Cheyne–Stokes respiration

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Cheyne–Stokes respiration
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Cyclic pattern of apnea and hyperpnea
Complications	Hypoxia, sleep disturbance
Onset	Can occur at any age, more common in heart failure and stroke patients
Duration	Episodes can last from a few minutes to several hours
Types	N/A
Causes	Heart failure, stroke, brain injury, altitude sickness
Risks	Heart disease, neurological disorders, high altitude
Diagnosis	Polysomnography, clinical observation
Differential diagnosis	Central sleep apnea, obstructive sleep apnea, Biot's respiration
Prevention	N/A
Treatment	Positive airway pressure, oxygen therapy, treating underlying conditions
Medication	N/A
Prognosis	Varies depending on underlying cause
Frequency	Common in patients with heart failure or neurological disorders
Deaths	N/A

Cheyne–Stokes respiration is a specific form of periodic breathing (cyclic variation of tidal volume) characterized by a gradual increase in depth and frequency of breathing, followed by a decrease resulting in apnea, before the cycle repeats itself. This pattern of breathing is often seen in patients with severe heart failure or those who have had a brain injury, including a stroke. It is named after two physicians, Dr. John Cheyne and Dr. William Stokes, who first described it in the 19th century.

History

John Cheyne and William Stokes, two physicians from Ireland, first described Cheyne–Stokes respiration in the 19th century. Cheyne published an article in 1818 describing the condition, and Stokes published a book in 1854 that also discussed the phenomenon.

Pathophysiology

The exact mechanism of Cheyne–Stokes respiration is not fully understood, but it is believed to involve a combination of impaired neurological control of breathing, hypoxia (low oxygen levels), and hypercapnia (high carbon dioxide levels). The pattern of breathing is thought to result from a delay in the feedback mechanisms involved in the control of respiration.

Clinical significance

Cheyne–Stokes respiration is often seen in patients with severe congestive heart failure, stroke, or brain injury. It can also occur during sleep in some people with sleep apnea. The presence of Cheyne–Stokes respiration can be a sign of severe disease and is associated with a poorer prognosis.

Treatment

Treatment of Cheyne–Stokes respiration primarily involves treating the underlying condition. This may involve medications to improve heart function in patients with heart failure, or oxygen therapy in patients with low oxygen levels. In some cases, a form of ventilation called bilevel positive airway pressure (BiPAP) may be used.

Gallery

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  Cheyne–Stokes respiration

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  Spiraling stable pattern

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  Spiraling unstable pattern

See also

• Central sleep apnea
• Kussmaul breathing
• Biot's respiration

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