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=== Clear Airway Clusters ===
At least in this image, we see CA events are highly clustered and that after the first pause in breathing that is not even flagged, you get into a kind of feedback loop of CA followed by recovery breathing (larger flow and volume than normal), and the cycle repeats, and slowly decreases becoming variable or periodic breathing before normal respiration is seen at the end. It's a very interesting sequence, that we have seen before. We think what happens is that following the first pause, you take a large recovery breath which may lower your serum CO2 (HCO3) casing minor hypocapnea which reduces respiratory drive. We can see flow diminishes then suddenly increases as HCO3 increases and spikes your respiratory drive resulting in more recovery breathing that terminates in a full CA event. This is a feedback loop that begins with a minor non-event but then amplifies through the sequence. At the end of the cluster your respiration rate increases to more breaths per minute of smaller flow and goes through several oscillations before normalizing.
This pattern can be exacerbated by pressure support or EPR which tends to increase ventilation to where the apneic threshold is reached. Reducing EPR or pressure support may help to make this feedback loop less likely to occur or eliminate it altogether. You are using fixed pressure of 13.4 with EPR at 3 which is a bilevel pressure of 13.4/10.4. There is nothing wrong with your respiration or neurology, this is just a high sensitivity to increases or decreases of CO2 which directly impacts your respiratory drive (apneic threshold). I think if you reduce EPR you can also lower the pressure by the same amount (12.4 with EPR 2). These events may appear disturbing to see until you understand them and realize they are not particularly harmful to your health or sleep. You may choose to ignore this unless it is a common occurrence or happens fairly often or for longer periods of time.
=== RERA ===
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