[split] Albercook - Son's Analysis Please

[Albercook]

This is from my son's(26yrs) CPAP (I have his permission to post this here). We looked at the card and saw a huge variation in AHI from night to night. 
           

Here is a link to the high resolution versions for several nights.

Any analysts would be appreciated.

[Crimson Nape]

Albercook - I have split your post off into its own thread to prevent high jacking another member's thread. You also need to include the let side of the Daily screen. In the future please use the F12 key (Fn+F12 for a Mac) to take the screenshot.
- Red

[Albercook]

Thanks for moving it.
           
So I don't need the URL?

[Albercook]

BTW he is very sleepy today. And it seems that the CPAP has not been having the same benefit of late. It used to be so dramatic. If he got 6 hours, he was so much more awake. (He had a brain tumor which impacted his sleep so it in no surprise that the effect is so noticble.

[Albercook]

I didn't look at the scale on the leak rate. That is certainly a problem. 

Can you tell from this if he needs a chin strap? He uses a nasal mask.

[staceyburke]

The last 2 nights you had a lot of positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  

Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

[Albercook]

Thanks for the explanation. You are amazing. Last night (before we read your reply) he used a chin strap. 
   
He also probably slept is a different position. What does this chart tell you?

[Albercook]

He wore the chin strap until about 9:20 AM.  He would really like to never wear the chin strap again.  It looks like he still has a lot of events and to my eye taking the chin strap off didn't make much difference.
What suggestions do you have?

[Cymbal21]

IMO you really need to be using an ASV. Needs confirmation and requires a bit of a workup tho, and can cost $$$$ if you have to get it out of pocket.

Can you post a screenshot of the Overview page to get an idea how frequently the big AHI nights are?

Are you in a position to judge how much actual sleep he gets? Is there a lot of wake or disturbed sleep?

There's a LOT of centrals. AAMOF, they may be ALL centrals.

Might need That Other Software for a more thorough look (specifically, to see if what appears to be a "good" night is in actuality as bad as the others).

[Albercook]

Is the type of sleep that he got last night going to be restorative? Are that many apneas going to disrupt his sleep architecture? He is very sleepy today.