Help with my cpap therapy

I usually sleep about 11 hours a day just to feel somewhat rested. I wake up 10 to 20 times every night , and during the day I feel kind of awful—like a zombie. I’m using the full face F20 mask and the ResMed Elite 11 (CPAP). I’ve tried different pressure settings because I still feel like I’m waking up due to obstructive apneas, even though most of my recorded events are central apneas (CA).

I’ve read about CPAP-induced central apneas, so I changed my settings to a lower pressure of 6 and turned off EPR. That helped a bit—I woke up about 20% less—but I still feel like the treatment isn’t making a significant difference.

This is day 9 of using the cpap machine, i know i need to get used to it but this feels like torture.

Link to all of my sleep data: https://sleephq.com/public/teams/share_ ... 832cd02234

Link to sleep study:
https://drive.google.com/file/d/1X22B7z ... p=drivesdk

I looked at your last couple of reports and the centrals were all post arousal.
The centrals didn't cause the arousals...they are just a symptom of the arousal or poor sleep quality.
Even if they were all the real deal fully asleep centrals....you aren't having enough of them to be a worry.
I doubt EPR made any difference.

So what "help" do you want?
Please be specific....I am not very good at answering questions that are still in your thoughts but I can't see them.

How many hours of sleep (not just laying in bed) are you averaging? I see the one night with a little over an hour...why so little?
Do you take any meds of any kind? If so, what?
Do you have any other physical or mental health issues going on?

BTW....from a quick glance of your sleep study and what I could understand due to language issues....Your OSA is about 4 times worse in REM sleep than non REM. That's quite common...I have it myself with my OSA being 5 times worse in REM.
Too bad your cpap machine only offers fixed cpap mode because you might get by with less pressure when not in REM.

With help i meant which settings i could tweak to get a better cpap experience.

I go to bed around 3 am, takes two hours to fall asleep and i wake up at 3/4pm. So in total i sleep around 10/11 hours, resmed registers anything past 1/2pm the next day.

No drugs/no mental issue, just have a sleeping issue

You mean you want to look better on paper???

Takes 2 hours or so to get to sleep???? Is this common for you or something that just started happening when you started cpap?

On paper your reports don't point to anything in need of urgent tweaking.
I think if you could sleep more soundly with less wake ups that your centrals will reduce even further.
Now fixing bad sleep.....much easier said than done. I got the T shirt to prove it.

Remember these machines can't measure sleep status. They don't know if you are asleep or awake and our awake/arousal breathing is much more irregular than asleep breathing so you get flagged events while not sound asleep.
If you aren't asleep they don't count in terms of therapy but they can point to simply crappy sleep from something other than OSA. The machines only measure breathing....not sleep status itself.

Where are you located?

Namso wrote: ↑

Sat May 24, 2025 1:05 pm

No drugs/no mental issue, just have a sleeping issue

You also got a PLM issue.

And a delayed onset REM issue.

Are you a shift worker? SWs' sleep is normally AFU.

I guess cpap doesn’t fix all that.

Worked at home, stoped working 4 months ago. Too fatigued during the day, always need random naps.

Namso wrote: ↑

Sun May 25, 2025 6:13 am

I guess cpap doesn’t fix all that.

Frankly, I find it difficult to find anything that CPAP will fix.

The graph that shows event length shows most of the hypopneas are long to very long, and while they might be technically scored as hypopneas, they're usually nothing:
Indeed, the respiratory events that cause arousals show an index of only 2.4, easily WNL.

As previously noted, the PLM arousal index is 11.8, so that's where you might get the most bang for your Euro.

However, the severe REM delay suggests that you're either on, or need, crazymeds so Rx of PLMs needs to be done with caution.

Nocibur wrote: ↑

Mon May 26, 2025 2:33 am

Frankly, I find it difficult to find anything that CPAP will fix.

AAMOF, when you are having respiratory stuff (significant snoring, block #1) you're sleeping like a rock:
And when PLMs stop, your sleep is fairly continuous (all blocks).

That said, PLMs are usually regimented, and yours are quite disorganized in re: timing and duration. One wonders if they're true PLMs or just part of an overall Train Wreck Pattern of sleep...

I think there is a lamguage barrier here, so are you saying that i’m f*ckrd?

Namso wrote: ↑

Mon May 26, 2025 7:31 am

I think there is a lamguage barrier here...

Nope!

I understand you perfectly!

You want to know where the Magic Button on the machine is that fixes Bad Sleep.

I'm (we're) trying to explain there isn't one.

Little update: still feel like shit

I’ve done some research about plmd, and i’m going to mention the high amount of arousals to my neurologist. Do you have any tips on the medications? I’ve seen that dopamine agonists and gabapentine can work for plmd, but you need to be careful. Iron and ferritine levels are both in range, but i’ve added an iron supplement just in case. Already been taking vitamin d3, b12, magnesium biglycinate and omega 3s.

Weird that the neurologist didn’t mention any treatments for my plm’s, could cpap improve this a lil bit?

Nocibur wrote: ↑

Mon May 26, 2025 2:48 am

Nocibur wrote: ↑

Mon May 26, 2025 2:33 am

Frankly, I find it difficult to find anything that CPAP will fix.

AAMOF, when you are having respiratory stuff (significant snoring, block #1) you're sleeping like a rock:

amster1.jpg

And when PLMs stop, your sleep is fairly continuous (all blocks).

That said, PLMs are usually regimented, and yours are quite disorganized in re: timing and duration. One wonders if they're true PLMs or just part of an overall Train Wreck Pattern of sleep...

Got a message back from the neurologist, need to finish using the cpap for three month before taking any medication for plms.

Namso wrote: ↑

Tue Jun 10, 2025 3:07 am

Got a message back from the neurologist, need to finish using the cpap for three month before taking any medication for plms.

OK reread this part:

Nocibur wrote: ↑

Mon May 26, 2025 2:48 am

That said, PLMs are usually regimented, and yours are quite disorganized in re: timing and duration. One wonders if they're true PLMs or just part of an overall Train Wreck Pattern of sleep...

If the people who scored the sleep study have NFI what they're doing, they're scoring "jumping around in bed" as "PLMs". So ask your neuro guy if the scored PLMs meet AASM Criteria. Doesn't matter if he knows what that is. He just has to consider if you really have PLMs or Train Wreck Sleep.

OTOH some PLM pharmaceuticals help Train Wreck Sleep so you might end up sleeping better but thinking you fixed "PLMs".

I suppose that really doesn't make a hill o'beans difference in the long run...

Also PLMs rarely appear in REM.

Speaking of which still gotta figure out that delayed REM.

BTW how old are you?

Any reason you're seeing a neurologist for your OSA (instead of a run of the mill respirologist)?

At this clinic i go to, it’s normal to get both the neurologist and the respirologist. The respirologist goes over my cpap therapy. He said that the cpap is showing an ahi under 5, so i’m doing well. Told the neurologist about having bad sleep even with the cpap, she told me i need to get used to it. Should atleast use it for three months, to see if i get improved sleep. This friday i have the exact same sleep study but then usin it with the cpap. I expect to see alot of plms again and not apneas (not sure ofc). After this sleep study, i got another appointment with the neurologist and will ask about the aasm criteria. Anything more i can ask?

Oh 26 years old btw, and didn’t hear the delayed rem sleep mentioned. I was just told that i have mild osa, and the extreme side effects i’m getting could be coming from the osa.