You are confusing criteria needed to establish a diagnosis of apnea with what the machine can actually do as far as treatment. Obviously oxygen levels aren't a factor in treatment (machine can't measure O2) but obviously they can be a factor in diagnosis.
There are simply limits when it comes to what the machines can do. We have to accept it and move on.
The idea being with effective treatment then it really doesn't matter if the criteria is looking at a difference between a 4% desat and a 3 % desat....stop them in the first place and they won't desat. That's why we look at prevention of the airway collapse being our first priority. Prevent something from happening in the first place and it can't desat can it???
Centrals....hold your breath for 15 seconds. That's essentially what a central apnea is. The airway is open but no air is moving because you aren't trying to breathe. So you held your breath for 15 seconds...did it cause you any problem or discomfort??? Of course not and if it did you got other problems with your respiratory system totally unrelated to sleep apnea. The problem with centrals happens when a person ends up having a truckload of them within a short time frame.
Doctors won't even raise an eyebrow about centrals unless someone is having a truckload every hour of every night...the diagnosis criteria for central sleep apnea is 5 per hour average of centrals happening...on a consistent basis and they have to be real asleep centrals. In a sleep lab if a person has a central apnea get flagged but they aren't asleep...doesn't count.
Sleep onset centrals are normal and they aren't going to be a problem unless someone has a truckload of them back to back and they either cause desats because of frequency or if they continually prevent someone from continuing the transition from awake to sleep.
You are NOT having a truckload of centrals while asleep. You are NOT having nearly enough centrals for a doctor to raise an eyebrow even if everyone of your centrals were indeed the real deal and you were asleep when they were flagged.
Yes...centrals are treated differently WHEN THEY ARE A BIG PROBLEM but the only real problem you have (at this point) is the extra worry and stress in your mind they are causing. That worry and stress is NOT helping your problems with your overall sleep quality at all. Could very well be feeding that sleep maintenance insomnia monster that you have.
You aren't feeling well rested...doesn't surprise me one bit because you still aren't even sleeping decently. Until you have better sleep quality you aren't really going to stand much of a chance of feeling more rested.
Now what is it that is causing the poor sleep quality and the fragmented sleep??? Million dollar question and it very likely has multiple components involved. Most likely a combination of small things adding up to cause a big problem.
What we do with cpap therapy is try to remove one potential component of those things adding up to cause the problem.
Unfortunately cpap therapy can't fix any problem/component that isn't related to the collapse of the airway...it doesn't touch other components.
I do think it would be advisable for you to have a heart to heart chat with your doctor about your poor sleep quality and not feeling well rested because of it. Perhaps adding a sleep aid short term (OTC or RX) to help you sleep better and reduce your stress/worry issues. Trust me....been there and done that myself and fought that battle for years but in my situation I knew the cause but even then it wasn't an easy fix. It's a battle I continue to fight every night. When I don't sleep good I feel like total dog crap the next day.
Fragmented sleep will totally trash sleep quality and we are going to feel it the next day....no matter how good our cpap therapy numbers might be or how effective the OSA is being treated when the fragmented sleep isn't from OSA.
There's a good article about how important good sleep quality is here.
https://www.sleepfoundation.org/nutriti ... -and-sleep
While this article is talking mainly about alcohol and sleep....just substitute the word "anything" for alcohol.
Anything that disturbs our sleep messes with the sleep stages and we end up not getting the progression into each sleep stage and the amount in each sleep stage that we need for the restorative powers of sleep to work their magic.
Google sleep maintenance insomnia and look at the long list of potential culprits...it's extremely long. OSA is but one item on that very long list and unfortunately it is the only item that cpap therapy can actually help fix on that very long list.
Your excessive worry about central apneas at this point (which you really can't do much about at this point and there is no urgent need to do anything about them anyway) isn't doing you any favors. I think that the bulk of your central apneas are a symptom of the poor sleep and not the cause of the poor sleep.
If you don't have a follow up appointment scheduled with your sleep doctor...make one so you can discuss your concerns.
Finally...do you take any medications of any kind? Even OTC? If so, what?
One of the main culprits for poor sleep or feeling poorly during the day is medication side effects. Any chance you are taking meds that could be a factor??
Mask leaking...definitely will mess with sleep quality when it wakes you up....that part you do have some limited control over. It's one of those items on the list where we say "anything that disturbs our sleep is unwanted".
At least you know of one likely culprit in your poor sleep quality....not fixing it may not be so easy.
but last couple nights I do not remember dreaming.