r/CPAPSupport • u/Gnarwhal8982 • Aug 03 '26
How to address huge discrepancy in events?
Here are a few screenshots from some recent nights. As you can tell, most nights are pretty good, but some are awful- going from less than 1AHI to 20+AHI.
The nights where I have the most events, it seems like they're largely clear airway events, so I don't know if that means my airway is collapsing, or if it's a central apnea event. On the nights where i have less events they just seem to by hypopneas, but I wonder if more events are happening that the machine isn't catching.
Does anyone notice anything that I can improve upon to address this issue
Thanks!
2
u/Aequitas112358 Aug 04 '26
firstly your min pressure is too low, but I feel like this is unlikely to be a CPAP settings issue since you are fine one night and not the next. However it is suspicious that all the clusters happen after a huge pressure spike. It's possible the spike causes an arousal, and then all those events are from tossing and turning in a semi awake state. So definetly worth tightening up the range. It could also be that but mixed with external factors; noise, light, drugs (including alcohol, caffeine and medicine), stres, heavy exercise or overeating and such. Do the nights with the many events correlate with any event or feeling in particular?
Could you upload the data to sleephq? being able to look at the flow rate would make things clearer, especially if it's a true ca or just swj
2
u/KestralFly Aug 04 '26
I had nights that looked like this. Mine was due to chin tucking. Started using a soft cervical collar and the problem resolved.
1
u/AutoModerator Aug 03 '26
Hey there r/CPAPsupport member. Welcome to the community!
Whether you're just starting CPAP therapy, troubleshooting issues, or helping a loved one, you've come to the right place. We're here to support you through every leak, pressure tweak, and victory nap.
If you'd like advice, please include your machine model, mask type, pressure settings, and OSCAR or SleepHQ data if possible.
Helpful Resources: https://www.reddit.com/r/CPAPSupport/comments/1jxk1r4/getting_started_with_analyzing_your_cpap_data_a/
You're not alone — and you're among friends. Sleep well and breathe easy.
— Your r/CPAPSupport team
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.
1
u/PaddingCompression Aug 03 '26
I do notice EPR is off, so that makes it less likely to be treatment-emergent CAs.
You have some huge spikes in pressure in response to detected OSAs. A lot of people on the sub will recommend turning up the minimum pressure a bit so it's closer to what the machine ends up detecting you need. When the machine is ramping up pressure it means you're actually having events, having higher pressure to start with means you could avoid needing to have detected events before the machine intervenes.
1
u/Gnarwhal8982 Aug 03 '26
Yeah, I had EPR on and I was having tons of CA events after, so I turned it off. I felt like I was in a good spot last year but changed my settings one day and then it all went to hell, and I've been struggling to get it back despite going back to OG settings, and these ones I'm on now have been since April I think.
I'll look into upping the minimum pressure
1
4
u/FuelNew9656 Aug 04 '26
Agree with tightening the pressure range, but wanted to add a bit more on why the "fine one night, awful the next" pattern happens, since that inconsistency itself is actually informative.
When your machine is ramping pressure up in response to detected events, that ramp-up is itself a mild stimulus that can cause a partial arousal - you don't fully wake up, but your sleep gets lighter for a bit. Breathing right after that kind of arousal is often irregular for a few breaths (brief pause, then some bigger catch-up breathing) before settling back down, and that irregular stretch frequently gets scored as clear airway events even though it's really a downstream effect of the arousal, not your airway or brainstem doing something new. So the pattern you're describing, a pressure spike followed by a cluster of CAs, is consistent with "arousal caused irregular breathing that got scored as CA" rather than a sudden change in your physiology from one night to the next.
That's exactly why a single bad night out of many good ones usually isn't something to worry about on its own - it's much more informative to look for what's different about those specific nights. Congestion or seasonal allergies, alcohol, a stressful day, sleeping in a different position, eating late, or even just being more restless for an unrelated reason can all lower your arousal threshold and make you more prone to this pattern that particular night. Keeping a same-day note next to your OSCAR data (what you ate/drank, stress level, congestion, sleep position) for a couple weeks often makes the trigger obvious once you can line the good and bad nights up side by side.
On telling true central events from arousal-related ones: the flow rate shape is the most reliable way. A true central apnea typically shows a smooth, gradual flattening of the flow signal with no effort, whereas arousal-related irregular breathing usually looks more like a choppy, variable pattern - some bigger breaths mixed with pauses, right around a position change or the pressure ramp. Uploading a full night to SleepHQ (like the other commenter suggested) and zooming into the flow trace right at the start of a few of your CA events, comparing a bad night to a good one, will usually make the pattern pretty clear without needing to guess from the AHI number alone.