False Detection of Cheyne-Stokes Respiration on Continuous Positive Airway Pressure Resolved After Treatment of Nasal Obstruction.

Cheyne-Stokes respiration (CSR) is a potentially dangerous abnormal breathing pattern that can be associated with serious cardiac events and poor prognosis. This case describes the unexpected recording of CSR events by a continuous positive airway pressure (CPAP) apparatus in a patient who was consistently CPAP compliant and had a stable medical history except for recent nasal obstruction. Respiratory polygraphy (RP) suggested the CPAP device had erroneously recorded obstructive sleep apnea (OSA) as CSR due to mixed apnea features that mimicked CSR. Treatment of the nasal obstruction resolved the problem with the erroneous readings, suggesting the nasal obstruction was the cause of the aberrant CPAP recording. This case highlights the limits of CPAP device reliability for detection of CSR and the need for standardized CSR detection criteria across CPAP devices.