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Why a sudden increase in central apneas?
Over the past two days, my "Clear Airway" events as reported by SleepyHead -- which I think are basically central apneas -- have shot up. They've gone from around 5/hr (sometimes as low as 1, sometimes as high as 10), to the last two nights of a 49/hr and a 62/hr. The change corresponds (although I can't say for sure this is the cause) with my machine provider changing my settings from CPAP@19 back to their original Bi-Level@10:20 (because the CPAP@19 was uncomfortable).

Anyone any ideas why centrals could go up like that? I'd have thought the move from CPAP@19 to Bilevel@10:20 would have, if anything, made centrals go down, but certainly not up.

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The discussion in this thread might helps
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(06-24-2013, 06:35 PM)zonk Wrote: The discussion in this thread might helps
Thanks Zonk, that's describing my experience pretty much exactly. But it goes against the reasoning behind my original titration (where they said CPAP was inducing centrals so they put me on a BiLevel for ongoing treatment). Hard to know who is right, but based on my current experience, something needs to change.

I guess I'll have to wait until I see the sleep doc and see what he has to say about it all.

Again, thanks for the info.
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I used to have a lot more CA events while on the QuattroFX too.
I tried the FitLife total FM and that cleared a lot of them up.
(my eyeballs were getting pressurized from the backside too.. not comfy)
I imagine because that bigger mask has a lot more dead space and accumulates a bit of CO2
that helps stimulate breathing just enough.

Any studies on this, anyone?

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

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Last few days of data. Hardly a robust clinical trial but seems to match what that paper is saying. CPAP pressure is 19, BPAP (BiLevel) is 10:20

Day 1 - CPAP: OA/hr =  5.29, CA/hr =  4.78
Day 2 - BPAP: OA/hr =  8.57, CA/hr = 48.96
Day 3 - BPAP: OA/hr =  6.67, CA/hr = 61.55
Day 4 - CPAP: OA/hr = 10.45, CA/hr =  5.16

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Can you use that thing in APAP mode?
That might get those numbers down by letting the machine try and "figure you out".

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

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C-PAP machine also made my central apnea shoot up as well. I found that the s9 VPAP Adapt work best for me. It figures out what is best for you.
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I'm on board with let the Auto see if it can find the right setting for you . Also remember if you sleep on your back the numbers usually go up move to your side they usually go down . Point being The auto can change with you and find that sweet spot . my auto found my sweet spot , most mornings when I check the #s are around .14 to .59 AHI and maybe 1 CA a night . Dreaming

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Sounds like the other guys have a good explanation, but just a shot in the dark -- have you been drinking or taking medication? That can also do it.
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New to this forum but not new to this. The increase in clear airway events is indeed due to reverting to bilevel. The explanation is that on bilevel the large pressure difference between inspiration and expiration is causing hyperventilation induced central events. The hyperventilation is lowering your CO2 levels below your apnea threshold causing you to reduce or stop breathing (unless your machine has a backup rate). After a short period (maybe 25 seconds) your breathing will restart and hyperventilation returns and the whole cycle starts again. Most people are not prone to this but unfortunately (like myself) you are.

One solution is to have a bilevel machine with a backup rate which stimulates breathing when the apnea occurs (but is not good for the already low CO2 levels). Reducing the pressure difference between inspiration and expiration will reduce the central events but a big change would be necessary. The best treatment is an ASV machine which will help both the hyperventilation and the hypopneas/apneas. Alternatively you can go back to CPAP if you can tolerate it (preferably at a lower pressure just enough to control obstruction) and without too much expiratory relief (CFLEX). If the expiratory relief is too high this will also cause hyperventilation central events.

I don't know if any of these suggestions are going to useful but hopefully understanding what is going on may help your discussions with your doctor. Good luck.
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