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Why a sudden increase in central apneas?
(02-07-2014, 03:51 AM)igdoc Wrote: New to this forum but not new to this.
Hi igdoc, welcome abaord
How you like the machine "Sefam auto evolve"

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Thanks Zonk,
The SEFAM is a French APAP machine derived from the Sandman. It is small and quiet with a built in humidifier. It tries to distinguish between central (clear airway) and obstructive events but (same as other APAP devices) is not 100% accurate at this. Before discovering that I had Complex Sleep Apnea with 30 central events per hour, the SEFAM would keep pushing up the pressure because some of the events were wrongly classed as obstructive. APAP machines and CPAP induced central events don't go well together!

I have managed to avoid needing an ASV machine by using CPAP mode at a low pressure and, most importantly, by disabling the exhalation relief (CFEX, AFLEX, EPR) to reduce the hyperventilation induced central episodes.

(Sorry in my first post I missed that this topic is relatively old but hopefully still relevant to the small percentage who have high numbers of central events)
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Hi igdoc,
WELCOME! to the forum.!
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Why does bilevel (compared to CPAP) induce hyperventilation? I know that hyperventilation blows off blood CO2 reducing ones central ventilation drive. But, what is it about bilevel that induces HV?

I'm seeing some CAs; and I am wondering is I should up my EPAP pressure by 1 cm-H2O to see if this reduces CAs.

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Be sure to use SleepyHead to look at your airflow waveforms and figure out how "real" and how serious the centrals are. Sometimes the machine will flag something that's not that concerning once you look at the waveforms. Or it might be long and complete apneas that are even more worrying.

Step one would probably be to undo the changes and see what happens. Then maybe experiment with a few other changes, such as lower pressure without bilevel, and monitor AHI and centrals.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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