Should I be concerned about these floods of CAs?

[rev0lted]

Hi Everyone, I'm a new cpap user and I'm looking at my Oscar data, I noticed this flood of CAs on my charts, should I worry about that? reducing the EPR did not help and is very uncomfortable. Does anyone have any idea if this is normal? thank you and i wait for answers

Note: The gaps are from moments when I unintentionally removed the mask (still in the process of adaptation)

[rev0lted]

more screenshots

[Pugsy]

Were you for sure sound asleep when these clusters got flagged?

How long have you been on cpap? Are you waking often during the night?

Take any medications?? If so, what?

They look more arousal/awake related to my eye than asleep related.
See the videos here.
http://freecpapadvice.com/sleepyhead-free-software

Do you have copies of any sleep studies you had? If not, get them.
Was the sleep study a home study or in lab?
If home study did you wear any sort of device around your abdomen or chest?

[rev0lted]

Pugsy, thanks for answering

I've been on cpap for a week, I wake up a few times before cpap and also with cpap.

I don't take any medication

I'm not sure if I was awake at these events, but it looks like I was between sleeping and waking up.

I haven't done a sleep study yet, it's scheduled for the end of the month, but as the symptoms all matched with apnea or UARS, other causes they've all been ruled out in hundreds of exams,
I decided to get an APAP and start therapy as soon as possible to see if I see any relief.

[Pugsy]

Ahhh...I understand now.

There is a central apnea event that is called a sleep onset central apnea. These are normal and no big deal but they don't usually come in clusters unless they continually bounce a person out of sleep and they have to transition to sleep again from awake status. Also called transitional centrals.

Yours look more like awake/arousal related centrals though and given your history with frequent awakenings these could very well be false positive central flagging. Add in new to cpap and all the awakenings/arousals that can happen while adjusting....high chance of these being a symptom of the awakening and not necessarily the cause of the awakening.

Awake/arousal breathing is much more irregular than asleep breathing. Also factor in while awake we often pause our breathing a bit and since the machine can't know if we are awake or asleep all it can do is flag the pause in breathing.
If we aren't asleep they simply don't count except to alert us to lots of arousals or poor sleep quality.
We have to be asleep for any flagged event to really matter.

What machine is this report from?
Do you see an events tab on the left side of the detailed report?
If you do click on it and you should see the 3 categories of events.....CA/central, obstructive and hyponea.
Click on the CA category and you should see a list of the events and when they happened.
Is there a number in parentheses after the time??? That may be event duration depending on what machine you are using.

When you have time please add your machine to your signature line like I have mine.
It helps when we know which machine people are using.

Something you can do to help isolate awake breathing....when you wake up for any reason reach over and push the on/off button to turn the machine off and then push to turn it right back on. This will give you a break in therapy line where you can easily see if awake or not and associate any flagged events right at the time of a known awakening so you can easily discount them.

For premature mask removal....try taping the straps to your face in hopes that when you remove the mask during your sleep that the skin being tugged on will wake you up and you can stop that unwanted behavior.

To really examine these detailed reports we need solid blocks of sleep. Awake breathing really messes up the evaluations and makes it hard to know what might be going on.

Since you already tried turning exhale relief off and that didn't reduce the clustering of centrals and it caused problems with breathing....don't worry about it and just use the exhale relief.
Turning exhale relief off only helps reduce centrals when the exhale relief is the cause of the centrals and while it does happen to a very small minority of people....it is about the only thing we can do with regular apap machines to try.
If it doesn't work then no sense in doing it.

I suspect that the bulk of your central flagging is related to awake/arousal false positives. Might be a few real centrals every now and then and that's normal and no big deal.
I suggest working on simply adjusting to cpap therapy at this time and work on not removing the mask prematurely if at all possible.

Have you ever tried OTC sleep aids? Might be something to consider (assuming you can take them safely) short term to help you get past this initial adjustment period.
FWIW...it took me about 3 months of adjusting before my brain quit waking me up just to tell me I had an alien plastered on my face blowing air up my nose and I had zero problems adjusting to the mask. Lets face it...this whole new way of sleeping isn't exactly normal and add that on top of problems sleeping before cpap....it's going to take some time.

Oh...when you are scheduled for the real sleep study...discontinue the use of the cpap machine for at least 3 nights before you get the sleep study. There is some thought that there is a "hold over" effect for a few nights after using cpap for a while and you don't want that chance of getting a negative sleep study because of hold over effect. I don't know how much truth there is to it but I wouldn't want to take the chance.

[Pugsy]

I see you are using some sort of ResMed machine...probably what we call in the US the AutoSet.
Where are you located? I see some non English terms.

[rev0lted]

Yes, it's a ResMed AirSense 10 AutoSet, I'm from Brazil, here in my country people don't have as much information about apnea and there are discussion forums like in other countries.

I'll leave a screenshot with the duration of the events as you mentioned

The only "soniferous" I used a few nights was melatonin, but most nights I'm so exhausted I don't need it. Do you recommend using low-dose melatonin (0.5 or 1mg) to aid in therapy?

[rev0lted]

Is there any chance I have UARS? in my appointment with the sleep doctor he mentioned my retracted jaw, but I doubt that here in my city they have a diagnosis of UARS. From what I researched, it is very contradictory in several countries and depends a lot on the clinic and the doctor who is taking care of the case. On my audio recordings at night I snored a lot and sometimes breathed hard. But fortunately I have seen numerous reports of people being effectively treated for UARS with CPAP/APAP

[Pugsy]

Give the melatonin a try....I don't know that it is all that great for staying asleep as it is mainly for help in falling asleep but worth a try.
There's sleep onset insomnia where we have trouble falling asleep.
And there's sleep maintenance insomnia where we have trouble staying asleep. Sleep maintenance insomnia is always a difficult problem to address because to fix a problem we have to first identify the problem and figuring out what is causing us to wake up too soon or too often isn't always an easy chore.
There's a miles long list of potential culprits for sleep maintenance insomnia.

Could it be UARS??? Sure it is possible....anything is possible but it's a hard diagnosis to get made with any certainty.
Unfortunately the data gathered by these machines isn't really all that helpful for UARS treatment. The machines simply weren't designed with UARS in mind.