Cheyne-Stokes respiration also known as periodic respiration, is an unusual breathing pattern where a person breathes deeply for a while, then breathes more shallowly, and this pattern repeats in cycles. This type of breathing can indicate problems with the lungs or heart.
Typically, every cycle of periodic respiration lasts from 30 to 120 seconds. It can happen both when an individual is asleep and when they are awake, but it is more often seen while sleeping.
Causes
The exact causes of periodic respiration are not completely understood, but researchers have identified several possible factors. One key idea is that the respiratory control system’s unstable feedback may play a role. This lack of stability happens when differentiating levels of carbon dioxide and oxygen within the blood leads to pauses in breathing and hyperventilation (rapid breathing).
Another factor is delayed circulation, which is seen in individuals with cardiac failure. In these individuals, the time it takes for blood to circulate through the body is increased. Although this is not considered a major cause of periodic respiration, it is linked to the duration of these abnormal breathing cycles.
Additionally, a decreased blood gas diminishing capacity might contribute to this condition. The bicarbonate diminishes structure in the body and assists in maintaining pH balance by throwing out carbon dioxide by exhalation. During episodes of hyperventilation, which are common in periodic respiration, the body’s carbon dioxide levels drop. This reduction can disrupt the normal diminishing capacity of the blood, potentially influencing the breathing patterns associated with this condition.
Symptoms
Individuals with periodic respiration often experience several noticeable symptoms. One common symptom is orthopnea, which is breathing troubles that occur when sleeping. This difficulty in breathing while in a horizontal position can be quite distressing.
Paroxysmal nocturnal dyspnea is another condition. This condition involves sudden, serious breath shortness and coughing fits that typically occur at night, disrupting sleep and causing discomfort.
People with periodic respiration may also suffer from excessive daytime fatigue and sleepiness. These issues arise because of periods of disturbed sleep caused by abnormal breathing patterns, leaving individuals feeling constantly tired and lacking energy throughout the day.
Risk Factors
Periodic respiration is more likely to happen in individuals who have certain health conditions. It is commonly seen in individuals with neurological disorders or cardiac failure. Research suggests that about 50 percent of individuals with average to serious cardiac failure also experience this respiration.
Additionally, Cheyne-Stokes respiration is often associated with sleep apnea, a typical sleep disorder. Sleep apnea is characterized by brief pauses in breathing while sleeping, and Cheyne-Stokes respiration can be considered a type of sleep apnea.
Diagnosis
The diagnosis of this condition can be challenging since it typically happens while a person is asleep.
If someone notices signs of periodic respiration or any unusual breathing patterns, they should see a healthcare provider. The healthcare provider will assess the signs and carry on a physical exam to determine the cause.
To diagnose periodic respiration, especially if it happens during sleep, the healthcare provider might suggest a sleep study called polysomnography. This test monitors various aspects of sleep, including breathing rate, heart rate, brain activity, levels of blood oxygen, movements of the eye, and other bodily movements. This comprehensive recording helps doctors identify the presence of periodic respiration and understand its impact.
Management and Treatment Options
Managing periodic respiration primarily involves addressing its primary cause. If cardiac failure is contributing to the condition, healthcare providers will use various approaches to treat it.
Heart Failure Intervention
When heart failure is the cause, treatment may include several options:
- Medications: Prescribed to manage heart function and fluid balance.
- Heart Valve Surgery: Performed to repair or replace damaged heart valves.
- Heart Transplant: Considered for severe cases where other treatments have not been effective.
- Pacemakers: Used to regulate heart rhythms and support heart function.
Supplemental Oxygen
Temporary oxygen therapy while sleeping can help decrease the symptoms of periodic respiration. Using supplemental oxygen at night may also enhance the overall standard of life and function of the heart.
Continuous Positive Airway Pressure
Continuous Positive Airway Pressure therapy is commonly used to treat sleep apnea, which can also benefit those with periodic respiration. This treatment involves using light air pressure to keep the airway open. The therapy requires wearing a mask connected to a Continuous Positive Airway Pressure machine that provides continuous airflow.
The benefits of CPAP include enhanced sleep quality, less sleepiness, and decreased snoring. Long-term advantages may include better blood pressure regulation, a lower chance of stroke, and enhanced memory.
Even though some older studies suggest that CPAP may not increase living rates for individuals with cardiac failure, recent research indicates it can still be beneficial for managing.
Prevention
Preventing periodic respiration primarily involves managing and treating the underlying medical conditions that can lead to it, such as stroke and heart failure. If you have these health problems, it is crucial to follow your doctor’s treatment plan carefully. Doing so can help control your symptoms and reduce the risk of developing periodic respiration.
Additionally, keeping away from contact with harmful toxins and heavy metals is important. These substances can lead to toxic encephalopathy, a condition that affects the brain and may contribute to abnormal breathing patterns like periodic respiration. Taking steps to minimize your exposure to these toxins can also help in prevention.
Summary
Cheyne-Stokes respiration also known as periodic respiration, is an unusual breathing pattern characterized by cycles of deep and breathing difficulty. It often occurs in individuals with neurological conditions or heart failure and is commonly associated with sleep apnea. Diagnosing the condition can be challenging, as it typically happens during sleep and may require a sleep study for accurate assessment. Management involves treating underlying causes, such as heart failure and may include medications, oxygen therapy, or CPAP. Preventing periodic respiration involves effectively managing related medical conditions and avoiding exposure to toxins.
