What is the Difference Between Cheyne Stokes and Biot’s

Cheyne Stokes and Biot’s are two different types of atypical breathing patterns. Atypical breathing pattern are often associated with underlying conditions.

The key difference between Cheyne Stokes and Biot’s is their breathing patterns. Cheyne Stokes consists of cycles of deep breathing followed by shallow breathing, while Biot’s respirations consist groups of quick, shallow inspirations followed by regular or irregular periods of apnea.

CONTENTS

1. Overview and Key Difference
2. What is Cheyne Stokes 
3. What is Biot’s
4. Similarities – Cheyne Stokes and Biot’s
5. Cheyne Stokes vs Biot’s in Tabular Form
6. Summary – Cheyne Stokes vs Biot’s
7. FAQ – Cheyne Stokes and Biot’s

What is Cheyne Stokes?

Cheyne Stokes consists of cycles of deep breathing followed by shallow breathing, which occurs commonly during sleep. Cheyne Stokes breathing can be caused by unstable feedback in the respiratory control system, delayed circulation, and reduced blood gas buffering capacity. Moreover, people with Cheyne Stokes usually experience orthopnea, paroxysmal nocturnal dyspnea, excessive daytime sleepiness, and fatigue. Each cycle of Cheyne Stokes respiration typically lasts between 30 seconds and two minutes.

Cheyne Stokes breathing can be diagnosed through medical history, physical examination, and polysomnography. Furthermore, Cheyne Stokes breathing is treated by managing the underlying cause of the condition, such as heart treatment, supplemental oxygen, and continuous positive airway pressure (CPAP).

Figure 01: Abnormal Breathing Patterns

What is Biot’s?

Biot’s is an atypical breathing characterized by variable tidal volume, random apneas, and no regularity. It was first characterized by Camille Biot in 1876. It is caused by damage to the medulla oblongata and pons in the brain by trauma, stroke, opioid use, and increased intracranial pressure due to uncal or tentorial herniation. People with Biot’s respiration experience irregular and rapid breathing with rhythmic pauses lasting 10–30 seconds. This can be accompanied by alternating periods of apnea and tachypnea.

Biot’s breathing can be diagnosed through medical history, physical examination, sleep study, and brain scan. Furthermore, Biot’s breathing is treated with intubation immediately upon diagnosis and mechanical ventilation to regulate patients’ breathing.

Similarities Between Cheyne Stokes and Biot’s

1. Cheyne Stokes and Biot’s are two abnormal breathing patterns.
2. Both types are associated with underlying conditions.
3. Both types can be diagnosed through medical history, physical examination, and sleep study.
4. They can be treated with proper ventilation and managing underlying conditions.

Difference Between Cheyne Stokes and Biot’s

Definition

1. Cheyne Strokes is an atypical breathing pattern characterized by a breathing pattern that starts out shallow and rapid.
2. Biot’s is an atypical breathing pattern characterized by complete irregularity of breathing, with irregular pauses and increasing periods of apnea.

Discovered by

1. Cheyne Strokes was discovered by John Cheyne and William Stokes in the early 19th century.
2. Biot’s was discovered by Camille Biot in 1876.

Lasting up to

1. Cheyne Stokes, on average, lasts 30 seconds to two minutes.
2. Biot’s, on average, lasts 10–30 seconds.

Causes

1. Cheyne Strokes can be caused by problems with the respiratory, circulatory, and central nervous systems.
2. Biot’s can be caused by damage to the medulla oblongata and pons in the brain by trauma, stroke, opioid use, and increased intracranial pressure.

Symptoms

1. The symptoms of Cheyne Strokes include loud snoring, labored breathing, sudden coughing fits, sudden limb movements during sleep, excessive daytime fatigue, sleepiness, and orthopnea.
2. The symptoms of Biot’s include irregular and rapid, with rhythmical pauses with alternating periods of apnoea and tachypnoea.

Diagnosis

1. Cheyne Stokes breathing can be diagnosed through medical history, physical examination, and polysomnography.
2. Biot’s breathing can be diagnosed through medical history, physical examination, sleep study, and brain scans (CT scan MRI).

Treatment

1. Cheyne Stokes breathing is treated by managing the underlying cause of the condition, such as heart treatment (medications, cardiac valve surgery, heart transplant, pacemakers and other devices), supplemental oxygen, and continuous positive airway pressure (CPAP).
2. Biot’s breathing can be treated by managing the underlying condition and using mechanical ventilation.

Associated Conditions

1. Cheyne Stokes breathing is associated with neurological conditions or congestive heart failure.
2. Biot’s breathing is associated with meningitis.

The following table summarizes the difference between Cheyne Stokes and Biot’s.

Summary – Cheyne Stokes vs Biot’s

Abnormal patterns of breathing can occur with certain medical conditions. Cheyne Stokes and Biot’s are two abnormal breathing patterns. Cheyne Stokes respiration is a distinctive, abnormal pattern of breathing characterized by cycles of deep breathing followed by shallow breathing. In contrast, Biot’s respiration involves periods of apnea alternating irregularly with a series of breaths of equal depth that terminate abruptly. Furthermore, Cheyne Stokes breathing is associated with neurological conditions, congestive heart failure, and infections. On the other hand, Biot’s breathing is associated with brain conditions such as meningitis. This is the summary of the difference between Cheyne Stokes and Biot’s.

FAQ: Cheyne Stokes and Biot’s

1. What happens in the Cheyne Stoke?

• Cheyne-Stoke respiration is a condition that causes abnormal breathing, commonly during sleep. This abnormal breathing often includes cycles of deep breathing followed by shallow breathing.

2. What does Cheyne Stokes breathing indicate?

• Cheyne Stokes respiration is believed to be a result of heart failure (infarction), neurological conditions, and infection. The presence of Cheyne Stokes respiration in patients with heart failure also predicts worse outcomes and increases the risk of sudden cardiac death.

3. What is a biot’s respiration?

• The Biot’s respiratory pattern was observed by a French physician called Camille Biot in 1876. It comprises a variable tidal volume, random apneas, and no regularity.

4. What condition causes Biot’s respirations?

• Biot’s respiration is caused by damage to the medulla oblongata and pons due to trauma, stroke, opioid use, and increased intracranial pressure. Often, Biot’s breathing pattern is also associated with meningitis.

5. What are the treatments for Biot’s respiration?

• Biot’s respiration can be treated with intubation immediately upon diagnosis, mechanical ventilation to regulate breathing, managing the underlying conditions like meningitis with medications such as antibiotics and antivirals, and stopping illegal substances such as opioids.

Reference:

1.  Eldridge, Lynne. “What Are the Causes of Cheyne Stokes Respirations?” Verywell Health, Verywell Health..
2.  Guri, Alex, et al. “Biot’s Breathing Associated with Acute Bacterial Meningitis in a Child.” BMJ Case Reports, BMJ Publishing Group.

Image Courtesy:

1. “Breathing abnormalities” By Sav vas – Own work (CC BY-SA 3.0) via Commons Wikimedia

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