Wake-sleep tansitional apnea issue

Benn using cpap for 15+ years, pressure set to 10cm, AHI typically 2-3, good compliance, good therapy for a long time until a couple years ago. Started to experience wake-sleep transitional apnea where I would wake up and breathing hadn't started for a split second. Increased pressure to 10.6cm and that seemed to resolve the issue for about over a year, however, I started to experience the transitional apnea again when falling asleep. I know this is often referred to as normal tansitional centrals and not real centrals. The issue is that I don't want to wake up before breathing restarts and not sure why things have changed after so many years of successful cpap therapy. Been trying to find info on how to resolve these wake-sleep transitionals, does anyone have any experience with this and resolving it? I have no issue once asleep, but the idea of waking up not breathing during this transition is wrecking my sleep lately.

If transitional apneas wake you up they are of concern. It would help to see an OSCAR graph along with details on the machine, settings and mask. I have complex apnea and my wake/sleep transition apneas can be extreme, with O2 drops into the '80s. My approach is to treat them like other open airway or central apneas. If you use ramp you may want to try different starting pressures, higher isn't necessarily better, it can exacerbate them, there may be a sweet spot. If you do find better ramp pressure you might want to try auto ramp rather than timed. Try turning off EPR if you use it, it can increase them. Unfortunately there isn't a setting for EPR off only during ramp... Finally consider what position you fall asleep in. Central apneas aren't supposed to be positional but mine are.

I was happy with autoset until i got older and the odd sleep transition problems got to be too much, even though I had the autoset figured out as best it could be. Wound up blindly experimenting with different types of machines and only the ASV worked with the backup breathing rate. Never had a lot of centrals, but the ASV smoothed the erratic breathing so the wake periods didn't completely ruin a given sleep cycle. It seems this was a lifelong problem, looking back on it, that was independent of the obstructive apneas that hit hard in 2003. The resmed ASV that came out in late 2012 allowing Min PS of 0 saved me. Post some graphs, maybe an expert can help. I chalked up the change to the aging process and was glad to have found this site.