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Turn Flex off or just down may not impact your centrals at all.
Worth trying but I am thinking probably won't change things much. It makes a difference for some people but not all people.

Many thanks, Pugsy, for generously sharing your wisdom on this thread and others.

If EPR is said to increase central apnea why is Bilevel often cited as a treatment for it? Isn't Bilevel just a more extreme EPR?

tyrone747 wrote: ↑

Sat May 04, 2019 8:47 am

If EPR is said to increase central apnea why is Bilevel often cited as a treatment for it? Isn't Bilevel just a more extreme EPR?

Yes, using any form of exhale relief does create a bilevel situation where there are 2 separate pressures...one for inhale and one for exhale.

The people who have central apneas pop up just because they are using exhale relief or bilevel pressures....actually a very small subset of people who find that cpap pressures trigger central apneas. So it's not common at all...very rare.
If it were common I don't think we all would have exhale relief offered to us as a user adjustable comfort feature.

Bilevel is usually the first line of attack when cpap pressures trigger centrals because sometimes it works....plain ordinary bilevel sometimes works and there's no need to go to the higher end machines.
Obviously for the small minority of people who find that using any exhale relief triggers centrals, going to plain bilevel won't help much and they will likely have to move up quickly to the machines designed to treat both central and obstructive apnea. All depends on how much of a problem those centrals might be.

Treatment protocols still address the majority of people's responses...so bilevel is the appropriate next step.
Those people who find that bilevel actually causes centrals are in such a minority that they aren't going to be using the same protocols.
I can count on one hand the number of people (on this forum that I have seen) who had centrals pop up just because of exhale relief.....very small percentage of an already small percentage of people who find that cpap pressures trigger centrals.
Protocols won't be changed for such a small number of people.

tyrone747 wrote: ↑

Sat May 04, 2019 8:47 am

If EPR is said to increase central apnea why is Bilevel often cited as a treatment for it? Isn't Bilevel just a more extreme EPR?

"bilevel" encompasses a number of very different treatment types that share one feature... different pressures for inhale and exhale.

plain or auto bilevel don't do anything for centrals... however, non-invasive ventilator bilevels like an ASV will treat centrals, because they trigger to higher (sometimes much higher) pressures automatically when you don't inhale on your own, thus forcing air into you.

Hello fabulous cpaptalk community!

I thought I would let you know that my AHI score has settled down, consistently below 1 since May 4th

I am on Resmed Airsense for Her, with a fixed pressure of 6.6.
I'm still not sleeping as well as I'd like, and suspect that poor sleep quality is contributing to the events that still occur.
Will continue to work on the lifestyle factors to optimize sleep hygiene.

Shout out to Pugsy, Katestyles, Palerider, ajack, LSAT, Julie and Tyrone 747 who provided information and support.

May you all have a fabulous weekend,
Best, Dee

Great to hear that things settled down for you!