People with Central Apnea know that CSA having neurological roots, is an entirely different sleep disorder to Obstructive apnea (OSA) which for the most part is a physiological disorder that only involves help keeping the upper passage open. As such and the way I understand it as a long time CSA sufferer, there's really no permanent "cure" for CSA, unless of course the roots of it are effectively diagnosed and treated first...so if like me, you are not a opiate painkiller consumer and have never been a regular CPAP user (apparently long term CPAP use to treat OSA can result in CSA, according to some studies), then a permanent cure for CSA may be a long way away.
This leaves people like me with the only remaining option which is expensive "therapy" like implanting a device that automatically triggers diaphragm functions when you are sleep (well over $30K and not so many insurance companies will cover it....Click on Remede for an example), OR a less expensive therapy like using a ASV machine.
That said, the machine should help you sleep better which starts with facilitating a a good sleep in the first place.
As far as I can tell (again I am not an MD), a good respiratory rate within the normal range as well as a normal Air Tidal Volume throughout the night, should provide me with what I need to fall asleep and stay asleep , while going through all stages of it, including the most important part, the REM phase (according to data available, you should spend about 20% of your total time sleep, in REM)...
That being said, a great mask pressure that will not keep you up all night with high pressure that forces leaks out of your mask while keeping you awake with high pressures, is essential, so I have never understood my doctor who keeps prescribing "higher" pressures" when I complain about "high pressure".
I have recently started transitioning from a Dreamstation Auto SV to Resmed Aircurve 10 ASV and based on the doc's advice,, I left the Auto ASV settings to default. This kept me up all night with high mask pressure, which I don't quite understand yet, as ASV machines are supposed to ONLY deliver air at volumes and pressures that they calculate , based on your normal pre-sleep breathing pattern.
Anyway, the first night was no fun and the second night was only a slight improvement after I changed therapy settings by lowering them in half. So last night I dropped the settings as low as I possibly could (see attachment) and I ended up sleeping well, even dreaming a few (very vivid) dreams with Practically no Central events or waking up with too much pressure in my mask (ASVs do not report on central events because they keep the Resp. rate at a constant, so the patient never stops breathing, like they do off the machine).
I am putting this out here, in case there are other CSA patients who are trying to get used to their machine settings and are having a tough time with staying sleep, because I believe that an effective sleep therapy should help you sleep, not keeping you awake...and I don't buy the argument that "you must get used to your machine", because sleeping with too much air pressure in my face is like sticking my head out the window of a speeding car while trying to fall asleep.