Another Newbie Looking for SleepyTime Feedback

My home sleep study showed moderate apnea and my primary doctor prescribed an auto CPAP (I found that it was lower cost for me to purchase on my own vs. going through my insurance program). I have a DreamStation 500 auto with Respironics DreamWear Gel Pillow mask.

My appointment with my Dr. is not until January and I'm trying to understand what the current SleepyTime results mean for me. If you have some thoughts or suggestions about the attached reports, I would be most appreciative.

On the report dated Nov 25 were you awake or asleep the last hour of so?...the 6:30 to 7:30 AM time frame...asleep or awake or partially either?
How was your sleep quality overall for the night? Sleep soundly for the most part or multiple awakenings with time spent with mask and machine on?

Pugsy, thanks for your response. I think I see what you are referring to on the chart starting at about 6:30am. In answer to your questions:

1. I only know of waking once during the night of Nov 25th at about 4:45am and I got up for a few minutes. (I typically get up once per night whether I'm using CPAP or not)

2. I think I slept pretty well on the 25th, as well as the other nights where the charts are shown.

3. I don't think I was awake at 6:30 to 7:30am on the 25th report (or if I was, I was not aware of it)

4. I don't find that I'm bothered by the CPAP machine or mask and don't think I wake during the night while wearing it. The only thing that seems somewhat different from when I did not wear the mask and using CPAP, is: after I wake up and during the day, I feel like I might have been making some effort to breathe during the night - like my chest feels a little tired (don't know that I'm explaining this very well and it is not bothersome feeling).

The chest feeling "tired" may simply be chest wall muscles rebelling a bit against the extra work load of exhaling against the pressure.
Very similar to the sore muscles when we take on a new exercise schedule and should gradually go away as your chest wall muscles get more used to the "work" involved with exhaling against cpap pressures.

Did you ever get a written copy of the home sleep study results?

Do you take any medications of any kind? Especially pain medications that might suppress respiration a bit?

On the 25 the report wasn't too bad until that last hour and then things went to hell.
And looks like it doesn't always go to hell...as shown by the night with the AHI in the 5 range.

Can you get me a zoomed in image of a time frame where the green PB shows up?
Go to the Nov 24 report....click on the Events tab so that you will see all the different categories for the flagged events.
Click on the Periodic Breathing category and it will take you to a list of all the PB flags with times when they happened.
Pick one...the 4:00AM time frame with the CA flagged in the middle...click on that and let the graph on the right for flow rate zoom in on the PB flow rate.
Get me a screen shot at that level of zooming in and hopefully the CA flag will be in the middle of it.

Welcome to the forum.
You did a great job posting the relevant data. I suggest leaving the settings for a week and let's see if your events settle down. Please update this thread regularly so we can easily follow your progression.

Here are some tips that helped me. The machine does not know when you are actually asleep, so it is common to have false events during transition to sleep. So knowing when you are actually asleep is important. Another important aspect is trying to discern when you are on your back vs side. Many people have more events when on their back. Reviewing your data everyday while your recollection is still fresh is helpful. When I awake during the night, I pull the mask away for 2 seconds so that a high leak rate marks the moment.

Hi TedVPAP, thanks for the tips. I do find that I switch from sleeping on side to on my back - I mostly don't know or remember doing this.

Hi Pugsy, thanks for your questions - answers are listed below:

Q. Did you ever get a written copy of the home sleep study results?
A. Yes, I have a copy of it. Is there something that I should look for on the study?

Q. Do you take any medications of any kind? Especially pain medications that might suppress respiration a bit?
A. Yes, I do take some medications, but I don't think any of them are listed as suppressing respiration. I do not take any pain related medications.

Q. Can you get me a zoomed in image of a time frame where the green PB shows up? (Go to the Nov 24 report....Pick one...the 4:00AM time frame with the CA flagged in the middle.
A. See attached chart. Also, I added a similar chart from the next day, during the time when "things went to hell". I don't know how to read or interpret these charts, however.

All the nosy questions were an effort to try to be able to blame some of the centrals on being awake or medications.
So doesn't look like we get to pooh pooh them off so easily.

I don't know what to make of your centrals (they look real to me) and the PB.
You have times where things are not so bad and times where things obviously aren't so good so that makes me wonder what changed from the not so bad to the obvious not so good.

Either the centrals/CAs are post arousal and related to an OA or hyponea causing and arousal or they are just because your body decided to quit breathing on its own. For sure need to keep that follow up appt with your doctor.

It might be that things will settle down with some time.

I am real hesitant to offer ideas about increasing the pressure a little in an effort to better reduce the OA and hyponea side of things because if those centrals are real and brought on by pressure then more pressure might make them worse....but if they are post arousal centrals reducing the OAs/hyponeas might reduce the arousals and thus reduce the centrals. I have seen it happen so I know it can happen.

There is a very small subset of people who find that if they use exhale relief in some fashion (exhale relief creates a bilevel pressure situation) that centrals can be caused by the bilevel situation. It's not very common at all but it is worth considering in your situation.

Turn Flex exhale relief off and see what happens.