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sleeptech

sleeptech
Joined Jun 2017
sleeptech
Joined Jun 2017

A few thoughts to clear up some of your confusion about treatment of central apnoea.

Firstly, elevated pressure does not always lead to an increase in central events. Sometimes it does but mostly it doesn't.

Secondly, not all central are caused by hyperventilation. In fact, most are not. When central events are the product of hyperventilation (breathing too much) that is when ASV is the appropriate treatment. It will only increase the amount of air it's pushing when the patient's own effort decreases, and when the patient's own breathing muscles are working it backs off. Thus it works to fill in the gaps in breathing and ventilate the patient as little as possible. This is desirable in cases of hyperventilation.

When there are central events and the patient is hypoventilated, which is more common in my experience, then BiPAP is the treatment of choice. It can fill in the gaps in breathing caused by central events and also increase the overall level of air breathed in and out by the patient. This is useful in raising oxygen saturation levels and decreasing CO2 levels. It is often used in managing conditions such as COPD, motor neuron disease, muscular dystrophy, severe scoliosis and more.

Both BiPAP and ASV have range of controls beyond just the 2 pressure levels which are set. They primarily affect the timing of breaths and can get rather complex. BiPAP in particular has a lot of different settings and different modes, which is why I so often say that it should be set up by technician with the appropriate training.