What Is Cheyne-Stokes Respiration? Risk Factors

Cheyne-Stokes breathing often occurs during deepsleepand may be seen innewbornbabies. Conditions associated with Cheyne-Stokes breathing include:

• Centralsleep apnea
• Altitude sickness
• Severeheart failure
• Stroke
• Head injury
• Chronichypoxia
• Diffuse cerebral atrophy
• Increased intracranial pressure
• Carbon monoxide poisoning
• Severeelectrolyteimbalances
• Severepneumonia
• Narcotic drug poisoning
• Obstructivesleep apnea(rare)

A repeated pattern of Cheyne-Stokes respiration in chronically ill patients indicates poor prognosis and often impending death. It may also indicate low sodium levels,brain injury, orcoma.

Your respiratory center lies in the brain stem and is stimulated by:

1. Increased carbon dioxide levels in the blood (primary stimulant)
2. Reduced oxygen levels (secondary stimulant)

Increased oxygen levels depress the respiratory center and cause a temporary pause in breathing until blood carbon dioxide levels rise and stimulate the respiratory center.

This negative feedback allows for steady and stable tissue levels of oxygen and carbon dioxide (CO2). In cases ofheartfailure orstroke, the spontaneous rhythmic activity of breathing is stopped. Thus, there is a gradual buildup ofhypoxia, which causes simultaneous accumulation of carbon dioxide in the blood. The excess CO2 hyperstimulates the respiratory centers and causeshyperventilation. This causes CO2 to wash out from the blood and result indepressionof the respiratory center, causing episodic apnea. This triggers hypoxia and the next episode of CO2 buildup. The cycle is repeated.

People with Cheyne-Stokes respiration may experience the following symptoms:

• Orthopnea:Inability to breathe upon lying down
• Paroxysmalnocturnaldyspnea:Shortness of breaththat occurs mostly at night and disruptssleep
• Fatigue:Daytime drowsiness due to insufficient sleep during the night.

Because Cheyne-Stokes respiration is a symptom, the underlying cause must be treated.

• Oxygen supplementation:补充增加了氧水平in the blood and reduces the risk of Cheyne-Stokes respiration. Nighttime oxygen supplementation has been found to be particularly useful.
• Continuous positiveairwaypressure (CPAP):This is the treatment of choice for sleep apnea. With CPAP therapy, a mask is worn over the mouth, nose, or both and then connected to a CPAP machine, which provides positive airflow to keep the airway open.

If Cheyne-Stokes respiration is not managed, it can cause an increase in carbon dioxide levels in the blood, leading to tissue hypoxia, organ failure, and eventually death.

Other abnormal respirations include:

• Kussmaul breathing:Deep, labored, fast breathing that occurs due to metabolic acidosis. It is mostly seen in diabeticketoacidosis.
• Hyperventilation:Characterized by deep, rapid breathing that leads to low carbon dioxide and high oxygen in the blood. Mostly seen with chronicstressandanxietyorpanic attacks.
• Biot respiration:Erratic respiratory pattern with alternating rapid short breaths and pauses, caused by damage in the respiratory center.