What adjustment is often made if persistent central apneas are observed during titration?

When persistent central apneas are observed during titration, an appropriate adjustment is to switch to adaptive servo ventilation (ASV). This is mainly because ASV is designed to automatically adjust airway pressures based on the patient's needs, particularly when central sleep apnea is present. Central apneas are characterized by a lack of respiratory effort, and traditional continuous positive airway pressure (CPAP) may not sufficiently address this pattern of breathing.

ASV helps in stabilizing ventilation by applying varying levels of pressure support to maintain adequate respiratory patterns and prevent further central apneas. This dynamic adjustment is beneficial as it can adapt to the patient's breathing patterns throughout the sleep study, providing tailored support that a fixed pressure mode cannot.

The other options are less effective as interventions for central apneas. Decreasing the inspiratory positive airway pressure (IPAP) might actually exacerbate the issue by removing some of the ventilatory support. Increasing the expiratory positive airway pressure (EPAP) can help with obstructive apneas but typically does not address central apneas effectively. Switching to a different CPAP device may not resolve the central apnea issue, as the underlying problem lies in the lack of respiratory drive rather than inadequate airway pressure. Hence, ASV is the most suitable choice for managing