Cheyne-Stokes breathing: Definition & how to treat

What is Cheyne-Stokes respiration? If you’re a regular reader of our sleep apnea blog, you know that Cheyne-Stokes respiration, or CSR, as it’s commonly called, is a health condition that’s commonly associated with sleep apnea, particularly central sleep apnea.

But what exactly is the Cheyne-Stokes definition, and what should people diagnosed with (or just concerned about) sleep apnea know about it?

Cheyne-Stokes definition and causes

Cheyne-Stokes respiration is a condition that causes abnormal breathing during sleep. This abnormal breathing often includes “apneas,” or periods of stopped breathing, which explains why the condition is so frequently referenced in sleep apnea medical circles.

These apneas occur because Cheyne-Stokes respiration generally causes a person’s breathing to follow abnormal patterns, or dysrhythmias. This means that breathing gradually increases and decreases during sleep, in a “crescendo-decrescendo pattern” as a medical study published in Thorax put it.¹

These cycles of increasing and decreasing breathing activity ordinarily last from 30 seconds to two minutes in duration, with five to thirty seconds of apneas, according to the MediLexicon medical dictionary.²

The study in Thorax study goes on to connect CSR not only with sleep apnea but with other serious conditions like cardiovascular problems, stating that Cheyne-Stokes respiration is “often observed in patients with congestive heart failure” and “likely to arise as a result of congestive heart failure.”

Other experts echo this conclusion, such as in this 2005 study from the Neurocritical Care Journal that states that CSR was first discovered as a condition “in patients with heart failure or stroke.”³

Cheyne-Stokes definition: The sleep apnea connection

So, what does all this mean for people with sleep apnea? As we’ve seen, Cheyne-Stokes respiration causes sleep apnea, though not of the obstructive sleep apnea (OSA) type, which represents most cases of sleep apnea in the United States.

Instead, the kind of sleep apnea that’s connected with CSR is central sleep apnea (CSA). CSA is the type of sleep apnea caused by neurological conditions and the presence of other health conditions, whereas OSA is caused by physical blockage to a person’s breathing airways during sleep, which, if it’s severe enough, can be resolved with CPAP therapy.

That may suggest that people with OSA are somewhat out of the woods when it comes to the risk of Cheyne-Stokes respiration. However, as in most issues related to medical health – particularly those involving the nervous system – the answer, unfortunately, isn’t quite as clear-cut as that.

Although OSA is far more common than CSA, the two conditions are actually found together fairly often. As Medscape puts it, in most cases of sleep-disordered breathing, “obstructive and central breathing disturbances (including Cheyne-Stokes respiration) coexist.”

So there isn’t necessarily a clear line between which type of sleep apnea is associated with Cheyne-Stokes respiration, and which isn’t. So, if you’re experiencing any of the symptoms of sleep apnea – such as excessive snoring or daytime drowsiness, irritability, difficulty staying awake during the day, we encourage you to speak with your doctor about the possibility of a sleep apnea diagnosis.

This blog post contains general information about medical conditions and potential treatments. It is not medical advice. If you have any medical questions, please consult your doctor.

References

1. Source: MT Naughton. “Pathophysiology and treatment of Cheyne-Stokes respiration.” Thorax 1998;53:514-518 doi:10.1136/thx.53.6.514. Retrieved from https://thorax.bmj.com/content/53/6/514.full (accessed April 1, 2014).
2. Source: “Cheyne-Stokes respiration” at MediLexicon Dictionary.
3. Source: Cherniack NS, Longobardo G, Evangelista CJ. “Causes of Cheyne-Stokes respiration.” Neurocrit Care. 2005;3(3):271-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/16377843/ (accessed April 1, 2014).