Go here and watch all the videos as it will explain how to better determine asleep vs post arousal flagged event.
http://freecpapadvice.com/sleepyhead-free-software
It's not so much that the dreams are causing the centrals as the centrals are a symptom of an arousal. We don't remember dreaming unless we wake up in the middle or right at the end of a dream. The fact that you remember lots of dreams tells me that you are waking more often than you realize you are. People don't always remember arousals/awakenings but if you are remembering dreams...you are waking often.
People think remembering dreams is a good thing...it actually isn't because it means we are waking often. When we sleep soundly we still dream but we won't remember it because we don't wake up.
When awake/semi awake or after an arousal our breathing is irregular and will often cause the machine to do a little flagging. Remember these machines only measure air flow. They have no way to measure sleep status.
How do we fix or reduce the number of post arousal centrals (or any flagged post arousal event as it can be any of the flagged events)....we have to sleep more soundly with less arousals. Easier said than done I know.
We can have breathing related arousals...like when the airway collapses and we struggle to breathe...and if you better prevent the collapses then you can better prevent arousals related to airway collapses. That's how CPAP therapy helps improve sleep quality.
Unfortunately we can also have spontaneous arousals...not related to breathing obstructions or problems and those arousals are much harder to prevent because we don't always know what is causing them and it's kinda hard to fix a problem if we don't know the cause of the problem.
Having an occasional real central isn't a big deal because it's normal to have an occasional central. Like sleep onset centrals...those are normal and not usually a problem. So a random central isn't cause for alarm. They are usually very brief and won't last long enough to cause any oxygen level drops or issues. Hold your breath for 10 to 20 seconds. That's essentially what a 10 to 20 second central is.
The airway is open but to air is moving. You can do this easily and it won't cause a problem unless you start doing it often within a really short period of time.
But here's the deal...when you have lots of arousals or awakenings (you may or may not remember any of them) you then also have another chance to go back to sleep and have another sleep onset central. So you get maybe more sleep onset centrals just from poor sleep quality as well as some likely post arousal not real central flagging going on. Makes it look like the centrals are the problem but instead the centrals are really a symptom of a problem and the problem is poor sleep quality from the multiple arousals/awakenings.
You prevent the centrals by improving sleep quality and reducing the arousals.
The obstructive component of your report is showing that the OSA stuff is well treated...so we assume that those arousals aren't related to breathing issues. That leaves spontaneous arousals as the likely culprit and those are hard to deal with because we don't always know what is causing them.
You are one week into therapy....that really isn't very long in the grand scheme of things and just wearing all this stuff is enough to cause the brain to go to hyper alert status and be much more likely to cause you to have an arousal because the brain hasn't yet come to terms with its new best friend...the mask and the machine ...so the brain will want to poke you and wake you up just to alert you which I always called it my brain poking me and saying "hey dude, do you know there is an alien stuck on your face blowing air up your nose".
Hopefully this will be the situation for you and with some time the brain will stop with the "hey dude" pokes to wake you up. I think it took me about 3 months before my brain quit doing the "hey dude" thing. Each person is different in how long it takes their brain to come to terms with all this new stuff being attached to us.
Of course there are other reasons for spontaneous arousals or poor sleep quality. Medication side effects are one reason. Other health issues is another. Pain or bed comfort reasons are other culprits. And unfortunately sometimes we simply don't know the reason.
It's normal to have a few arousals or awakenings....like it's normal to awaken briefly after a REM stage sleep is completed. Most of the time awake is very brief and we don't have time to form a memory of the awakening. So some of your post arousal centrals might simply be from a brief arousal that happens after a REM cycle is completed and then you go back to sleep and maybe have a real sleep onset central. That's why we don't worry about random real centrals.
So for you we say give it some time for the brain to get used to its new best friend and hope that your overall sleep quality will improved and you will have less arousals and with less arousals the chances of post arousal centrals will also reduce.
Work on your general overall sleep hygiene issues in case you are doing something bad in terms of sleep hygiene that is known to mess with sleep quality. Caffeine is a big culprit there along with late night use of the computer or phone. Review any medications you might take (even OTC stuff) that might also have an impact on sleep quality. I take a pain pill for my arthritis that comes with a may cause drowsiness sticker on it but for me it causes insomnia...I go to sleep fairly quickly but it won't last. In a couple of hours I am wide awake and cleaning the house.
It's a side effect that happens to a really small percentage of people who take that particular medication.
So I have to take a different pain med at bedtime because if I didn't the pain would wake me more often than it does now and it's pretty bad now even with the different medication. Talk about damned if you do and damned if you don't.
Try to quit worrying about the centrals being a cause of a problem but instead they are a symptom of a problem that you need to try to figure out and address. The problem being poor sleep quality in general from multiple arousals/awakenings. It's not always an easy problem to identify the cause of though but you can try with some detective work...and at the same time do give it time for the brain to learn to accept all this new stuff being attached to us.
Do you have another appointment for follow up with your sleep doctor some time in the future? Usually they do one sometime after 30 days beginning treatment up to 90 days because a lot of insurance require it. If after 30 days you are still showing evidence of poor sleep quality with a lot of post arousal flagged events then talk to your doctor about ways to improve sleep quality.
I may have to RISE but I refuse to SHINE.
