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Cheyne–Stokes respiration is a pattern of breathing in which periods of gradually increasing and then decreasing tidal volume alternate with intervals of apnea. The breaths have a waxing and waning amplitude, and the episodes of apnea may last several seconds to a minute or more. This cyclical pattern is classified as a central form of sleep-disordered breathing, arising from delayed feedback control of respiration rather than airway obstruction.

The phenomenon was described in the 19th century by John Cheyne and William Stokes, and its mechanism is linked to unstable control of breathing. Factors such as prolonged circulatory time, heightened chemoreceptor sensitivity to carbon dioxide, and fluctuating cerebral perfusion can produce a slowly oscillating drive to breathe. CSR is often observed in individuals with significant cardiopulmonary or central nervous system disease.

Common clinical contexts include congestive heart failure, advanced systolic dysfunction, stroke, brain injury, brain tumors, and other conditions affecting central respiratory regulation. It can also appear in older adults during sleep or in severe hypoxic states and, in neonates, may be a normal variant during sleep, though it is less typical in healthy adults.

Diagnosis typically relies on polysomnography or capnography, which reveal the characteristic waxing and waning tidal volumes with periodic central apnea. Management focuses on treating the underlying condition; in some cases, therapies such as continuous positive airway pressure (CPAP), bilevel positive airway pressure (BPAP), or supplemental oxygen may reduce CSR and improve sleep quality. CSR often indicates significant disease burden, and prognosis depends largely on the primary disorder.