Sierra

When you switched to CPAP mode it appears your pressure settings were overridden, and you were getting a constant EPAP pressure of 5 cm. This clearly shows you need quite a bit more than 5 cm to address your apnea. But if you had set it at 13 cm or so, it potentially could have worked quite well.

When you change the mode to CPAP there should be a cmH2O icon - Pressure setting become available in the setup menu. It may default to 5 cm if you don't actually set it.

I think it is normal for body temperature to drop some at night. It helps you sleep. When we are too hot that usually results in a poor sleep. However, your drop does seem excessive. How are you measuring it? It can be hard to get an accurate reading of body temp.

I really doubt that the CPAP could be causing that much of a drop. That said I use a heated hose on my CPAP with automatic humidity control and a delivered air temperature set point of 27 C (81F). I suppose that may help prevent excessive cooling, but since I have no temperature measurements I don't know.

More or less blanket covers are the usual way to control temperature to maximum comfort. I believe 18 C (65 F) is considered to be an ideal room temperature for sleeping, so blankets are required at that temperature for most.

Joe from time to time I have had issues going to sleep. However for me it seems to be associated with my CPAP equipment. When I first started using a CPAP or try a new mask that doesn't get along with me, I can have issues. Here is one such event captured in SleepyHead which is a free software that one can use to display CPAP machine data. This was an attempted 45 minute afternoon nap to test out a mask that did not work well for me. I doubt I was asleep for much if any of the time displayed. However the machine recorded many CA or central apnea events, possibly as I went to sleep briefly and woke up again. This was using a constant pressure at machine start up.

Now here is last night's going to sleep period where I am using the Auto Ramp feature of the ResMed AirSense 10. I also am using an EPR of 3, which turns off once the ramp/hold period is over. Notice that the breathing pattern is much smoother and no apparent apenea events. However they would not be flagged, as ResMed suppresses the report during the hold/ramp period. I think the other part of this is the EPR function where the exhale pressure is 3 cm lower than the inhale pressure. This may assist breathing and avoid some of the sleep wake irregular breathing issues. Notice that at some point the breathing becomes quite regular (probably asleep), then the pressure starts to ramp up, and when it reaches set pressure the EPR stops, and the mask pressure stops cycling up and down.

If your machine is compatible with SleepyHead you may want to use it to look at your areas of difficulty and see in more detail what is going on.

How effective is the treatment for you? Are you getting low AHI numbers? I'm just wondering if you may be still having some residual apnea events.

You say you are a long time sleep apnea sufferer. Have you been diagnosed with sleep apnea, and are you using a CPAP or APAP to control it?

Something to discuss with your doctor. The process may differ based on your location, but where I am, I was given these tests by my doctor, and when I came up as high risk, he arranged an at home sleep study to quantify the apnea. I failed that too, so now I have a CPAP!

I really can't say much on the jerking while waking. About all I know is that during REM sleep the body keeps you from moving and acting out your dreams. Perhaps that is not totally working for you in the transition to waking. Or it could just be waking up during REM sleep. I believe that is basically how you remember dreams. You have to wake up during them. And that all could be caused by sleep apnea. About the only way to know for sure is to get a sleep study. Normally the process is to do a screening test first, and if that indicates a higher risk, then a sleep study is done. Here are are couple of tests you could self evaluate yourself with. See this link.

Sleep Apnea Screening

Central apnea is something that seems to never be consistent. I certainly have not figured out what makes it come and go. My thoughts are that if AHI averages under 5 then it is not too concerning. If averages get above that, then it probably needs further investigation.

If you keep monitoring your results with SleepyHead you may be able to further refine your pressure settings.

My recollection is that another contributor here, SnuzyQ, uses that mask, so perhaps will comment on any quirks it may have.

Do you have the heated ClimateLIne hose? Where is the machine located, elevation wise to your head when sleeping? The concern would be if there is any spot where water could pool in the hose... This issue is generally called rainout. See this link from ResMed.

Rainout FAQ

I recalled after my first post, that I once move my machine with the hose connected and the humidifier full of water. Water got into the hose and that was a problem until I got up and dumped it out!

Full face type masks can have a flapper valve in them, but to my knowledge nasal pillow masks do not. They just have a vent where air escapes out. What specific make and model of mask do you have?

I have a ResMed AirFit P10 nasal pillow mask and I have very occasionally heard what sounds like a clicking or popping noise when I am getting into bed with the machine already on. I don't recall having in mid sleep when I wake up. I frankly don't know what causes the sound in my case, and since it only occurs occasionally before sleep, I have not worried about it. I suppose it possibly could be some nasal congestion.

Do you have a heated hose and have your machine set on auto climate control? Some, and especially those without a heated hose, can have trouble with moisture in the tubing. It may cause noise. I suppose overfilling the humidifier reservoir might do it as well.

My wife uses a F&P Brevida nasal pillow mask. She sometimes has trouble with the nasal extensions collapsing. However, that happens on exhale, and it feels like a blockage making it difficult to exhale.