- Risk Factors
- How It Happens
- Abnormal Breathing
Cheyne-Stokes respiration is an abnormal breathing pattern characterized by a gradual increase then decrease in respiration that may be seen over a period of many hours. It has two alternating periods:
- Hypercapnic period or rapid, deep respiration
- Apnea or stopped breathing
After an episode of apnea or hypopnea, the pattern repeats in a cycle, with each cycle typically lasting around 45-90 seconds.
Who is at risk of Cheyne-Stokes respiration?
- Central sleep apnea
- Altitude sickness
- Severe heart failure
- Head injury
- Chronic hypoxia
- Diffuse cerebral atrophy
- Increased intracranial pressure
- Carbon monoxide poisoning
- Severe electrolyte imbalances
- Severe pneumonia
- Narcotic drug poisoning
- Obstructive sleep apnea (rare)
How does Cheyne-Stokes respiration happen?
Your respiratory center lies in the brain stem and is stimulated by:
- Increased carbon dioxide levels in the blood (primary stimulant)
- 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 of heart failure or stroke, the spontaneous rhythmic activity of breathing is stopped. Thus, there is a gradual buildup of hypoxia, which causes simultaneous accumulation of carbon dioxide in the blood. The excess CO2 hyperstimulates the respiratory centers and causes hyperventilation. This causes CO2 to wash out from the blood and result in depression of the respiratory center, causing episodic apnea. This triggers hypoxia and the next episode of CO2 buildup. The cycle is repeated.
What are the signs and symptoms that accompany Cheyne-Stokes respiration?
People with Cheyne-Stokes respiration may experience the following symptoms:
How is Cheyne-Stokes respiration managed?
Because Cheyne-Stokes respiration is a symptom, the underlying cause must be treated.
- Oxygen supplementation: Oxygen supplementation increases the oxygen level in the blood and reduces the risk of Cheyne-Stokes respiration. Nighttime oxygen supplementation has been found to be particularly useful.
- Continuous positive airway pressure (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.
What are other abnormal respirations?
Other abnormal respirations include:
- Kussmaul breathing: Deep, labored, fast breathing that occurs due to metabolic acidosis. It is mostly seen in diabetic ketoacidosis.
- Hyperventilation: Characterized by deep, rapid breathing that leads to low carbon dioxide and high oxygen in the blood. Mostly seen with chronic stress and anxiety or panic attacks.
- Biot respiration: Erratic respiratory pattern with alternating rapid short breaths and pauses, caused by damage in the respiratory center.
Health Solutions From Our Sponsors
Rudrappa M, Modi P, Bollu PC. Cheyne Stokes Respirations. [Updated 2021 Aug 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK448165/
Science Direct. Cheyne Stokes Breathing.https://www.sciencedirect.com/topics/nursing-and-health-professions/cheyne-stokes-breathing
Yumino D, Bradley TD. Central sleep apnea and Cheyne-Stokes respiration. Proc Am Thorac Soc. 2008 Feb 15;5(2):226-36. https://www.atsjournals.org/doi/10.1513/pats.200708-129MG
Top What Is Cheyne-Stokes Respiration Related Articles
What Is the Best Remedy for Altitude Sickness?Descent is the best remedy for all the stages of altitude sickness. It means to go down to a lower altitude as swiftly and safely as possible.
Common Medical Abbreviations & Terms
Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
- ANED: Alive no evidence of disease. The patient arrived in the ER alive with no evidence of disease.
- ARF: Acute renal (kidney) failure
- cap: Capsule.
- CPAP: Continuous positive airway pressure. A treatment for sleep apnea.
- DJD: Degenerative joint disease. Another term for osteoarthritis.
- DM: Diabetes mellitus. Type 1 and type 2 diabetes
- HA: Headache
- IBD: Inflammatory bowel disease. A name for two disorders of the gastrointestinal (BI) tract, Crohn's disease and ulcerative colitis
- JT: Joint
- N/V: Nausea or vomiting.
- p.o.: By mouth. From the Latin terminology per os.
- q.i.d.: Four times daily. As in taking a medicine four times daily.
- RA: Rheumatoid arthritis
- SOB: Shortness of breath.
- T: Temperature. Temperature is recorded as part of the physical examination. It is one of the "vital signs."
What Sleep-Disordered Breathing Conditions Are Treated With a CPAP Machine?A continuous positive airway pressure (CPAP) machine treats the following sleep-disordered breathing conditions including obstructive sleep apnea and Snoring.
Heart Failure QuizWhat is heart failure? Learn about this dangerous condition, as well as who is at risk, and what to do about it.
Hypoxia (Hypoxemia)Hypoxia is a condition in which the normal concentration of oxygen in the blood is not enough for normal life functions. Symptoms of hypoxia and/or hypoxemia may be acute such as fast heart rate, rapid breathing, and shortness of breath; or severe symptoms include confusion, the inability to communicate, coma, and sometimes death. Treatment of hypoxia and/or hypoxemia is to provide supplemental oxygen to the body as soon as possible.
Reasons You're Short of BreathHave you ever found yourself gasping for air after just a short flight of stairs? You may just need to do a bit more exercise, or it could be something more serious.
Sleep ApneaSleep apnea is defined as a reduction or cessation of breathing during sleep. The three types of sleep apnea are central apnea, obstructive apnea (OSA), and a mixture of central and obstructive apnea. Central sleep apnea is caused by a failure of the brain to activate the muscles of breathing during sleep. OSA is caused by the collapse of the airway during sleep. OSA is diagnosed and evaluated through patient history, physical examination and polysomnography. There are many complications related to obstructive sleep apnea. Treatments are surgical and non-surgical.
Sleep Disorders: Insomnia, Sleep Apnea, and MoreLearn about the different types of sleep/wake disorders such as insomnia, narcolepsy, and sleep apnea. Explore the symptoms, causes, tests and treatments of sleep disorders.
Sleep Related Breathing DisordersSleep-related breathing disorders are characterized by disruptions of normal breathing patterns that only occur during sleep. Snoring and sleep apnea are the most common sleep-related breathing disorders.
Stroke QuizTake the Stroke Quiz to learn about stroke risks, causes, treatment, and most importantly, prevention.
What Are the Three Types of Sleep Apnea?Sleep apnea is a sleep disorder that can potentially lead to serious health complications. In sleep apnea, the person may stop breathing for some time during sleep. The three kinds of sleep apnea are obstructive sleep apnea, central sleep apnea, and mixed sleep apnea.
What Does Agonal Breathing Sound Like?Agonal breathing may sound like gasping, snorting, heavy or labored breathing, gurgling, or groaning. Learn about causes and treatment.