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Thanks, Archangle.

I have more AHIs for you but as to obstructive events vs central, my centrals are more than obstructive. 11 non-supine central, and 5 non-supine obstructive, 59 central supine and 32 obstructive supine. There's more... but this told me that on my right side is where I appear to do best.

There's a 'short report' chart on the study with event statistics where it says: 'Events (Apnea + Hypopnea)' and under a 'total count' collum the number is 134 and Index is 26.4. Under another collum titled 'With Arousal' the count is 27 and index is 5.3

It further breaks down apneas vs hypopneas and the hypopnea occurences are minimal, around 10% of apneas. I'm concerned I am not making very clear sense of this, typing back to you.... but I could use some more help interpretting. I had no follow-up and had to work to get the report, plus some real questions about the study.

For example, the total sleep time was 5.1 hrs. Out of that, the total time in REM was 2 minutes! Not only that, but 61% in the pie chart is stage 1 and 38% stage 2. No stages 3 or 4. My experience was of trying to deal with all the equipment and remain as relaxed as possible and steadily breathe, there was a low level anxiety all through the night and subjectively I'd say I couldn't lose it into any kind of sleep until the very end, shortly before I was fitted with a mask, then with the mask and some titration. By then I was tapped. That part to me seemed like a few minutes but it appears to be around an hour of trying settings.

In the chart where it gives scores over titration, the AHIs go to zero by 8 cm, it gets a little more fine grained where they test settings for a few minutes. It wound up where for 26 minutes I maintained -0- AHI at 9 cm. However also I saw -0- at 8 cm.

A couple months ago when I thought I really needed to get serious with all this, I noticed that the issue of exhaling into the pressure was really stumping me. Can't imagine what this would be like for people with settings in the high teens or twenties, yikes. I would be waking up though after my unsatisfying four hours with an aching chest, as though I had been 'working--' no fun. After a few nights of this I wound up hacking into the machine and adjusting down and then building up pressure again.... I am now back up to 8 cm.

Indeed, I'm not completely trusting here that this is understood well enough, and it concerns me that with central apnea too much pressure might create dampening of repiratory effort.

Last night actually I did a little better and hope I can repeat this, I stayed asleep on my back for some time, this was a bit of a breakthrough

It is also a little strange that I am waking up with the sats still in the low to even mid 90s.

The body has an incredible capacity to compensate for conditions like this. The big issue is when the body can no long draw on any reserve to compensate, meanwhile the restorative energy of the body is used to compensate for low O2 sats at the expense of other system.

Find out the reason for the low O2 sats, treat the reason, not the symptom. Supplemental O2 can get you by while the reasons are discovered and treated, hopefully you can remove the need for supplemental O2. My wife needed O2 at night after a hospital stay. When she got her sleep apnea and some pulmonary edema issues under control, she was able to get rid of the O2, but only after a multi night SpO2 study both on and off the O2 to make sure her sats did not go below 90%

Glad things got smoothed out, Dave. And that is certainly evidence of gently helping the body do what it knows how to do better. Something like that...Well I wasn't thinking I was a candidate for 02 supplementation, being under the impression that brief dips into low to mid 90s are not cause for concern, perhaps even with non apneic people. The serious numbers I hear about as a result of breath pauses or slowing go down into 80s and even 70s.

I am learning a lot reading this board. For instance it's getting through to me that even if my sp02 is ok (I have been so obsessed with all this as to wear a finger pulse ox and review the overnight sats), it doesn't particularly matter when it comes to arousals -- arousal is arousal....I might have a bit of a hypervigilant brain, or that working together with some mild obstructive issues, or restless legs or other form of peripheral wonkiness...or these things in some configuration and some measure of neurological respiratory drive failure.

That last one, however, is still a miserable thing to just accept and not dig around to get a sanity check, see if it could be something else. Wonder if ways I kind of cope with anxiety symptoms in waking life are involved and ingrained.

For instance, stuck in traffic occasionally and with a somewhat claustrophobic sensation I'll notice my breathing is slowing w-a-y down, and it's gotten pulled out of its automatic mode in the background of things, the conscious part is in some sense thinking it is responsible for breath. I think of this as a stress response, whereas in context of a yoga class or meditation, one would practice slow steady breathing and there's underlying trust in the body's autonomic intelligence.

I wonder about the connections with ‘central’ apnea being suggested, but beyond simply ‘failure of elec message to breathe’ it’s based in stress coping habits that exist in sleep.

Anyway, thanks for letting me ramble.

Again I’m glad things are better with your wife!! All best -- Brien

It is important to be vigilant, you must be a partner in care with your doctor and health care team. My doctor told me "You know your body better than I do. I see you for 30 minutes every 6 weeks, you see your self every day." He is very receptive with me bringing in data, questions, and encouraged me to keep a daily journal on how I felt. With this he sees a bigger picture and can treat effectively. I always ask questions, it may irritate some doctors, but push for answers.

It also helps that I have known my doc since he was a "wet behind the ears intern" and I was an ER Paramedic on his first day and his first CODE BLUE.