Help with poor sleep, hypopneas and centrals

Some people feel like they do better in terms of results and sleep quality with either a tight range in pressure or even a fixed pressure.
No way to know until you try it.
Everyone is different and we sometimes just have to do a bit of experimentation.
And some people don't do well with EPR while the next person might have similar sleep issues if they tried going without EPR.
There aren't any hard fast rules. Nothing that is a guaranteed setting that will work for everyone.

Pugsy wrote: ↑

Thu Sep 03, 2026 5:06 pm

There aren't any hard fast rules. Nothing that is a guaranteed setting that will work for everyone.

^^^^THIS^^^^

zonker wrote: ^^^^THIS^^^^

Yep, exactly. With CPAP settings there’s a lot of “try it and see,” but it helps to change only one thing at a time and give it a few nights if you can, unless it’s clearly making sleep worse.

For this situation, I’d be looking at comfort and actual sleep quality as much as the AHI. A pretty chart doesn’t help much if the person is waking all night or fighting the machine.

rainy_gull24 wrote: ↑

Sun Sep 06, 2026 7:42 am

zonker wrote: ^^^^THIS^^^^

Yep, exactly. With CPAP settings there’s a lot of “try it and see,” but it helps to change only one thing at a time and give it a few nights if you can, unless it’s clearly making sleep worse.

For this situation, I’d be looking at comfort and actual sleep quality as much as the AHI. A pretty chart doesn’t help much if the person is waking all night or fighting the machine.

i won't tell you just how long it took for this to penetrate my thick skull. i was absolutely convinced there was some magic combination that would make me sleep better. once i succumbed to the notion of comfort, the rest fell into place with a minimum of fuss.

Might benefit from a look in SleepHQ and running the poor sleep algorithm, but IYAM, besides sleep being inherently AFU this is a case where Auto is somewhere between ineffectively applied and totally inappropriate.

So 2 nights ago I had soft pressure adjustment setting, EPR off, pressure at 7.6-9.6 with AHI 2(1hypopnea/1 central)! Best score I have ever had, but still felt somewhat tired. I narrowed the range from 7.6-9.4 last night and I SLEPT 10 HOURS. My wife had to come wake me up! I honestly did not know where I was for 5 min while my brain was catching up. Unfortunately, AHI was 4.6 (2.2 hyp/2.6 CA). I was kind of bummed assuming it would be like zero or one based off of my perceived excellent sleep. But I am telling myself there is more nuance to this whole thing than the numbers on the screen and I know I’m headed in the right direction with all of the guidance you all have given me. The only things left to do are more narrowed pressure, straight CPAP pressure, or turn soft to standard pressure changes. I’ll probably leave every as is for a bit if I can sleep like this even with the slight uptick in AHI.

Should I try out sleepHQ alongside OSCAR? Any additional benefit to doing the paid membership for a short stint as I am learning? I’m guessing it is like a fitness tracker, where the paid membership is really helpful, but once you get enough data to line up against your techniques and perceived effort you really lock in on knowing your body.

Slpd89 wrote: ↑

Mon Sep 07, 2026 7:18 am

Any additional benefit to doing the paid membership for a short stint as I am learning? I’m guessing it is like a fitness tracker, where the paid membership is really helpful, but once you get enough data to line up against your techniques and perceived effort you really lock in on knowing your body.

Paying isn't going to give you anything more than you could get here if you posted the results to SleepHQ here.
Your choice since it is your money.

Slpd89 wrote: ↑

Mon Sep 07, 2026 7:18 am

So 2 nights ago I had soft pressure adjustment setting, EPR off, pressure at 7.6-9.6 with AHI 2(1hypopnea/1 central)! Best score I have ever had, but still felt somewhat tired. I narrowed the range from 7.6-9.4 last night and I SLEPT 10 HOURS. My wife had to come wake me up! I honestly did not know where I was for 5 min while my brain was catching up. Unfortunately, AHI was 4.6 (2.2 hyp/2.6 CA). I was kind of bummed assuming it would be like zero or one based off of my perceived excellent sleep.

patience, grasshopper. please do NOT chase zero. it's a mugs game. (ask me how i know!) 4.6 is a decent ahi for someone who is just starting out.

also, keep sleeping with that setting and see what happens over the next few nights.

OH! congrats on the 10 hours of sleep!

Thank you! Appreciate you all!

OK, I have given it a full week under my new settings. This is the BEST SLEEP I HAVE HAD IN YEARS. Although I am very happy with this, my numbers from a central and hypopnea standpoint do not seem to be budging. Also, I am occasionally getting a 0.1 obstructive reading. I am posting my SleepHQ link below. Any insight on what this means or if I have room for improvement and better numbers would be appreciated! Also, I really like this SleepHQ interface!

https://sleephq.com/public/teams/share_ ... bf0b08939b

Give yourself at least another week ( 2 weeks or more would be better) at these settings.
I scrolled through the flow rate for the entire night and saw maybe 2 asleep (real) centrals which is actually normal even if they were real and the rest of them were post arousal. Same thing for the hyponeas with 2 maybes and the rest were post arousal.

Your overall sleep quality is probably a little less than what we would like to see but this is a long marathon and not a sprint. It's actually fairly common. Your brain is used to waking often and it can take some time for the brain to relearn that it doesn't have to wake so often from the apnea events.
You can have arousals without remembering them depending on how long the arousal lasts so it doesn't surprise me.

Keep up the good work. Remember the one medication that you need to take.....the patience pill. Hard to do because we are all wired to look to the data numbers as verification of how well we are doing but with cpap therapy the machine can't tell if you are asleep or not. It only measures air flow/breathing and sometimes our awake/arousal breathing gets flagged when we aren't sound asleep.

That patience pill is hard to swallow though so try not to look at the overall numbers as effectiveness measurement because it isn't always totally correct. You have to mentally toss those post arousal flagged events out the window because they don't really count as part of effectiveness in terms of actual apnea events but instead point to overall sleep quality not being ideal.

Hey Pugsy,

Thank you so much for this info and pep talk! I am feeling really positive about it all and for the first time in a long time, I am looking forward to bedtime! I will get there soon I am sure

Oh one other little bit.

Sometimes you will feel like you took a stroll down the tank and have a bad night either for general sleep quality or the "numbers" and I don't want you to panic when/if you do because we all have them. Even cpap veterans like me (since 2009 I have used cpap) for any number of reasons and sometimes you might know the culprit that caused the bad night. Don't panic....it happens to all of us occasionally so don't worry unless you make a habit of it.

Don't rely on just the numbers....the main yardstick to measure is how you sleep and how you feel.