New Bipap user, worried by frequency of central events

Hi everyone!
I recently got a Bipap through Lofta to treat my sleep apnea. I went straight to Bipap after getting the results of the sleep study from their doctor.
Going from the OSCAR results over the last 3 weeks or so, I have had some really good nights and some not so good nights. I am concerned about the amount of Clear Airway events I am seeing. These CA events seem to occur in clusters with OA events.
After the first night, I felt great. But since then I have still had several days feeling tired and have a headache when I wake up (although some days I feel noticeably better than before)
After seeing all these CA events I am worried I might not be getting good results from the Bipap, but I still feel very lost.
Here is my sleephq link. If anyone in the know can take a look and tell me what might be going on, I would greatly appreciate it.
-Michael
https://sleephq.com/public/teams/share_ ... 2e438f09e
Here is the initial result I got from Lofta:
Obstructive Sleep Apnea (G47.33) - Severe, based on pAHIo= 78 and O2 nadir of 78%. Central Sleep Apnea (G47.31) - Moderate to severe, based on pAHIc= 29.3. Severe snoring.
If there are any other pieces of info needed I will reply promptly. Thanks again!

The bulk of both your CA/Central and OAs are post arousal/awake events pointing to not being sound asleep when they were flagged.
If you zoom in on those event flags you will see large irregular big breaths in you flow rate and when asleep these breaths should be nice and boring and regular.

Now why you had trouble sleeping....we don't have any way to know for sure but the events are a symptom of simply poor sleep quality and not necessarily the cause of the poor sleep quality.

Any idea on why you were awake so much?

Here's an example of mine from a while back.

I circled the for sure asleep breathing in red .....all that other stuff is arousal or maybe awake breathing but I didn't remember an awakening at that time.


same time frame but just zoomed out more

Pugsy wrote: ↑

Mon Jul 06, 2026 5:22 am

The bulk of both your CA/Central and OAs are post arousal/awake events pointing to not being sound asleep when they were flagged.
If you zoom in on those event flags you will see large irregular big breaths in you flow rate and when asleep these breaths should be nice and boring and regular.

Now why you had trouble sleeping....we don't have any way to know for sure but the events are a symptom of simply poor sleep quality and not necessarily the cause of the poor sleep quality.

Any idea on why you were awake so much?

Thanks for the response Pugsy. I think you might be right.
Last night was very interesting. I had a solid block of sleep with no apparent problems. Then I got up to use the restroom, and for the rest of the night I recall tossing and turning and finding it very difficult to maintain side-sleep (I'm naturally a back-sleeper) with the mask and hose in the proper position with no leaks. I was really struggling with it. I think I am unconsciously trying to roll onto my belly instead of staying on my side at this point, because I was constantly waking up in discomfort. I even have a large block of sleep where the machine isn't recording, but I know I was actually asleep when this happened. I think I got annoyed and turned off the machine, but I can't actually recall doing it. The OSCAR screenshot below shows what I mean.

I have a wedge pillow from Amazon coming today https://www.amazon.com/dp/B0GN21RKHW to see if I can sleep on my back while avoiding obstructions.
I have the F20 full face mask, where the hose is on the front of the mask. It is inconvenient for side sleeping, but this mask has worked great otherwise.
I also have tried to Resmed F30 Hybrid mask, which seemed ideal because the hose comes out of the top of the mask. But I didn't even last one night using that one. I felt like I couldn't breath enough through my nose. (I breath through both my mouth and nose at night)

These machines are NOT able to distinguish between asleep breathing and awake/semi-awake breathing.
So it just responds to what it thinks it is sensing and if it thinks you are having OAs it will increase the pressure as it thinks it needs (per the auto adjusting algorithm).....so when you see all those OA flags the machine goes on a hunting mission to try to prevent further OAs.
Centrals won't get a pressure response...that's also in the algorithm.

I think any of those events kind of as false positives and it doesn't really matter that the machine flagged them in terms of thinking "is my apnea problem being fixed adequately. So we just have to mentally manually say they don't matter and toss them out the window.
Instead we need to work on the sleep problem causing the arousals/awakenings that ends up causing the false positives.

In your case the machine increased the pressure in response to the false OA positive flags. It didn't know that you were maybe awake and those OAs don't count so they don't need a flag. These machines are good but they do have some limitations.
My biggest consistent wish for these machines is that they are able to distinguish sleep...if not the stages but at least be able do tell the difference between asleep and awake.. Many years now I have had that wish....been on cpap/apap since May 2009.

Yes you probably took the mask off....don't beat yourself up about it unless you make a habit of doing it.
I did it for about 2 hours a couple of weeks ago myself.

For side sleeping with any mask.....position your head of the very edge of the pillow so that the mask can sort of dangle off the end of the pillow and not touch much of anything.

Once your mask issues get sorted out and we don't have false positive muddying up the report I think your event flagging will reduce considerably....Because the arousals will have reduced.
You will probably still occasionally see a false positive because crap just happens.
My AHI long term average is around 1 but out of say 8 events all night probably 75% false positives.

Getting the mask issues sorted out and/or finding the right mask......hardest part to all this cpap therapy stuff.
Takes practice and time though and resign yourself to the fact that sometimes crap happens. We just don't want a load of crap all night long or every night.

Oh...the "good" nights and the "bad" causing you to feel good and/or bad the next day.
On the "good "nights you probably were able to sleep more soundly with minimal wake up (we all wake up during the night at times) so
you feel good.
On the "bad" nights you simply didn't sleep well or long enough for the restorative powers of sleep to do their thing.
So the headache, etc could simply be from poor sleep or not enough sleep.

So if you are having a lot of "bad" nights you need to work on figuring out why and what you can do about.