Breathing of Cheyne Stokes: Key Points and Causes

Definition: is one of several types of unusual breathing with recurrent apneas (dysrhythmias).

It was initially reported in patients with heart failure or stroke and was then recognized in other diseases and as a component of the sleep apnea syndrome.

It is enhanced and perpetuated by changing the states of excitement that occur during sleep. Recurrent hypoxia and the waves of sympathetic activity that often occur during apneas can have serious health consequences.

Heart failure and stroke are risk factors for sleep apnea.

Recurrent apneas and intermittent hypoxia with sleep apnea further damage the heart and brain.

Although all respiratory dysrhythmias do not have the exact cause, the instability in the feedback control involved in the chemical regulation of respiration is the leading cause.

Mathematical models have helped a lot in understanding the causes of recurrent apneas.


Cheyne-Stokes respiration is an abnormal breathing pattern common in patients with decompensated congestive heart failure and neurological diseases. The periods of tachypnea and hyperpnea alternate with periods of apnea.

In most of these patients, ventilatory patterns may not be recognized, and the underlying disease process usually dominates clinical features.

However, Cheyne-Stoke’s breathing can profoundly affect the cardiopulmonary system, causing oxygen desaturation, cardiac arrhythmias, and changes in mental status.

In addition to conventional therapy, the treatment of Cheyne-Stokes breathing in congestive heart failure with supplemental oxygen or continuous positive pressure in the nasal airways can improve general cardiac function and perhaps the patient’s prognosis.

Key points

– When the Cheyne Stokes pattern occurs during sleep, it is considered a form of central sleep apnea.

– People who are dying often experience breathing under the Cheyne Stokes pattern.

– This type of abnormal breathing is severe and typically related to heart failure or stroke.

Cheyne Stokes breathing is a type of abnormal breathing. It is characterized by a gradual increase in breathing and then a decrease.

This pattern is followed by a period of apnea where breathing stops temporarily. The cycle then repeats itself.

Normal breathing, the process of moving air in and out of the lungs 12 to 20 times per minute, is something most people rarely think about. However, abnormal breathing like Cheyne Stokes is severe and can be frightening.

When is it most likely to happen?

According to the research, Cheyne Strokes breathing can occur while awake, but it is more common during sleep.

It can happen more during peaceful sleep than deep sleep; this is done by studying it through fast or slow eye movement.

When Cheyne Stokes breathing occurs during sleep, it is considered a form of central sleep apnea with a prolonged period of rapid breathing (hyperventilation).

Central sleep apnea causes you to stop breathing briefly and increases carbon dioxide levels in your body.


Patients with Cheyne-Stokes are usually breathing present with symptoms of orthopnea, paroxysmal nocturnal dyspnoea, excessive daytime sleepiness, and marked apneas in congestive heart failure.

Cheyne Stokes’s breathing is a poor prognostic sign, most often seen in the care of terminally ill patients.

However, it may also be a normal finding in children and healthy adults after rapid ascent at high altitudes or sleep.

The causes include:

  • Brainstem injuries: cerebrovascular event.
  • Encephalitis.
  • Increase in intracranial pressure.
  • Heart failure.
  • Chronic pulmonary edema.
  • Vertigo.

The Cheyne Stokes pattern is usually related to heart failure or stroke. It can also be caused by:

  • Brain tumors.
  • Traumatic brain injuries.
  • Illness due to altitude
  • Encephalitis.
  • Increased intracranial pressure.
  • Chronic pulmonary edema.

People who are dying often experience Cheyne Stokes breathing.

This is a natural effect of the body’s attempt to compensate for changing carbon dioxide levels. While it can be distressing to those who witness it, there is no evidence that Cheyne Stokes’s breathing is stressful for the person experiencing it.

Breath of Kussmaul VS Cheyne Stokes

Kussmaul breathing and Cheyne Stokes breathing are characterized by rapid breathing and excess carbon dioxide in the body, but that is where their similarities end.

Kussmaul’s breathing does not alternate between rapid and slow breathing or causes the breathing to stop as Cheyne Stokes’s breathing does.

Instead, it is characterized by a deep and rapid breathing rhythm throughout its duration.

Kussmaul’s breathing is often caused by late diabetic ketoacidosis.

Diabetic ketoacidosis is a metabolic disease caused by a lack of insulin and too much glucagon in the body.

Glucagon is a hormone produced by the pancreas that increases blood sugar. Kussmaul’s breathing may also be present in people with kidney failure.

Cheyne Stokes’s breathing is profound. It can be challenging to diagnose since abnormal breathing often occurs during sleep.

An asleep study known as polysomnography is necessary to diagnose sleep-related to Cheyne Stokes breathing and other forms of sleep apnea.

Consult your doctor if you have symptoms of Cheyne Stokes, sleep apnea, or other abnormal breathing.

The breathing of Cheyne Stokes is also known as periodic breathing, with breathing cycles that are getting deeper and deeper with possible periods of apnea.

Although 50% of patients with moderate to severe congestive heart failure are affected by significant Cheyne Stokes breathing, their exact pathophysiology remains uncertain.

Typically, an episode of 10 to 20 seconds produces apnea or hypopnea for one minute, followed by breaths of increasing depth and frequency. The cycle then repeats itself.