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With CPAP, none of the breathing work is done by the machine. It's all you. All the CPAP does is hold you airway open. All of the movement of air in and out of your lungs is done by your muscles, just like it normally would be, so CPAP does not cause any reduction in muscle tone. If anything, in some cases the respiratory system can improve in its efficiency. That is one of the many good things about CPAP.
That sounds like your brain is still adjusting to being able to sleep properly. When you first start treatment your brain can often try to make up for lost time by getting more of the sleep stages it has been missing out on for so long, which is called rebounding. This messes up your sleep cycles and usually results in you waking up groggy. It should pass with time. How long varies a lot from one person to the next and can be anywhere from days to months.
The one thing your doctor will be most interested in is AHI. Don't know if SleepyHead does that but it probably does. If you AHI is below 5 that is generally a good sign.
How is your humidifier set? Also, you may need to swap from an "up the nose" mask (intranasal) to an "around the nose" mask (nasal).
Exactly which mask are you using? Some are worse for slippage than others.
If it is so slow that your oxygen level is dipping significantly between breaths then it would be scored as central apnoea on your study. If your were breathing that slowly it would also be bad for you. However, your breathing when you are asleep is governed by a different mechanism than when your are awake, so the two are probably not related. If your events were obstructive then it's nothing to do with your respiratory rate.
EPR does not treat centrals. Although it operates in a similar way to low level BiPAP, the level is too low to effectively treat central apnoea. It is, however, just enough extra ventilation that, in a few cases, it causes hyperventilation which induces central apnoea. So EPR does not reduce centrals but it can cause them.
You don't need to sleep for 50 minutes to get an AHI of 50. AHI is the number of apnoeas and hypopnoeas you have throughout the whole night divided by the amount of sleep you got. If you have 50 events and 1 hour of sleep, you will have an AHI of 50. If you 50 events and half an hour of sleep you will have an AHI of 100.
If you do have another study with your appliance, would you mind letting us know of the results? It would be quite interesting.
The best mask is the one you find easiest and most comfortable to use. Try any you can get your hands on. All masks have the same size fitting for the hose and all of them do the job of sealing against your face/nostrils to achieve increased pressure in your upper airway. The only difference between them is how well they suit you. Bear in mind that you can often get masks cheaply on Ebay, or other online retailers. Do a bit of googling and get some ideas. My current favourite full face masks are the Amara View (Respironincs) and the Simplus (Fisher & Paykel). Have you every tried anything but an full face mask? If not you mat want to consider a nasal or intranasal mask. I know lots of people who were only ever offered a full face mask but turned out to be fine with a nasal.
