I have a question regarding my father and his respiration wave form and whether Bilevel would provide any advantage to normalize his breathing waveform. His monthly average AHI figures are around 3 AHI and with pressure setings of 13-17 has nights with AHI's below 1. There are times where the machine sits on maximum pressure and there are no apneas but there are flow limitations. Increasing max pressure further just seems to result in a worsening of performance figures.
He has clear inhalation phase and exhalation phase, but when breating in the daytime normally, during the inhalation phase its almost like he inhales in small steps. He has scoliosis and I believe that due to his small chest cavity and smaller lung capacity it causes a bit of physical limitation and weak muscles dont help to control his inspiration well. When using his CPAP machine, this is much less pronounced but still present a little bit which I believe is reflected in his OSCAR Data. You can see the uneven respiratory waveform and on the odd occasion during the inspiration phase, the breath goes below the zero line briefly. Only on very rare occasions does he have something that looks like a normal waveform.
I enabled EPR to see if that made a difference but when activated it makes his performance figures worse.EPR doesnt seem to help nor does it improve the respiratory wave form. I'm wondering if the reason for that is that machine registers some of the inspirations that go below the zero line as exhalations and therefore drops pressure for a very short moment within each breath in. Would these drops below the zero line be registered as expirations?
I read some other posts on here about Bilevel which suggest it is just a stronger form of EPR, however on other posts I see there are ways to adjust the duration and sensitivity settings relating to inhalation and exhalation on Bilevel machines.
My question is, with a bilevel machine is it possible to adjust the settings/sensitivity so it does not consider these "fake exhalations" and keeps a steady pressure going during the inspiration phase?
If suitable I would also like to find a UK bilevel supplier as I can see from reading posts on here, its not so easy to do.
Apologies in advance if any of my terminology is wrong as I am new to the board. Thanks.
Full night view

Respiration waves dropping below zero line

Most common respiration waves for a nights sleep

brief periods with some more normal looking respiration waves

another period with slightly more normal looking waves

Respiration waves examples

flow limitation and more erratic pattern

Flow limitation and typical breathing wave

a few normal waves
