[Health] Periodic breathing: Cheyne-Stokes?

[Wrz77]

Hello I am wondering if this periodic breathing graph segment is indicative of Cheyne-Stokes or not. This is the first time a PB event was logged in my 2 weeks or so usage of CPAP.

Note: I did take an opioid analgesic ("narcotic") before sleeping in this particular instance so perhaps even if it was CSR it is not a big deal and doesn't indicate the serious stuff like stroke, congestive heart failure, and/or Parkinson's disease.



EDIT: Correction, I've had previous PB events but not that many. Added second attachment showing other PB segments.

[Possum]

I am not an MD; however, from my admittedly limited experience the periodicity of your breathing is suggestive of CS.

I know that opiates can increase central / open airway apneas, since they depress the central nervous system and can interfere with or slow down the brain's signal to the diaphragm to breathe, but I've never heard of them causing CS respiration patterns. Do you see similar patterns without narcotic use?

[Sn00zeAlarm]

I get a lot of that sort of pattern, with no opiods. Some get classified as CA, some as H, some as OA. It seems more a matter of the intensity of each cycle rather than anything else. The pattern takes about 90 seconds to repeat, which match a sawtooth pattern in the SpO2. It is not continuous, but seems to happen in clusters.

Is yours continuous?

[PoolQ]

hang in there, we have some really good people on here that know a lot about PB.

[Wrz77]

Only one happened while on opioids, the others I did not take any before bed.

Well they all seem to be a minute or so in length. Only in one case did I get two happen in a single sleep session. The others were just a single instance that seemed to be a minute to two minutes in duration.

Here are the stats, as you can see most days they do not occur at all.

I do often get CA events, but always less than OA events. There are also often hypoapnea events logged. In both CA and hypoapnea's cases they also happen without PB occuring. Sometimes, albeit rarely, I get 0 CA or Hypo events and just get 1-3 OAs.

[vsheline]

Hello I am wondering if this periodic breathing graph segment is indicative of Cheyne-Stokes or not. This is the first time a PB event was logged in my 2 weeks or so usage of CPAP.

Note: I did take an opioid analgesic ("narcotic") before sleeping in this particular instance so perhaps even if it was CSR it is not a big deal and doesn't indicate the serious stuff like stroke, congestive heart failure, and/or Parkinson's disease.

EDIT: Correction, I've had previous PB events but not that many. Added second attachment showing other PB segments.

Hi Wrz77, welcome to the forum.

In my understanding, true CSR and true PB are central in origin/type, but I think the terms CSR and PB are often misused to describe events which are primarily obstructive in type.

Further, true CSR (the pattern described in the medical literature as indicative of serious disease) applies to the pattern when seen without 'PAP therapy. CPAP therapy-induced PB and CSR-like breathing patterns are not rare and I think usually do not indicate disease.

Your second and third examples of what SleepyHead has marked as "PB" or "CSR" are flagged with RERA, which is obstructive in type, caused by partial restriction in the airway. So, in my view, those examples should not be considered PB.

Based on the often flattened (non-rounded) tops of the Flow waveforms, the other examples also do not appear to me to be simply or purely central and usually have a significant obstructive component. Obstructive conditions are usually improved by adjusting the pressure higher (or, in an APAP machine, by adjusting the Min Pressure higher).

The apneas are usually too short to be flagged. Officially, apneas, hypopneas and RERAs must last at least 10 seconds to be scored.