Cheyne Stokes - Should I be concerned?

[Suzi]

               

Hi everyone.   I've recently started having more RERA events and last night a Cheyne Stokes.  I've had an relatively mild heart arrhythmia forever that acts up sometimes and I see a cardiologist for that, though I haven't seen her in a couple of years.   Lately I've had more daytime heart palps, and will be seeing my regular GP tomorrow.    She doesn't manage my sleep apnea but can order an Echo if needed.   Is this Cheyne Stokes event something I should be concerned about?

Thank you.

[SarcasticDave94]

Here's my suggestion in 2 parts

1. Zoom in on the CSR flagged area to 10 and 3 minutes for the chart gurus to take a look. No I'm not one but others will pass through soon enough.

2. I would consider the CSR flags as maybe cause for concern right now given your known other heart issues, call you cardiac and PCP offices to voice your concerns.

Note the biggest cause of real CSR would be the heart condition CHF/Congestive Heart Failure. I am not saying you do or do not have this, just conveying info. If you had CHF, likely you'd be seeing cardiac doc more often and for this specific need.

[Gideon]

This is not CSR, though it may be something similar. CSR has central Apneas at the nadir of the pattern, and you have no central Apneas there.

[Suzi]

Thanks Dave.   I've scheduled an appt with my cardio.

[Suzi]

This is not CSR, though it may be something similar.  CSR has central Apneas at the nadir of the pattern, and you have no central Apneas there.

Thanks Gideon.  If it's something similar to CSR, what might that be?  Could it have to do with the extra RERA's I've been having lately? 
For instance,  a couple weeks ago I had 32 RERA events, 10 hypopneas, and only one central and one obstructive.
 
My AHI's rarely exceed 2 and have never been over 3.  I still have the original pressure setting my pulmonologist ordered.  But I set the EPR at 2 long ago because I was swallowing too much air.   I won't monkey with the pressure settings because my equipment provider said by law it would void my Medicare coverage unless my dr ordered it.   I told them about changing the EPR and she inferred that she would turn a blind eye to that.   Would changing the EPR setting up or down improve the RERA's?

[Gideon]

Post a 10 minute view and we can make a specific analysis. Other than some form of periodic breathing it would only be a guess.

[SarcasticDave94]

I'll add this, you editing your PAP pressures will not cancel insurance coverage on your PAP or supplies. The DME lied to you to scare you into only allowing them and the doctor to edit your settings.

Yes, the doctor can order setting changes, and this must accompany a script change. BUT if you change any setting, it is legal for you to edit this yourself without any script.

[Suzi]

       

Post a 10 minute view and we can make a specific analysis.  Other than some form of periodic breathing it would only be a guess.

I don't know how to do that.   It says it lasted 18 min 20 sec

I made an appt with my cardio but can't get in till Nov 5.  I have an appt with my GP tomorrow.   Not sure what to tell her except I'm having more palps and don't feel good.  (but I also have other chronic health conditions)  Don't know if I should mention this report - she might not be familiar with CPAP readings.

[SarcasticDave94]

I think you can zoom in on OSCAR chart segments this way, I did so with my windows laptop, click on the chart about the middle of the CSR flagged area then use the up arrow on the keyboard to zoom in, down goes out, left and right shift the zoomed area along the chart.

In prep for your cardio doc appointment, print out the OSCAR shot above and take it with you. Bring the print out during discussion and try to point to your concern. If doc isn't interested in seeing it, just describe your concern.

[Suzi]

Thanks again Dave.