Low AHI on VAuto but repeated shrinking breaths / pauses — anyone seen this?
I’m currently using a ResMed AirCurve 11 VAuto. My AHI is usually under 2, leaks are essentially zero, and obstructive events appear well controlled.
What I’m trying to understand is something I repeatedly see when I zoom into my flow rate. My breaths progressively become smaller and smaller, sometimes reaching almost no airflow for around 10–11 seconds, and then breathing resumes with larger breaths.
I’ve seen essentially the same pattern on different PAP settings and even on my previous Luna bilevel, so changing pressure/PS hasn’t made it disappear.
I’m not assuming these are central apneas from the PAP graph alone, because the machine can’t tell me whether respiratory effort continues during the low-flow period. I have an in-lab sleep study coming up that should help sort that out.
Has anyone here had a similar pattern despite a low treated AHI? If so, did your sleep study determine whether it was obstruction/RERAs, central or unstable breathing, sleep-stage/arousal related, or something else? And did you ultimately stay on bilevel or move to another therapy such as ASV?
I can post SleepHQ zooms if that would help.