Ezil71,
I've now had a chance to look at the images you posted.
Just to make it easer:
https://1drv.ms/i/s!AgFs7hWqVGNflXjLoRToJ6Eh4bRo is from 0:48 to 1:10, which is when you woke up, turned the machine off, and went to the bathroom. Based on the timing (roughly 90 minutes after you turned the machine on and went to sleep) together with the variability in breathing, I think you probably were in REM sleep prior to this wake. My guess is the CAs at 1:02 and 1:04 along with the H at 1:04 are sleep transition events that occurred as you were in the process of waking up.
https://1drv.ms/i/s!AgFs7hWqVGNflXV_U9LwkULUhwS8 is from 1:14 to 1:26, which is just after you went back to bed after the bathroom break. The breathing in this snippet settles down into a pattern by 1:17, but it's not the usual "sleep breathing" pattern we usually see when someone is sound asleep: The exhales seem very sharp and there's a certain periodicity that is no where near pronounced enough to be called "periodic breathing". Could you zoom in again on the breathing here giving me a shot that shows the same set of graphs, but only from 1:20 to 1:25?
I'll also note, that if this were
my data I'd be thinking that I fell asleep really briefly right around 1:15 and then woke right back up and started tossing and turning. I'm basing that on what my normal sleep breathing looks like when I'm sleeping soundly. More on that later.
https://1drv.ms/i/s!AgFs7hWqVGNflXZuKB1I25Y5wSgs is from 2:09 to 2:20. This is just before things start to fall apart for the rest of the night. Between 2:09 and 2:15, the breathing is stable enough in terms of RR and TV, and the shapes of the inhalations and exhalations is a continuation of the shape that is established by 1:17. My guess is that you are lightly asleep here, but probably not soundly asleep. Again, I'm basing that on the usual shape of high quality sleep breathing.
Just before 2:14:45 there are a few LARGE inhalations. You can see this in both the size of the inhalations in the wave flow as well as the spike in the TV graph. My guess (and it is just an educated guess) is that this is a spontaneous arousal or a miniwake. But instead of getting back to full sleep after the arousal, it looks like you get "stuck" in trying to transition back to full sleep: You have a cluster of events
after that arousal at 2:14:45, so the arousal is not caused by the event cluster. So it is reasonable to hypothesize that the cluster is a sleep transition cluster. And the periodicity in your breathing pattern becomes distinct enough to be flagged as "periodic breathing" for a short period of time. (For what it's worth, this bit of periodic breathing is not long enough to be a huge issue and it does NOT look like classic Cheney-Stokes respiration.)
https://1drv.ms/i/s!AgFs7hWqVGNflXceFpQh0D28nRtA is from 3:06 to 3:17. This is the peak of the nastiest cluster of events during that last 90 minutes of the data on this night. My first question is whether any central apneas were scored on your diagnostic sleep test. Because all these events, including the ones labeled OAs, look like they are CAs. And the question is whether they're CAs that happened when you were awake or semi-awake and hence not technically "sleep disordered breathing" OR whether they are evidence that every time you are stuck in sleep transition because everytime you almost complete the transition to sleep, a CA happens that arouses you just enough to prevent you from getting to full sleep. In other words, the question is: Are you stuck in Stage 1 sleep unable to transition to Stage 2 sleep because of the CAs.
Stage 1 sleep is very light sleep and when you are sleeping well, you quickly progress from Stage 1 to Stage 2 sleep, which is "light" sleep, but Stage 2 is persistent light sleep and actually is restorative sleep, unlike Stage 1 sleep. In a normal sleepy hypnogram, only 5-10% of the night is spent in Stage 1 sleep whereas 45-55% of the night is spent in Stage 2 sleep.
An important question is whether any CAs were "scored" on your sleep test or not. If CAs happen when the EEG says you are "AWAKE" during a PSG, the CAs are typically NOT scored since they're not sleep disordered breathing events because sleep disordered breathing has to occur when you are actually asleep. So if there was nothing said about CAs on your diagnostic sleep test, then my guess is that if you had any breathing periods that looked like the stuff between 3:06 to 3:17 on your PSG, the EEG said you were in WAKE when they happened.
Finally I want to again comment on the shape of your inhalations from the parts of the night where it appears you were sleeping your best: As I said, the breathing pattern in the wave flow doesn't really look like high quality normal sleep breathing, even though it is very regular in terms of RR and TV. The usual shape of the inhalations in high quality sleep breathing are very round and the exhalations are a bit more V shaped, often with a small pause between the end of the exhalation and the beginning of the inhalation. In my own CPAP data, when I am in high quality Stage 2 or Stage 3 sleep, my breathing pattern looks like this:
![[Image: FZu5i1xl.png]](http://i.imgur.com/FZu5i1xl.png)
My guess is that if you zoom in on your own breathing during this night it will not be this regular looking even during the times you appear to be most soundly asleep.
I'm beginning to wonder whether the RLS may be a bigger problem than you may realize. RLS would explain why you might get stuck in Stage 1 sleep for long periods of time, and if you are getting stuck in Stage 1, that may then increase the tendency for you to have clusters of sleep transition CAs. And if you frequently have periods where the breathing is as ragged as it is on this night between 3:00 to 3:15, that might explain your on going problems with feeling unrested on waking in the morning.
If I were you, I'd consider asking the sleep doctor about whether taking something for the RLS might help you get more restful sleep.
