flagged by Resmed machines are false.
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#10
RE: Cheyne Stokes Respiration
Thank you! That makes me feel much better!
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