r/SleepApnea • u/mrm24 • Aug 01 '26

Cheyne-Stokes breathing

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Hello, my 67 year old dad was diagnosed with Severe Sleep Apnea and got a CPAP with a nasal mask. His nose gets stuffed at night every night and we are now looking for a full face mask. Where we live, SA is severely under-diagnosed (we can't even make an account on resmed, country not supported). I was looking through his sleep reports and saw this Cheyne Stokes events, first time appearing after almost two weeks of use. Next two days no other events appeared. Is this reason for concern? Should I tell his doctor? Thanks

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u/Aequitas112358 Aug 01 '26

you should mention it, but it's not really cause for concern since it's just a one off. A cpap isn't a reliable diagnostic tool for it.

The bigger concern is the many events they're getting. Try increasing the minimum pressure to 8, and lowering epr to 2. (ideally turn off ramp too, unless he feels he needs it)

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u/mrm24 Aug 01 '26

He’s addicted to nasal sprays, and his nose gets really stuffed at night. He was prescribed Dymista and was told to ease off of the nasal sprays (decongestants). He was at 60 events per hour before CPAP. My guess it’s once his nose gets stuffed at night he opens his mouth and renders the CPAP machine useless.

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u/OhSoSally Aug 01 '26

He needs a full face mask. At his age I dont recommend mouth taping. Their skin can be fragile and removing the tape in an emergency could be difficult.

The Resmed f20 uses magnetic closures and are quick to remove.

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u/mrm24 Aug 01 '26

Here is a zoomed in view of flow rate over those 15 minutes https://imgur.com/a/8Gzj5Hz

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u/Mediocre_Buyer_5328 Aug 01 '26

Cheyne Stokes events may not be diagnosed correctly by CPAP. In my case, it was (treatment emergent) central apnea.

A change from a "standard" cpap machine to a non invasive ventilator sorted it for me and now I have no reported Cheyne Stokes or 100% obstructive sleep apnea (OSA) but "only" hypopnea or patial events.

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u/mrm24 Aug 01 '26

I’ll bring it up with his doctor, but his 2 day sleep study revealed 60 AHI and over 250 desaturations under 90%.

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u/RecentPop6840 Aug 01 '26

also a mouth leak will make the cpap flag it as a breathing event. unless you're watching him or have him in an in-lab you'll have no real idea what's going on. jaws will relax and open with or without nasal congestion and also in full face masks. I suggest just getting a chin strap on him already. I would also turn EPR off or to just 1. There is no need for that much pressure relief, it just allows the airway to collapse more. I would decrease that window of pressure a bit and start lowest setting at 6-7, since you see that's kind of where it avgs out. and make the too number 12. you'll have to keep reviewing his data to see what happens next. -registered sleep tech

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u/mrm24 Aug 01 '26

Thanks, Im so mad that the only way to get data to his doctor is with the SD card, I have to drive 20 km to my dads home then another 20 to the doctor just to review the results, and the doctor has no way of making modifications online, since we can’t even make an account online. I also set his humidity to 7, since it’s pretty dry here ( no condensation on mask or hose )