Need some Sage advise!

CPAP has been good for me. Initially started (10 years too late) because of complaints of snoring, morning headaches, dry mouth and tiredness. 2016 Sleep study showed 57 events an hour and very low oxygen levels. The original prescription was for a straight 8 on pressure which of course I have played with many times since then. Biggest improvements are with the snoring and morning headaches, all mostly gone! So I will present some data for your advise. 60 to 70% of my AHI is comprised of clear airway events. Wondering if I can improve that or if it even matters. 40% of the clear airway events normally happen in the arousal period in the morning. Of the non-arousal period clear airway events, 50% show some arousal activity just before (maybe tossing and turning) and 50% seem to be just normal "for me" breathing just before the event. I ask for advise as I just went through a 2 week period where I turned the EPR off to test that possibility and that did not seem to lower my percentage of clear airway events. So do I just put that out of my mind, or what do you say?? I will also include a summary graph that defines some effect of full mask type changes on leaks. Leaks have been my biggest problems to fix. Short story, for me the F30 ResMed is the clear winner for less leaks. Bear with me on the graph attachments...
Statistics Summary Detail Close Detail
Sorry it does not appear I can add more than three files to my attachment tab of this software?? Just two clear airway events. One with activity before and one normal breathing.

In the Summary tab, I deduce the following from the leak information:
<Dec10 = ResMed F20 FF silicone
Dec11-Dec17 = ResMed F30 trial
Dec18-Jan1 = ResMed F20 FF silicone
Jan2-Jan6 = ResMed F30 new
Jan7-Jan22 = ResMed F20 memory foam
Jan23 -Present and continue = ResMed F30 the clear winner for less leaks and comfort for my face!

So what would be next steps to lower clear airway, or just call it a day? Not sure how good I should feel as I age. 69 years of age. Thanks for your advise.

close few of detail - sorry for the second post!

I would just call it a day if it were my report.
You aren't having nearly enough centrals to be a worry even if every single one of them was the real deal......and clearly they aren't all real asleep centrals anyway.
It's entirely normal to have a central apnea every now and then that is the real deal anyway.

The 2 that you zoomed in on....I actually think that both are probably arousal related.
The first one because of the obvious arousal breathing before the flag and the second because of the obvious awake breathing after the flag....the breathing in between is sort of iffy in terms of actually being asleep breathing anyway...or maybe it is a transitional flagged central after the obvious arousal flagged central and you did maybe go right back to sleep.

Either way....until you start seeing 4 to 5 per hour centrals that are real asleep centrals flagged every night all night long...I wouldn't give them a second thought.

Thanks much Pugsy. I kinda guessed that would be your answer. But I see so many screen shots here that talk about AHI of 1 and trying to do better, it makes me wonder about my 2 to 3 average. I also see many screen shots with no clear airway event at all, makes me wonder some more. Any guess what it means that some people don't have any and other have many? Genes, other bad habits, or just luck of the draw? thanks again

When we go see the sleep clinic on our routine checks, they do not use the central apneas when calculating our AHI. I have very few of them, but my wife will sometimes have three or more every hour. Normally, her centrals stay around 1.5 to 2 peer hour. She has been this way ever since she started treatment.

We can usually reduce OAs and hyponeas with some pressure tweaks but most of the time we can't do much about central apneas unless maybe they are related to EPR and that is actually rather rare.

Since it is entirely normal to have sleep onset centrals....and since it is normal to wake after each REM cycle...and since we probably can have 4 to 7 REM cycles a night depending on how long we sleep....there's a chance for 4 to 7 entirely normal centrals to happen during the night. Normal, expected and nothing to worry about whatsoever.

Then there are the awake/arousal related flagged events...lets face it...most of us wake up at least a couple of times during the night that we remember and maybe more that we don't remember for whatever reason in addition to potential REM related wake up.

I rarely have an AHI less than 1.0 but for me I sleep about as well as I can expect considering the arthritis stuff that messes with my sleep.
Most of my AHI now is always arousal related...the pain wakes me up and and have to change position and I get some false positive flags in all categories sometimes.

If you are happy with your sleep quality and how you feel....don't worry about it.
Don't worry about what other people say or do or need because remember that YMMV sticker....it's bigger than life for everyone and you can't compare yourself to someone else because you have no way to compare your body to theirs.

Numbers are just a small part of all this anyway. I have had AHI 0.0 nights and felt like total dog crap the next day because I slept like crap but it was from something unrelated to sleep apnea.
And probably the very best I have ever felt when on cpap followed a night with the AHI of 10.3....go figure that one.
If I could feel like that every day...I would gladly take a report with AHI of 10 every day of the week. I felt like I slept great and I felt like super woman the next day. Numbers don't really mean all that much to me....it's how I sleep and feel that is most important to me.

nlt6mor wrote: ↑

Tue Jan 28, 2020 8:42 pm

Thanks much Pugsy. I kinda guessed that would be your answer. But I see so many screen shots here that talk about AHI of 1 and trying to do better, it makes me wonder about my 2 to 3 average. I also see many screen shots with no clear airway event at all, makes me wonder some more. Any guess what it means that some people don't have any and other have many? Genes, other bad habits, or just luck of the draw? thanks again

oh dear! i'm afraid i'm one of those that prattle on about averaging under one. but i try to talk about it in a way to encourage folks, not discourage them.

it took me almost four years to get where i am today. i too thought i was going to just be stuck at 2-3. the difference is, that i felt terrible with that average. i don't mean to say i felt ashamed or anything. i really felt badly after a night's sleep. brain fog and logy and even slight aches.

if i had felt okay at that average, i'd never gone any further. it's all down to how we each feel after a night of sleep. the numbers are nothing compared to how we sleep and how we feel when we wake up. i've had a handful of zero ahi recorded. it surprised me, because i didn't feel any different than if i'd had an ahi of 1.

it's all down to you and how you feel. you don't have to compare yourself to others when it comes to some numbers on a chart.

you be you and get a good night's rest!

nlt6mor wrote: ↑

Tue Jan 28, 2020 8:42 pm

Thanks much Pugsy. I kinda guessed that would be your answer. But I see so many screen shots here that talk about AHI of 1 and trying to do better, it makes me wonder about my 2 to 3 average. I also see many screen shots with no clear airway event at all, makes me wonder some more. Any guess what it means that some people don't have any and other have many? Genes, other bad habits, or just luck of the draw? thanks again

An Obstructive AHI of 2 means your sleep is getting disrupted at least twice an hour. so, we like to see it under that.

A few centrals are much less stressful, so I generally don't worry until the centrals are getting much over 5/hr.

Keep working on improvement, but don't stress about it, you're not doing bad, give it some time.