Cheyne-Stokes Respirations - Definition, Meaning, and Prognosis

Causes and Treatment of Cheyne-Stokes Respirations

photo of a woman praying at the bedside of a dying man
What are Cheyne-Stokes respirations?.

Definition: Cheyne-Stokes Respirations

Cheyne-stokes respirations are a pattern of irregular breathing often seen in the last days of life, but also seen in some people with congestive heart failure. Breathing can be very deep and rapid, followed by periods of slow shallow breaths, or episodes of apnea, where an individual stops breathing altogether for a period of time.

Causes of Cheyne-Stokes Respiration

Cheyne-Stokes breathing is commonly seen when people are in the  dying process from any illness including cancer.

This will be discussed first, but keep in mind that there are other causes discussed further below, and this breathing may occur in people who are not actively dying.

Cheyne-Stokes Breathing as Part of the Dying Process

Irregular breathing may occur at the end of life and can be very disturbing to family members who are present. It's important to note that this breathing is not uncomfortable to the dying person, and it does not need to be treated for comfort purposes. In fact, it is probably a way that the body compensates in some way for other physical changes taking place.

You may be wondering what else to expect in the final stages of dying. During this time it's not uncommon for people to talk of seeing loved ones who have died before, even seeming frustrated as they try to describe things for which they can't seem to find words. Your loved one may let you know she is dying in a kind of "near death awareness" in which she may tell you that she will miss you and say she is going away.

It can be painful for those who are dying to have their comments dismissed as hallucinations or to be corrected. Try to listen during moments your loved one is awake, and reassure her that you believe her and love her.

Other Causes of Cheyne- Stokes Breathing

In addition to being an end-of-life occurrence, Cheyne-Stoke breathing may be seen with:

  • Congestive heart failure
  • Carbon monoxide poisoning
  • Hyponatremia (a low sodium level in the blood)
  • Sleeping at high altitudes
  • Stroke
  • Traumatic brain injury
  • Some medication overdoses such as morphine

Physiology and Purpose

It's not known exactly why this type of central sleep apnea (breathing that is monitored by the central nervous system) occurs. Recent thought has been that this breathing may be a way in which the body compensates in some way, rather than a problem in and of itself. It's thought that the pattern of waxing and waning may result first from deep breathing to increase oxygen level to the body (which decreases carbon dioxide levels in the blood) followed by periods of apnea (not breathing) as the body compensates for the decreased carbon dioxide by limiting breaths while the carbon dioxide in the blood increases.

Cheyne-Stokes Breathing in Congestive Heart Failure

This type of breathing is fairly common among people with congestive heart failure and is considered a poor prognostic sign, though it may occur in people who have the potential to live for quite some time.


Over the years a fair amount of research has been done on the right way to treat Cheyne-Stokes respiration. At the present time, the view is leaning towards believing that this is a physiological compensatory response that does not necessarily need to be treated per se. Central sleep apnea such is this disordered breathing may alert doctors to examine other findings with regard to heart failure. Home oxygen therapy, as well as continuous positive airway pressure (CPAP), are a few of the treatment options that have been used for this type of central sleep apnea.


Cheyne-Stokes or Hunter-Cheyne-Stokes breathing was first defined in the 1800's by 2 physicians: Dr. John Cheyne and Dr. William Stokes.

Also Known As: agonal respiration, periodic breathing

Examples: When his father developed Cheyne-stokes respirations, Jordan called his family to let them know it appeared his father was dying.


Malhotra, A., and J. Fang. Sleep disordered breathing in heart failure. UpToDate. Updated 11/02/15.

Mehra, R., and D. Gottlieb. A Paradigm Shift in the Treatment of Central Sleep Apnea in Heart Failure. Chest. 148(4):848-851.

Naughton, M. Cheyne-Stokes respiration: friend or foe?. Thorax. 67(4):357-60.

Wang, Y., Cao, J., Feng, J., and B. Chen. Cheyne-Stokes respiration during sleep: mechanisms and potential interventions. British Journal of Hospital Medicine. 2015. 76(7):390-6.

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