Cheyne Stokes respiration (CS)

[Thefroggydude]

  

I’m so grateful for your time and thoughtful responses to my queries. I will try an SCC and will let you know how it works out.

[Thefroggydude]

Here are the screenshots that you requested. Also I bought a SCC yesterday and tried it out. It worked great. I had few obsrtuctives or hypopneas. I still had a few clusters of centrals however. I wan't awoken by apneas at all and slept through the night. I will continue to use the SCC. do you want a screenshot of last night's sleep?

[Sleeprider]

Sounds like things are getting better and no need for now to post more images. Most of the problems above seem obstructive, so it makes sense you are putting the SCC to good use.

[Thefroggydude]

I had 2 more events last night labeled CSR (8.05%) by my ResMed machine (but possibly RB as you previously stated). This is the first time that I have ever had 2 CSR events in the same night. Counting these 2 events that makes 11 total CSRs since Aug 19/23. CSR #1 last night was at 03:39 (1136) and #2 was at 05:11 (1167). Event #1 had 16 apneas labeled CA and 1 labeled OA. CSR#2 was at 05:11 (1167) also with 16 CA and 1 OA during that time. I had a total AHI of 8.05 (6.41CA, 1.26 OA, 0.38 H & 0.13 RE). I often get completely exhausted during the day even though I usually sleep 8 or 9 hrs at night and take a nap of 20 minutes to 1hr most afternoons. I cannot do any physical activity that gets my heart rate up since I have been diagnosed with exercise induced left bundle branch block, however I do walk 6km (4 mi) per day which doesn’t get my heart rate up too high. I am scheduled for 2 MRI (chest & abdomen) in early December. I have been wearing a SCC every night and every nap since you recommended it. At what point do I get concerned about this?

[Sleeprider]

They are not CSR, but PB is a possibility. Resmed should never have used this label, and in my opinion, the Oscar team should not have continued the mistake.

[Thefroggydude]

Thank you SR. But after reading the info on OSCAR on CSRs I still don’t understand why you believe that to be so. Can you explain it to me in layman’s terms or try to convince the poobaas at OSCAR to change the information on their site to make it more understandable? You really have made me feel more at ease and I appreciate that. Thx.

[Gideon]

OSCAR uses the terms that the manufacturer uses.

[Thefroggydude]

That’s either a good thing or not. If it is, stand by them and defend it. If not, convince them otherwise or reject them.

[Sleeprider]

First of all, the examples of CSR posted above from September 5 are good examples of obstructive positional apnea. Event the central flags are incorrect. We see clusters of repeating apnea accompanied by reduced flow volume leading into an apnea, followed by high-volume recovery breathing. I'm not going to sit hare and explain how to identify and diagnose CSR when the problem is obstructive chin-tucking and possibly random central apnea events or breathing pauses. In many cases here, the events flagged as central here are simply incomplete obstruction resulting in a slightly open airway but sufficient flow reduction to flag a apnea.

The decision of the OSCAR team was one I didn't agree with, but accepted with full understanding that Oscar is first and foremost a "reporter" of the data produced by these machines. I had proposed "Periodic Breathing" which is how Philips identifies these oscillations. Perhaps at some point in the future the team will revisit that decision. For now we will just have to look at CSR flags the same way the medical profession does, as a likely incorrect label for a period of oscillating breathing flow. Knowing whether these events arise from the apneic threshold and the fluctuating PCO2 levels around this threshold that affect respiratory drive, is key to identifying the source of the problem. Beyond that CSR specifically arises out of heart failure or stroke and is clearly a very serious diagnosis that affects some, but very few of our members. Once we eliminate that possibility, we just won't discuss this patter as CSR unless it is persistently presented throughout the night and displays some specific characteristics of an apneic threshold feedback loop.

[Millstone50]

One can simply edit the descriptions of the events if they don't like the defaults. Everybody wins.