Which breathing pattern is characterized by periods of deep breathing alternating with periods of apnea?

• A. Kussmaul breathing
• B. Ataxic breathing
• C. Cheyne-Stokes breathing
• D. Sighing

Answer: (C)

Cheyne-Stokes breathing is defined by repeating cycles of progressively deeper and faster breathing followed by periods of apnea. In each cycle, the tidal volume waxes and wanes—the person breathes in with increasingly larger breaths, then gradually slows and becomes shallower, and pauses briefly before breathing again. The apnea period interrupts the pattern and then the cycle starts over.

This waxing and waning with a central pause reflects instability in the respiratory control system, often due to impaired cerebral perfusion or altered CO2 sensitivity, commonly seen with advanced heart failure or neurologic injury. The apnea allows CO2 to rise again, triggering the next bout of breathing and continuing the cycle.

Other patterns don’t show this characteristic regular crescendo-decrescendo with a true pause. Kussmaul breathing features persistent deep, rapid breaths without pauses. Ataxic (Biot) breathing is irregular and unpredictable, with varying tidal volumes and irregular pauses. Sighing involves occasional large breaths but no repeating apnea phase.