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Do you take any medications of any kind? If so, what?

Are you sleeping soundly or waking often during the night?

Do you have any physical or mental health issues going on besides the apnea?

Are those leaks waking you?

Have you had a chat with your doctor about your continued fatigue?

Please review this thread and redo you image so that it looks like the examples.
http://www.cpaptalk.com/viewtopic/t1585 ... eview.html

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Short on time at the moment but I did a quick scan through the SleepHQ report and the majority of the centrals/CAs are arousal related and you weren't asleep when they got flagged...so they aren't real asleep centrals.
Instead they are caused by irregular arousal/awake/semi awake breathing and the centrals are a by product of the awakenings.
You aren't sleeping as soundly as you think even if you don't remember a lot of awakenings.
The poor sleep quality is the culprit causing the central flagging but we have no idea what might be causing the arousals.
The machine can't measure sleep....it only measures air flow or our breathing. Irregular arousal/awake breathing will fool the machine when it spots pauses in breathing that it thinks are centrals.

And yes...your doctor is correct in that a substantial number of people who start cpap will still experience fatigue (and/or crappy sleep) for any number of reasons.
Medication side effects is one of those reasons but it isn't the only reason. Sometimes we can't figure out a reason and to fix a problem we really need to know the cause of the problem.

More later when I have a bit more time.

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I can zoom in on the flow rate using SleepHQ and see each individual breath.
Using OSCAR you have to do the zooming in and then you have to grab a screen shot and load it into Imgur and then post the link. Obviously SleepHQ is easier for both of us.

Again short on time but asleep breathing is nice and regular with no blips, bumps or ragged stuff.

Imgur has screwed up their website "improving" it...so I can't access my normal stash of educational images.
Go here
viewtopic.php?f=1&t=187767&p=1451526#p1451526

I got other examples but I have to leave and go pick up hubby and no time to go hunting them at the moment.

Learning to figure out asleep vs awake/arousal breathing takes a bit of experience and time.

But here's one from your report Prior to 03:43:40 You were asleep...see the nice regular boring breathing?
After that you had a major arousal of some sort arousal until at least 03:52 (don't have after that time frame yet) and none of those flagged centrals are real and they don't mean much except you weren't sound asleep.
Basically anytime you see a blip or spike (even if tiny) it means you weren't sound asleep.

Gotta go....more later.

Quick example of "real asleep Centrals"....not from your report
https://imgur.com/a/qx7nPFs


https://imgur.com/jc0SJ2G

Frigging imgur.......I don't have time to fix it right now.

Scroll down a little bit for the image on the links above.

Thank you!

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elikrohner wrote: ↑

Tue Jul 08, 2025 3:22 pm

Can you see if I am still experiencing a lot of arousals?

Sorry......for some reason your flow rate (breathing) isn't showing up and I need to see individual breaths to try to spot asleep breathing vs arousal/awake breathing. Probably are though. I don't know why they aren't showing up but it isn't there.
Impossible for me to even hazard a guess without being able to zoom in on the breaths.

elikrohner wrote: ↑

Tue Jul 08, 2025 3:22 pm

What else can be causing arousals?

The list is a mile long and sleep apnea events of some sort are only a very small part of that list.

elikrohner wrote: ↑

Tue Jul 08, 2025 3:22 pm

Or perhaps I have some other cause for the fatigue like minor flow limitations not being flagged by the machine?

You are wanting all your problems to be from the sleep apnea stuff and then you want the machine to fix them.
Sorry doesn't work that way.

Want to know what causes fatigue? Google "what can cause fatigue"
want to know what can cause arousals? Google "what causes arousals from sleep"

Why such a tight pressure range??? I am okay with restricted range with a good reason but your settings are WAY tight.
Minimum pressure 5.6
Maximum pressure 7.8
EPR set to 1

Hell even if your machine wanted to go killing something you sure haven't given it much ammunition.

There's flow data up until July 2. Wonder if OP is pulling card out before file is completely written.

elikrohner wrote: ↑

Tue Jul 08, 2025 3:22 pm

Can you see if I am still experiencing a lot of arousals?

Speaking of July 2, looks more to me (using The Sleep Parameter That We Made Up Because That's All We Got) that half the night isn't even something that one would call sleep.

Nocibur wrote: ↑

Tue Jul 08, 2025 4:59 pm

There's flow data up until July 2. Wonder if OP is pulling card out before file is completely written.

Yeah I wondered about that but we do have leak and pressure graphs on the 7th.....and I didn't think we would have those graphs if the SD card got yanked too soon or wasn't left in all night.

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I changed the range to be tighter because I thought the lower max range would help for pressure related arousals. My average pressure is usually: 6.4–6.6

95% pressure: 7.2–7.4