Cheyne Stokes

[bdlegreid]

My compliance 30 Day report indicates 2% Cheyne   Stokes respiration and has since started over a year ago.  I am sleeping better and my obstructive  has been reduced to 0 but my central remains at 2.5 - 3.5.  Question: is 2% Cheyne Stokes normal (ie: safe range) or should I have it checked out.  My primary care doctor said not to be concerned but also admits he doesn’t know what it means.

[Sleeprider]

It is probably more accurate to name the breathing fluctuations "periodic breathing". Cheyne Stokes is a specific type of periodic breathing, usually associated with congestive heart failure. Your description of 2% CSR does not sound very serious, and it is probably not CSR. If you are able to post some #Sleepyhead charts with the pattern, we can probably help you understand it better or perhaps improve your results.

I notice you have a Resmed Airsense 10 Autoset set at a pressure of 7.0. Are you using the EPR (exhale pressure relief) feature?

[bdlegreid]

Thank you for the quick response.  I do not have the SleepyHead app but plan to get it and will post the results.  The EPR is set to Off and the Mode to CPAP which are the same as when I received the machine over a year ago-should either of these be changed? Thanks again.

[Sleeprider]

Fixed pressure with EPR off tends to be the best solution for people with central apnea. If you have a copy of your sleep report, it would be interesting to see the results of the diagnostic and titration studies (redact names and personal details). I just have a feeling that centrals (CA) was a part of your diagnostic profile which explains the low pressure and no EPR. Your results are borderline for considering a more advanced therapy called "adaptive servo ventilation" ASV. Lots of members are using it, and we can help coach you that direction if it is indicated by how you feel and a lack of efficacy with CPAP. If you're comfortable and reasonably well rested, then it's not worth considering, but if you're not satisfied that the therapy is living up to expectations, it's something we can discuss.

[bdlegreid]

Over the past year of therapy my Apnea index for OB has been reduced from 0.9 to 0.0 and my CA from 4.2 to 2.4.  My CSR has fluctuated between 1% and 2%.  It is the  CSR that concerns me but maybe as you stated is not really CSR.  I will post my sleep studies and SleepyHead report when I get it.  In the meantime I am doing a bit of experimenting on my own.  Last night I changed the mode on my machine from continuous CPAP to  Auto and for the one night posted 1.4 events which is very good for me.  I realize one night is not a trend but hopefully this one change will make a difference.  Do you have any thoughts on the effectiveness of Auto mode for treating CA?

[Sleeprider]

Different things work for different people. Some require no EPR or Flex, while others do better with it. Similarly, many people with CA do better on fixed pressure while others do better with a limited range of auto-CPAP. CPAP is not intended as a treatment for central apnea, and it takes some experimentation to see what is tolerated best.