Can high loop gain be changed?

[NoddingHacker]

I'm looking at all of these papers about loop gain, but nobody bothers to mention if it's genetic and if it can be changed. Is loop gain like a chronotype (i.e. you cannot change it, its how you work) or is it like insulin sensitivity (i.e. there is a big margin of potential improvement for most people).

[Sleeprider]

We know that therapy onset of CSA will generally improve or fully resolve in most new users of CPAP, so there appears to be an adaptation mechanism that plays a role for most individuals that are sensitive to a loop gain in pCO2. "CPAP-emergent CSA occurs during the initial nights of CPAP in up to 15% of patients with OSA, with near complete abolition after 2 to 3 months of CPAP". https://www.apneaboard.com/wiki/index.ph...entilation

We know that certain disease pathways such as heart failure greatly increases the occurrence for CSA and CSR, and that these individuals are also more prone to loop gain in CPAP or spontaneous bilevel therapies. It is easily observed that there is an individual response to CPAP and spontaneous bilevel pressure, and differences in the tolerance to pressure and pressure support before loop gain (aka apneic threshold) becomes apparent. Environmental conditions such as high altitude also significantly increase the liklihood of loop gain. I don't know that we can rule out a genetic factor, because there is a great deal of individual variation in how people react to pressure and pressure support as well as general health, altitude and other factors. I am not aware of research into genetics as a root cause.

Beyond the adaptation to lower PCO2 that seems to occur for most individuals, the symptoms of loop gain can be treated or mitigated by using therapy that prevents onset of the hyperventilation - hypoventilation cycle that seems to characteristic. ASV is specifically designed to mitigate loop gain and is effective in treating CSA that would normally occur when these respiratory cycles are out of control.

[CPAPfriend]

Look into buteyko breathing. I haven't reviewed that actual scientific literature on it, but they claim you can change your loop gain.