Cheyne Stokes respiration (CS)

[Sleeprider]

Millstone, I agree that we can use the Oscar Preferences to rename events. The problem that arises with CSR is the extremely consequential implication of such a diagnosis or event showing up in people who really don't need that additional stress. CSR is a very specific diagnosis, as is Biot respiration, Kussmaul respiration, and many other pulmonary abnormalities listed here: https://www.ncbi.nlm.nih.gov/books/NBK470309/ Neither Resmed nor Oscar should use specific diagnostic terms, particularly with the severe disease implications inherent in CSR. That is not the role of a PAP manufacturer and in my opinion should not be repeated by Oscar; however the original error is indeed by Resmed in this case.

[Millstone50]

Millstone, I agree that we can use the Oscar Preferences to rename events. The problem that arises with CSR is the extremely consequential implication of such a diagnosis or event showing up in people who really don't need that additional stress. CSR is a very specific diagnosis, as is Biot respiration, Kussmaul respiration, and many other pulmonary abnormalities listed here: https://www.ncbi.nlm.nih.gov/books/NBK470309/  Neither Resmed nor Oscar should use specific diagnostic terms, particularly with the severe disease implications inherent in CSR. That is not the role of a PAP manufacturer and in my opinion should not be repeated by Oscar; however the original error is indeed by Resmed in this case.

I'm wondering how closely ResMed is following the clinical guidelines to flagging it, eg. >40 sec cycle time, more than 3 events in a row with a CA.

[Sleeprider]

Millstone, based on what we have seen posted as CSR on Apnea Board, they do not follow that guideline at all. We could probably do a search for CSR on Apnea Board and get a number of examples, i.e. Cheyne Stokes site:apneaboard.com https://www.google.com/search?q=Cheyne+S...e&ie=UTF-8

[Thefroggydude]

SR. You have helped allay my concerns and I thank you again for that. You are right that this manner of reporting by ResMed can cause unnecessary concern. I just wanted to point out that I doubt that the mislabeled CA events are not likely due to chin tucking now since I have been wearing the SCC since you recommended it. I did have my adenoids cut (not removed) in 1978. I’m not sure why they suggested that procedure, that’s been quite a while ago now. Anyway I’m imagining that the mislabeling of CA may be due to positional effects that cause my apneas. The adenoids might be partially blocking my airway when I lie on my back for example.

[stevew77]

Regardless of the cause of the reported CSRs by ResMed, it can be a reason for getting an ASV paid for by Medicare, even if you did not have more than 50% central vs. obstructive apneas in your sleep study. Just sayin'. ASV is great, IMO.

[Sleeprider]

Steve, I think ASV has its place, but it's not for everyone. It will eliminate nearly all events for most people, but the disruptive effects of changing pressure support can outweigh the therapeutic benefits. At least with ASV we know an event is obstructive, because anything else is generally resolved. The ability of ASV to treat flow limitation and UARS has been advocated by some pretty prestigious names like Dr. Barry Krakow, but I tend to prefer the Vauto for events like that, and even what Thefroggydude has posted. I just think it is more capable of treating events arising from obstruction without the disruptive effects. So I reserve ASV for complex or central apnea, but I'm open to trying to help members self-treating for other conditions as well.

[stevew77]

Cheyne-Stokes respiration and periodic breathing have different causes, but are the results not the same?

[Thefroggydude]

Stevew77 is there evidence that the results of CSR & PB are the same? What are they?