Hi Joe,
"Sleep-onset central sleep apnea is not uncommon phenomenon, and is usually regarded as a normal sleep pattern."
https://www.e-jsm.org/journal/view.php?number=91
If you're waking up because of it, it may be that the machine's response to your apnea is the culprit. The Respironics machines send a single 2cm pulse of air lasting one second after you have had an apnea for ten seconds, in order to detect if your apnea is central or obstructive. That can be enough to wake you while you're transitioning into sleep.
The Resmed machines use a different method. They send a 1cm oscillating pulse starting a 4 seconds and continuing until the apnea stops. With Resmed, if you enable a timed ramp (not an auto ramp), the pulsing won't occur at all until the ramp time is over, which can allow you to avoid the pulsing until you get to sleep. You can disable the pulsing entirely if you have a ResMed BiLevel in Bi-level mode and turn Easy-Breathe OFF. Even in Bi-Level mode, you can set the pressure to be the same, so that the machine is essentially as CPAP.
Alternatively, you could buy a cheaper machine, like the Apex XT, which I've been told doesn't do anything to try to distinguish between central and obstructive apneas.
While I agree with your statement that taking sleep medications is generally a bad idea, both my father and a friend that I've known for twenty years have taken them every night for years. My dad takes Ambien and my friend takes an OTC (antihistamine type) medicine. While taking medications does involve risks, not getting enough sleep involves significant risks as well. I've begun experimenting with melatonin, with mixed results.
