For any sort of apnea event to actually be flagged it has to last at least 10 seconds and there has to be a certain amount of flow reduction too. So 2 main criteria for a flag...duration and amount of reduction in the flow rate.
Perhaps what you are having with those sleep onset transitions are normal sleep onset centrals that don't last at least 10 seconds....and thus no flag.
Some people have this happen often and so repeatedly that it becomes a serious problem because they can't ever actually get to sleep.
So all night long lots of these sleep onset centrals and no sleep. Doesn't sound like that is happening with you and if that's the case...the doctors won't do much about it. Heck, it's sometimes hard to get them to do anything about it when people are having a lot of those sort of centrals during sleep stage transition.
I don't know if that is what it happening with you at sleep onset...maybe...it's about my best guess.
You could zoom in on the flow rate at the beginning of the night and look for arousal breathing where there is a flow reduction that is rather short and/or smaller than usual. Sometimes it is really hard to spot minor differences though.
There's so much more to getting good restorative sleep and feeling those good numbers than just not having very many apnea events and getting a nice low AHI. Getting good numbers is the easy part...actually feeling them isn't always so easy because there are so many other things that can affect our sleep and how we feel besides sleep disordered breathing issues.
Obviously all those nosy questions was to do some detective work to see if any of the common potential causes for poor sleep quality might be a factor in your not feeling those good numbers. We look for how many hours a person is sleeping...are those sleep hours fragmented....we also look for medication side effects as a potential culprit for not feeling so great or even not sleeping so great.
I can't count the number of times I see people here complaining of fatigue and they are on medications well known to cause fatigue.
The best cpap therapy in the world can't fix medication side effects.
Same thing with the other health issues question...this helps me weed out meds sometimes.
Obviously we struck out in looking for the obvious and usual suspects in your case....so you have to do more detective work in an effort to try to figure out why you don't feel as good as you expect you should feel.
You might be having a lot of arousals for some reason that you don't remember...anything that messes with sleep quality/architecture (those needed cycles in normal progression and normal %) messes with how we feel. So you might take the time to learn about how to spot arousal breathing and then do some microscopic work looking for flow rates that are irregular and might be arousal related.
We don't have to remember an arousal for it to be enough to cause a problem and there doesn't necessarily have to be a flagged event associated with it for it to mess with sleep.
The videos here explain how to scroll through the flow rate and look for irregular breathing which might mean arousals.
http://freecpapadvice.com/sleepyhead-free-software
Your diagnostic AHI wasn't all that remarkable...11 is rather "mild" but I use that term loosely because it doesn't always reflect severity in terms of effects on the body. My own OSA was just 12 per hour during non REM but rocking and rolling during REM with 53 per hour but those 12 events per hour were rather long in duration and I was having desats down into the low 70s%...
I don't know how "bad" your OSA was in terms of stress on the body with oxygen desats...
I mention all this because there is a problem that sort of goes along with "mild" OSA or even not enough criteria met to meet OSA diagnosis that might be an issue for you and responsible for your not feeling those good numbers. It's called UARS or Upper Airway Resistance Syndrome. Google it and see if you think any of it fits your situation.
I don't know that you have it but it wouldn't be impossible. It might explain the low numbers and not feeling so great. It's not an easy diagnosis to make.
The fix is cpap...but usually more pressure is needed beyond what gives us a good AHI. These machines weren't designed to treat UARS or report anything that might help us treat UARS...we just have to do some trial and error stuff in an effort to figure out what makes us feel better.
Almost always when I see documented UARS here on the forum the people end up having to use more pressure just to feel better than the machine wants or needs to give. The algorithm is obstructive apnea...not UARS...so the machine won't go higher.
So while there's really nothing on the report that points to you needing more pressure....if (I stress the IF part) you do have an underlying UARS component going on you might do a little better with even more minimum pressure past what is effective for the OSA stuff.
Finally maybe your not feeling so great has nothing to do with sleep disordered breathing and there's nothing the machine can do about stuff that isn't airway related.
Maybe time for an extensive work up to rule out other potential culprits...normal labs which should include thyroid function as well as maybe some special labs like vitamin D levels and hormone levels.
Another thought too...if your not feeling like you got good sleep is because you are just plain sleepy a lot during the day...there are some people who despite effective cpap therapy still have excessive residual sleepiness. Happens in about 10% of the cases the last I read or depending whose paper you are reading.
So what symptoms are you having to make you think you aren't feeling as good as you like?
Is it fatigue or excessive sleepiness??? They aren't necessarily the same.
I may have to RISE but I refuse to SHINE.
