Can you show me confirmed examples of central sleep apnea?

I've seen several posts of people here asking if they have Central Sleep Apnea, only to be quickly told that they don't. Myself included, I sometimes think I might have had CA events, but a few people quickly let me know that I don't.

Yesterday I posted this image; very diminished breathing with a Clear Airway for about 30 seconds:

And today I had this happen again:


To me, a layperson, I'd say this is looks like "Observed episodes of not breathing or abnormal breathing patterns during sleep". But I'm no professional. Does anybody here have examples and explanations of actual Central Apnea events, and what makes them such?

You first have to learn how to distinguish awake/arousal breathing flow rate from asleep breathing flow rate.
Anything flagged when NOT asleep isn't a real sleep disordered breathing event....no matter what the flag.
Awake breathing is irregular....asleep breathing is very rhythmic and not irregular looking.
Your past examples...I don't think you were asleep.

Awake breathing example full of centrals but they don't count...I wasn't asleep.


A maybe real asleep central but not a perfect example because of the little irregular breathing immediately preceding the flagged event.


Asleep breathing circled in red....the rest of the flow rate is awake/arousal related including flagged events.

Thank you so much for your reply! The reason I'm asking is because I've been suffering from a strange condition for a month. Every time I'm dozing off to sleep, I can feel my breathing slowing down. I'm too tired to do anything about it, so I just let it take over. But 1-2 seconds after I finally fall asleep, my body jolts me awake. Sometimes it's just a return to consciousness to breathe, but every 5 attempts or so, it's a full adrenaline rush, and I have to get out of bed. I'm trying to figure out what it could be.

Do you have any examples of what normal "falling asleep breathing" should look like? Is there a noticeable change in rhythm, like do they have a pause, or is my body's slowing down abnormal? I'm trying to figure out if the problem is my breathing, or maybe neurological. Everyone says it isn't central apnea, so I'm wondering what normal "falling asleep" looks like?

From last night....I drew a red line where it looks like I fell asleep.
Asleep breathing is nice and rhythmic and regular....it's a gradual process. You can see where it starts out very irregular and then starts smoothing out but it takes a little while before the breathing is extremely regular and I finally transition to asleep.

wetwilly wrote: ↑

Wed May 03, 2023 1:00 pm

Thank you so much for your reply! The reason I'm asking is because I've been suffering from a strange condition for a month. Every time I'm dozing off to sleep, I can feel my breathing slowing down. I'm too tired to do anything about it, so I just let it take over. But 1-2 seconds after I finally fall asleep, my body jolts me awake. Sometimes it's just a return to consciousness to breathe, but every 5 attempts or so, it's a full adrenaline rush, and I have to get out of bed. I'm trying to figure out what it could be.

Do you have any examples of what normal "falling asleep breathing" should look like? Is there a noticeable change in rhythm, like do they have a pause, or is my body's slowing down abnormal? I'm trying to figure out if the problem is my breathing, or maybe neurological. Everyone says it isn't central apnea, so I'm wondering what normal "falling asleep" looks like?

Central apneas don't jolt you awake.

transitional apneas are common/normal as the body switches from awake breathing mechanisms to asleep breathing mechanisms (and vice versa).

wetwilly wrote: ↑

Wed May 03, 2023 1:00 pm

But 1-2 seconds after I finally fall asleep, my body jolts me awake.

I wonder if he is having hypnic jerks?

ChicagoGranny wrote: ↑

Wed May 03, 2023 2:33 pm

I wonder if he is having hypnic jerks?

I get those too, but only occasionally. My main problem is that my breathing gets shallower and shallower as I'm falling asleep. Once I'm finally asleep, my body wakes me up to manually take a breath.

Shoot, guys... I think my sleep-breathing's broken. After seeing Pugsy's breathing pattern, I've realized how irregular mine is.

This is me, with regular breathing before falling asleep last night:


And this is me a few minutes later, when the problem starts. You can see the breathing gets more labored, which matches what I'm experiencing.


Is this breathing pattern normal? That very low-effort breathing at 23:58:30 is the stuff that wakes me back up. It happens over and over again. I'm worried there's something wrong with whatever system breathes automatically.

It's common for awake breathing to be irregular. That's not something to worry about.

Were the charts you posted at the top of this thread zoomed in on times when you were falling asleep, maybe after having woken up during the night? It looks as though you didn't have CAs at the start of the night, when you would for sure have been falling asleep. Do you experience the jerks when you fall asleep at the beginning of the night?

I'm wondering whether the spates of CAs are one thing and the jerks a different thing. As you may know, sleep jerks often include a brief image of something that is connected with a muscular contraction: falling is a common one. You may have the impression you're jerking awake because you haven't been breathing and are gasping, but that impression may be wrong.

Meanwhile, you're having spates of CAs for sure. While it isn't clear to me in the zoomed-in views whether you're truly asleep or not, I can tell you that CAs can come in spates like this while breathing restabilizes. You breathe more deeply, maybe because of an arousal, and that washes out enough CO2 to reduce your drive to breathe. When the CO2 builds back up, you may take deeper breaths to recover from the pause. But those deeper breaths may start the whole cycle all over again. It can take a while for your breathing to settle back down again.

It'd be helpful if you'd include the left panel when you post graphs in the future. Sometimes it can offer clues.

Miss Emerita wrote: ↑

Wed May 03, 2023 3:31 pm

While it isn't clear to me in the zoomed-in views whether you're truly asleep or not,

I'm not asleep on either of them. The top view (23:40) is me relaxing in bed, waiting to fall asleep. The bottom view (23:57) is me starting to doze off, but struggling to do so. The two breathing patterns look pretty different, the bottom one looks pretty irregular with pauses in between, whereas Pugsy's just continues to be normal.

But yeah, the hypnic jerks are minor. I'm not worried about those. What worries me is waking up to the need to breathe every time I finally lose consciousness.

Thanks for that clarification. We’ll put the CAs to one side, since they occur when you’re awake. But I’m still pondering your description of the problem: “ But 1-2 seconds after I finally fall asleep, my body jolts me awake.” That sounds like a form of hypnic jerk to me.

When you jerk awake, do you have the impression you haven’t been breathing?

ChicagoGranny wrote: ↑

Wed May 03, 2023 2:33 pm

wetwilly wrote: ↑

Wed May 03, 2023 1:00 pm

But 1-2 seconds after I finally fall asleep, my body jolts me awake.

I wonder if he is having hypnic jerks?

The timing would be right.

wetwilly wrote: ↑

Wed May 03, 2023 3:16 pm

ChicagoGranny wrote: ↑

Wed May 03, 2023 2:33 pm

I wonder if he is having hypnic jerks?

I get those too, but only occasionally. My main problem is that my breathing gets shallower and shallower as I'm falling asleep. Once I'm finally asleep, my body wakes me up to manually take a breath.

Shoot, guys... I think my sleep-breathing's broken. After seeing Pugsy's breathing pattern, I've realized how irregular mine is.

This is me, with regular breathing before falling asleep last night:


And this is me a few minutes later, when the problem starts. You can see the breathing gets more labored, which matches what I'm experiencing.


Is this breathing pattern normal? That very low-effort breathing at 23:58:30 is the stuff that wakes me back up. It happens over and over again. I'm worried there's something wrong with whatever system breathes automatically.

Two things.

1) right click on the y axis, select 'lines' and turn on the zero line.

Second, double click on the y axis so that it turns on dynamic scaling, it's very hard to interpret the squished lines (not your fault).

Also, your second image shows a pressure increase, but you didn't show the rest of the charts, so we can't tell what is causing the pressure increase, I'm guessing flow limitations, which means your min pressure is too low.

Here's a little test I just did for a few minutes. Pressure felt good, and my breathing also felt kind of normal for once.


Resmed Airsense 10
Minimum pressure 9
EPR 3 full time
Max pressure 13