New to APAP

[Davileet]

Hello all. The whole process of getting an APAP machine and the excitement of the idea to get a good nights sleep to remediate the brain fog, morning headaches, etc has led to frustation. I have tried to use the APAP machine for about a week now, but after laying in bed wide awake gasping at the occaisonal catch up breaths, and just the discomfort of the mask, I toss it aside and go back to sleeping without the machine. I am becoming discouraged.

Since I am having troubles getting to sleep and/or staying asleep, I haven't been able to get a lot of chart information, and I'm not sure if I should even be trying to make informed decisions with the information I do have.

That said, from my WatchPAT sleep study, my AHI was 16, and my central apnea event was a single 1 event for the whole night.

My current pressure settings are 10-20cm of pressure with EPR of 3 full time, and no ramp time. Even though I am comfortable with the inhale at 10cm, the exhale is uncomfortable. After a couple minutes of breathin on the APAP, I find myself feeling that I am just not getting enough oxygen and have to take huge breaths in to get satifisfied which I think is leading to some anxiety towards the whole thing.

My thoughts on the charts below is that I am having treatment-emergent central sleep apnea as they weren't present in the study. My question is, is it normal for APAP to create central apnea for newcomers onto APAP? Should I be looking into an ASV for CA or BiPAP machine for comfort of exhale? Or do I suck it up and keep on fighting with APAP and see if my body turns it around? Thanks

First night, fell asleep around the 23:45 mark.


Second night with breaks in between two small sleep sessions.

[LSAT]

I don't see a problem Don't be concerned about 1 CA. Maybe you can get concerned if you have 25-30+ consistantly... You don't need a ventilator.

[robysue1]

Hello all. The whole process of getting an APAP machine and the excitement of the idea to get a good nights sleep to remediate the brain fog, morning headaches, etc has led to frustation. I have tried to use the APAP machine for about a week now, but after laying in bed wide awake gasping at the occaisonal catch up breaths, and just the discomfort of the mask, I toss it aside and go back to sleeping without the machine. I am becoming discouraged.

Part of your problem was unrealistic expectations: While a few people are capable of putting on a CPAP mask for the first time and sleeping through the night and waking up feeling much better, most of us have to actually work (hard) at learning how to sleep with the dang hose attached to our nose. We have to learn how to fall asleep with the machine blowing air at us. And we have to learn how to keep the mask on every night, all night long. And even then, it can take several weeks to a few months for our body to really heal from all the damage that was done by years of bad sleep caused by the untreated OSA.

I have tried to use the APAP machine for about a week now, but after laying in bed wide awake gasping at the occaisonal catch up breaths,

Now we can start troubleshooting your problems.

When you say you are "gasping at the occasional catch up breaths", exactly what do you mean? I ask because people use this kind of language to describe a variety of problems which have different solutions.

So do you mean:

A) There's too much air coming into the mask for you to exhale comfortably and completely and the "catch up breaths" are your attempt to not inhale until you want to.

B) There's not enough air coming into the mask for you to inhale comfortably and completely and the "catch up breaths" are your attempt to get a really good, deep satisfying inhalation.

C) You have EPR turned on and the machine's changing pressure on each and every inhalation/exhalation is not in sync with your own breathing. In other words, you feel like the machine is encouraging/forcing you to inhale before you are ready to inhale. Or you feel like the machine is encouraging/forcing you to exhale before you are ready to exhale.

So which of these three things is the best description of what you are trying to convey when you say you are lying in bed wide awake and gasping at the occasional catch up breaths? Tell us that and we'll be able to make solid suggestions of things to try.

and just the discomfort of the mask

The mask itself should not be uncomfortable. Make sure you do not over tighten the headgear. And consider contacting the DME and asking for a replacement mask to try.

It would also help us help you if we knew what mask you are using and whether you think you are a mouth breather.

Since I am having troubles getting to sleep and/or staying asleep, I haven't been able to get a lot of chart information, and I'm not sure if I should even be trying to make informed decisions with the information I do have.

Until you've got more data from a whole night's sleep the data is not very meaningful. As soon as you rip the mask off your nose and go back to sleep without the machine, your apnea comes back and you're right back at your untreated AHI of 16. And that's also part of why you're not feeling any better (yet): Most of your sleep is still apnea-filled because most of your sleep is without the machine.

My current pressure settings are 10-20cm of pressure with EPR of 3 full time, and no ramp time. Even though I am comfortable with the inhale at 10cm, the exhale is uncomfortable. After a couple minutes of breathin on the APAP, I find myself feeling that I am just not getting enough oxygen and have to take huge breaths in to get satifisfied which I think is leading to some anxiety towards the whole thing.

The italicized statement would indicate using a bit less pressure at the start of the night would be a useful experiment to try. Perhaps reducing your min pressure to 8cm would help with the exhalation problem. Or perhaps turning the ramp on with a beginning ramp pressure of 7cm might help.

But the bold faced statement indicates that using a bit more pressure is what's needed to fix the problem that you are describing.

And then there's the anxiety issue, which is making everything worse. As hard as it sounds, what you need to do is find a way to concentrate less on your breathing while you are trying to get to sleep.

It sounds counter-intuitive, but what I would recommend is this: Give yourself what feels like about 15-20 minutes to fall asleep with the mask. DO NOT WATCH THE CLOCK during this time---just go by what "feels like" about 15 or 20 minutes. If you are NOT asleep after 15 or 20 subjective "minutes" OR if you find yourself getting anxious about the breathing, take the mask off and get out of bed. Go to a different room and do something quiet until you settle yourself down and feel sleepy enough to try going to sleep with the machine again. Only at that point go back to bed and put the mask back on and turn the machine on before trying to get to sleep.

Yes, at the beginning you may have to get out of bed multiple times before finally falling asleep.

If you get really anxious about how much time you are spending out of bed instead of lying in bed (not sleeping), it is worth considering asking your doctor for a short course of sleeping medication. Sometimes using sleeping pills for a couple of weeks is all that's needed for a person to learn to sleep with the machine all night long. Sometimes using sleeping pills on an "as needed" basis for several months is what's needed for a person to learn to sleep with the machine all night long.

My thoughts on the charts below is that I am having treatment-emergent central sleep apnea as they weren't present in the study. My question is, is it normal for APAP to create central apnea for newcomers onto APAP? Should I be looking into an ASV for CA or BiPAP machine for comfort of exhale? Or do I suck it up and keep on fighting with APAP and see if my body turns it around? Thanks

Personally I think you are overreacting to the CAs in your data. A quick cursory look at your data indicates that many of the CAs scored are most likely post arousal "events". Meaning there's a high probability that the CA was scored while you were awake, and these would not be scored on an in-lab sleep test with EEG data available. Or they're normal sleep transition centrals that occur as the control of your respiration is handed off to the autonomous nervous system and the CO2 trigger for inhalation is reset to higher level. Those kind of centrals are also not scored as sleep disrupted breathing problems on an in-lab sleep test with EEG data available.

Yes, there are a small minority of new CPAP users who develop treatment emergent centrals after starting CPAP. But a diagnosis of treatment emergent central sleep apnea is not going to be made until a person is sleeping all night long, every single night with the CPAP and the person is getting boatloads of centrals all night long. And by boatloads, I mean dozens and dozens---enough to trigger a CAI > 5.0 in at least 4 or 5 hours of sleep and every single night over an extended period of time.

It's worth pointing out that the usual approach to treating treatment emergent centrals is cautious waiting: Most of the time the problem resolves itself in a few weeks to a couple of months and there is literally no need to put the patient on a much more expensive machine.

It's also worth pointing out that ASV machines are usually much more difficult for people to get used to sleeping with than simpler CPAPs: An ASV machine can aggressively increase IPAP pressure whenever it thinks there is something that indicates a string of CAs may be getting ready to start---but this means that it can aggressively increase IPAP pressure when you are awake if your wake breathing is sufficiently ragged in just the right way to trick the machine. No xPAP machine can reliably tell when you are actually asleep, and they will all misread certain normal wake breathing patterns as sleep disrupted breathing patterns and then do what their algorithm says to do about that particular sleep disrupted breathing pattern.

Finally, I'll add this: I think that what is happening when your machine is scoring CAs is this: You're stuck in what we call "sleep-wake-junk" (SWJ) around here. In other words, you're bouncing back and forth between a groggy/tired "wake" stage and a very light "sleep" stage, but because you are now also more keenly aware of---and focusing on---your own breathing patterns, every time you almost transition to a real sleep and a normal sleep transition central occurs, your brain is aware that you just stopped breathing for a few seconds and it wakes you right back up. In other words, you're getting stuck in the transition to sleep. That's not a sleep disrupted breathing problem per se; it's an indication that the conscious part of your brain is not yet fully willing to trust this crazy thing on your face to keep working once you fall fast asleep.

[Miss Emerita]

Those charts suggest you were mostly not asleep. You'll find it helpful to learn to recognize the difference between asleep breathing and arousal/awake breathing. Asleep breathing generally looks like the stylized flow-rate trace inside the Oscar logo. Arousal breathing looks deeper and messier. And awake breathing -- well, pick a period when you know you were awake and take a look.

I would suggest that you pause your night-time use of the machine for a few days. Instead, set up the machine outside your bedroom and using it during the day or evening when you're watching TV, reading, or doing something else sedentary and somewhat distracting. Do this for at least several hours per day. This will help you get used to the new experience more quickly.

I just saw robysue1's post, which is packed with helpful information and advice. I would especially underline these points: it's common to take a while to sleep comfortably with the machine, and there's no reason to think you have a CA problem.

It's great that you've been diagnosed and are starting therapy for your apnea. It's also great that you're already using Oscar. If you add to that some patience and a willingness to experiment, I'm betting you'll do very well with PAP.

[Pugsy]

I concur with MissE, Robysue and LSAT about your not having a central apnea problem bad enough to warrant using a different machine.

Please review which graphs to include when you share a report.
You have stuff not needed and omitted stuff that is needed.
So pay attention to the formatting of the graphs.

http://www.cpaptalk.com/viewtopic/t1585 ... eview.html

[robysue1]

First night, fell asleep around the 23:45 mark.

The wave flow data indicates that you finally got into a real sleep around 23:48. I think all eight events scored between 23:36 and 23:47 are likely false positives---meaning the machine scored events that occurred while you were awake. That means we don't count these events as sleep disordered breathing.

Rather that bit of breathing indicates you were having a bit of difficulty transitioning to real sleep. As I indicated in my previous post, that's a different problem. And it can't be fixed by dial wingin' (changing the settings) or machine wingin' (switching to a different kind of xPAP).

It also looks like you had an arousal just before 0:14 and you didn't get back to sleep before turning the machine off at 0:26. So all five of the events scored between 0:14 and 0:26 are likely false positives. It's worth pointing out that the arousal at 0:14 does not appear to be respiratory related---the first CA is scored after that arousal has already taken place and you are awake.

Now what is noticeable is that you had a pretty significant leak between 23:47 (when you likely fell asleep) and about 0:13. The leak rate drops to 0 right at the arousal and then spikes and then drops down to near zero for the rest of the session. My interpretation is that your mouth probably dropped open as soon as you fell asleep and triggered the large leak. Eventually you woke up, perhaps because the leak caused your mouth to dry out or perhaps because it finally started hitting something that bothered you enough to wake up. At any rate, you woke up, noticed the leak, and fixed it, probably by closing your mouth. Then you may have momentarily fiddled with the mask (triggering a very short leak spike), but after that you had your mouth closed, but some kind of small pesky leak was irritating you enough to prevent you from getting back to sleep. And then at 0:26 you got frustrated, took the mask off, and went back to sleep for several hours of apena filled sleep without the mask on your nose.

And then, of course, you woke up tired the next morning---because of the several hours of apnea filled sleep that you got after you took the mask off at 0:26.

Second night with breaks in between two small sleep sessions.

If you were asleep during this stretch, it was a pretty restless sleep with what looks to be like a lot of spontaneous arousals. The OA at 0:02 is likely a real event; the CA shortly before 0:08 may be a real event OR it could be a sleep transition central. But it's not enough to worry about. The two REs may or may not be real. The H scored around 0:17 is post arousal and a false positive.

I don't think you ever got into a sound sleep during this very short 15 minute session.

Again, you intentionally took the mask off after turning the machine off at 0:46 and went to sleep without out the CPAP for several hours. So again, it's not a surprise that you woke up feeling tired after several more hours of apnea-filled sleep.

[Davileet]

There is a lot to unpack in these replies, so please forgive me having to post multiple replies.

When you say you are "gasping at the occasional catch up breaths", exactly what do you mean? I ask because people use this kind of language to describe a variety of problems which have different solutions.

So do you mean:

A) There's too much air coming into the mask for you to exhale comfortably and completely and the "catch up breaths" are your attempt to not inhale until you want to.

B) There's not enough air coming into the mask for you to inhale comfortably and completely and the "catch up breaths" are your attempt to get a really good, deep satisfying inhalation.

C) You have EPR turned on and the machine's changing pressure on each and every inhalation/exhalation is not in sync with your own breathing. In other words, you feel like the machine is encouraging/forcing you to inhale before you are ready to inhale. Or you feel like the machine is encouraging/forcing you to exhale before you are ready to exhale.

So which of these three things is the best description of what you are trying to convey when you say you are lying in bed wide awake and gasping at the occasional catch up breaths? Tell us that and we'll be able to make solid suggestions of things to try.

I would say that I feel I am not able to exhale as easily and completely as normal with the mask, and just overtime I feel the need to inhale large so I can exhale large to expel all the stale air. Hope that makes sense.

The mask itself should not be uncomfortable. Make sure you do not over tighten the headgear. And consider contacting the DME and asking for a replacement mask to try.
It would also help us help you if we knew what mask you are using and whether you think you are a mouth breather.

I have several masks through trial and error, but have found a nasal F&P Solo mask to be my preferred at this point. I might need to give the F20 another go and see if it doesn't have a massive air leak again, but I find it a bit stuffy and hot feeling to use.
I do think I am a mouth breather, but because of the comfort I find with nasal masks, I am thinking of trying to taping my mouth shut.

Until you've got more data from a whole night's sleep the data is not very meaningful. As soon as you rip the mask off your nose and go back to sleep without the machine, your apnea comes back and you're right back at your untreated AHI of 16. And that's also part of why you're not feeling any better (yet): Most of your sleep is still apnea-filled because most of your sleep is without the machine.

Agreed.

Perhaps reducing your min pressure to 8cm would help with the exhalation problem. Or perhaps turning the ramp on with a beginning ramp pressure of 7cm might help. But the bold faced statement indicates that using a bit more pressure is what's needed to fix the problem that you are describing.

I can give lowering the pressure a try, I think 8cm min would be tolerable for me. Even though the high pressure feels better when breathing in, it makes breathing out less tolerable.

And then there's the anxiety issue, which is making everything worse. As hard as it sounds, what you need to do is find a way to concentrate less on your breathing while you are trying to get to sleep.
It sounds counter-intuitive, but what I would recommend is this: Give yourself what feels like about 15-20 minutes to fall asleep with the mask. DO NOT WATCH THE CLOCK during this time---just go by what "feels like" about 15 or 20 minutes. If you are NOT asleep after 15 or 20 subjective "minutes" OR if you find yourself getting anxious about the breathing, take the mask off and get out of bed. Go to a different room and do something quiet until you settle yourself down and feel sleepy enough to try going to sleep with the machine again. Only at that point go back to bed and put the mask back on and turn the machine on before trying to get to sleep.

Yes, at the beginning you may have to get out of bed multiple times before finally falling asleep.

I can give this a try. When laying in bed I do become impatient when I start thinking too much about how the mask feels or how its blowing my nostrils like a balloon.

If you get really anxious about how much time you are spending out of bed instead of lying in bed (not sleeping), it is worth considering asking your doctor for a short course of sleeping medication. Sometimes using sleeping pills for a couple of weeks is all that's needed for a person to learn to sleep with the machine all night long. Sometimes using sleeping pills on an "as needed" basis for several months is what's needed for a person to learn to sleep with the machine all night long.

I have considered possibly trying some over the counter medicine for this. But I feel like when I wake up feeling a struggle to breathe, it may not be the best to sleep through, haha.

Yes, there are a small minority of new CPAP users who develop treatment emergent centrals after starting CPAP. But a diagnosis of treatment emergent central sleep apnea is not going to be made until a person is sleeping all night long, every single night with the CPAP and the person is getting boatloads of centrals all night long. And by boatloads, I mean dozens and dozens---enough to trigger a CAI > 5.0 in at least 4 or 5 hours of sleep and every single night over an extended period of time. It's worth pointing out that the usual approach to treating treatment emergent centrals is cautious waiting: Most of the time the problem resolves itself in a few weeks to a couple of months and there is literally no need to put the patient on a much more expensive machine.

Completely fair, and I think the same thing. I know from last night the CA events are probably a real thing as it was causing me to open my mouth and gasp for breath and interrupting my sleep. I will give it more attempts to see if I can make it over the hump of an hour asleep.

Finally, I'll add this: I think that what is happening when your machine is scoring CAs is this: You're stuck in what we call "sleep-wake-junk" (SWJ) around here. In other words, you're bouncing back and forth between a groggy/tired "wake" stage and a very light "sleep" stage, but because you are now also more keenly aware of---and focusing on---your own breathing patterns, every time you almost transition to a real sleep and a normal sleep transition central occurs, your brain is aware that you just stopped breathing for a few seconds and it wakes you right back up. In other words, you're getting stuck in the transition to sleep. That's not a sleep disrupted breathing problem per se; it's an indication that the conscious part of your brain is not yet fully willing to trust this crazy thing on your face to keep working once you fall fast asleep.

Is there a trick to overcome these CA events from waking me up from the intial light sleep that I enter into? Would a take home sleep test ignore these CA because they know its junk and not count it in my statistics?

[Davileet]

I would suggest that you pause your night-time use of the machine for a few days. Instead, set up the machine outside your bedroom and using it during the day or evening when you're watching TV, reading, or doing something else sedentary and somewhat distracting. Do this for at least several hours per day. This will help you get used to the new experience more quickly.

It's great that you've been diagnosed and are starting therapy for your apnea. It's also great that you're already using Oscar. If you add to that some patience and a willingness to experiment, I'm betting you'll do very well with PAP.

Thank you. I did spend some time yesterday and today trying to find my ideal settings and getting used to the machine while awake and trying to relax. I do find it made it much easier to fall asleep last night.

[Davileet]

I concur with MissE, Robysue and LSAT about your not having a central apnea problem bad enough to warrant using a different machine.

Please review which graphs to include when you share a report.
You have stuff not needed and omitted stuff that is needed.
So pay attention to the formatting of the graphs.

http://www.cpaptalk.com/viewtopic/t1585 ... eview.html

I looked through this wiki prior to posting, but I am not terribly clear on where my mistake was. Can you tell tell me what I am missing or should have omitted?

[Davileet]

The wave flow data indicates that you finally got into a real sleep around 23:48. I think all eight events scored between 23:36 and 23:47 are likely false positives---meaning the machine scored events that occurred while you were awake. That means we don't count these events as sleep disordered breathing.

Rather that bit of breathing indicates you were having a bit of difficulty transitioning to real sleep. As I indicated in my previous post, that's a different problem. And it can't be fixed by dial wingin' (changing the settings) or machine wingin' (switching to a different kind of xPAP).

It also looks like you had an arousal just before 0:14 and you didn't get back to sleep before turning the machine off at 0:26. So all five of the events scored between 0:14 and 0:26 are likely false positives. It's worth pointing out that the arousal at 0:14 does not appear to be respiratory related---the first CA is scored after that arousal has already taken place and you are awake.

Now what is noticeable is that you had a pretty significant leak between 23:47 (when you likely fell asleep) and about 0:13. The leak rate drops to 0 right at the arousal and then spikes and then drops down to near zero for the rest of the session. My interpretation is that your mouth probably dropped open as soon as you fell asleep and triggered the large leak. Eventually you woke up, perhaps because the leak caused your mouth to dry out or perhaps because it finally started hitting something that bothered you enough to wake up. At any rate, you woke up, noticed the leak, and fixed it, probably by closing your mouth. Then you may have momentarily fiddled with the mask (triggering a very short leak spike), but after that you had your mouth closed, but some kind of small pesky leak was irritating you enough to prevent you from getting back to sleep. And then at 0:26 you got frustrated, took the mask off, and went back to sleep for several hours of apena filled sleep without the mask on your nose.

If you were asleep during this stretch, it was a pretty restless sleep with what looks to be like a lot of spontaneous arousals. The OA at 0:02 is likely a real event; the CA shortly before 0:08 may be a real event OR it could be a sleep transition central. But it's not enough to worry about. The two REs may or may not be real. The H scored around 0:17 is post arousal and a false positive.

I believe you are spot on.

I don't think you ever got into a sound sleep during this very short 15 minute session.

Agreed. So, I guess there isn't a trick to stopping these arrousals aside from keep trying?
I have been reading about CA being induced by APAP and lowering or turning off EPR helping. Should I give that a try or leave it at 3?

[Pugsy]

Can you tell tell me what I am missing or should have omitted?

Don't need Exp time graph and that being gone would maybe let the other graphs be a bit larger.
I don't know what you are doing but I can't read much of anything on your reports....too tiny.
Plus I want a big picture of the whole night without a bunch of snippets.
You can do snippets but they don't mean much to me without seeing the whole night to put those snippets in context.
I mentioned it for future report sharing. No need to redo what you have already done.

My main point to posting was to show my agreement with the others about your not having a problem with centrals to the point that you might have needed a different machine to deal with the centrals.

If the others are okay with how you present your reports.....hey...doesn't really matter to me. I will let MissE and Robysue continue to help. They don't need me. I will bow out.

[Davileet]

Can you tell tell me what I am missing or should have omitted?

Don't need Exp time graph and that being gone would maybe let the other graphs be a bit larger.
I don't know what you are doing but I can't read much of anything on your reports....too tiny.
Plus I want a big picture of the whole night without a bunch of snippets.
You can do snippets but they don't mean much to me without seeing the whole night to put those snippets in context.
I mentioned it for future report sharing. No need to redo what you have already done.

My main point to posting was to show my agreement with the others about your not having a problem with centrals to the point that you might have needed a different machine to deal with the centrals.

If the others are okay with how you present your reports.....hey...doesn't really matter to me. I will let MissE and Robysue continue to help. They don't need me. I will bow out.

Noted, thank you. I will make adjustments for the next time I post charts. And will try to get longer sessions.
I believe since I have an ultrawide monitor it could be affecting what you and others see, I will adjust that as well next time.

[Pugsy]

since I have an ultrawide monitor it could be affecting what you and others see,

That's probably what it is. You aren't the first to post tiny reports (or at least too tiny for my old eyes to see well).
A lot of people have big monitors....but I only have this laptop screen and it isn't a huge laptop.

Now if you were having a lot of nights with a lot of this central flagging....then we have a chat about those centrals.

I slept right through that whole mess (see report below) and it has happened one other night only. Don't ask me what happened because we haven't figured it out. I have been on CPAP for over 15 years and twice this sort of thing has happened with the boatload of centrals popping up....and we have no idea what happened. I guess I will have to put the blame on my favorite scapegoat....aliens.

[Davileet]

Now if you were having a lot of nights with a lot of this central flagging....then we have a chat about those centrals.

I slept right through that whole mess (see report below) and it has happened one other night only. Don't ask me what happened because we haven't figured it out. I have been on CPAP for over 15 years and twice this sort of thing has happened with the boatload of centrals popping up....and we have no idea what happened. I guess I will have to put the blame on my favorite scapegoat....aliens.

That is very interesting chart you have there. Is it possible that these machines aren't perfect at knowing an OA from a CA, and that these could have been OA events that didn't recieve support? They do look a lot like Cheyne-Stokes imo though, and more to the left that didn't quite flag an CA.

[Pugsy]

That is very interesting chart you have there. Is it possible that these machines aren't perfect at knowing an OA from a CA, and that these could have been OA events that didn't recieve support? They do look a lot like Cheyne-Stokes imo though, and more to the left that didn't quite flag an CA.

These machines aren't perfect....that's for sure. Plus they can't discern awake vs asleep breathing and 75% of my AHI has always been awake breathing false positives because I wake often during the night (other health issues causing poor sleep).
And it didn't flag any of those centrals as Cheyne Stokes either.

At any rate I ran my two oddball reports, with all those centrals back to back, by a friend of mine who is a "pro" in the field.
He ran a sleep lab in a big hospital in the Northeast so he knows his stuff and he was as bumfuddled as I was.
If you were to really zoom in close on those centrals they don't look like perfect CSR which was probably why I didn't get the CSR flagging. It's close but not exact.

It was decided that I would just wait and see if it was something that I started seeing all the time or much more often and if that was the case then I would put more effort into figuring it out or get the sleep doctor on board. I never advocate making big changes in something just because of a weird off ball report or two. If I was seeing that sort of stuff every night....yep, I would probably be hunting up an ASV machine. But not for 2 odd ball reports in over 15 years of reports.

Sometimes crap happens...even to cpap veterans. Was kinda exciting though....at least compared to 15 years of boring reports. That was back in May of this year and I haven't seen it since then. I had nothing happen that I could blame it on that I could think of. I wasn't ill or anything like that and I sure felt like I was asleep during that mess.

When I can't explain away something that is when I usually blame the aliens for screwing with me. As good of a reason as anything I guess. My point is that we don't always have clear cut answers in front of us.

BTW those breaths to the left that look sort of like PB/CSR....the duration wasn't long enough to earn a flag.
OAs, Centrals, and hyponeas all have to have a duration of at least 10 seconds to earn a flag. Those to the left side...didn't last long enough.