Review and help with spouse's cpap settings

[Motorheadrulz]

Hi folks,
I already have a separate thread for myself, but am asking for suggestions for my wife and her data. Attached are 2 sample nights. I know her biggest issue is OA and it shows by the clusters, but I wasn't expecting all the CA events. From what I see, her pressure and EPAP settings are low and could use some tweaking. She spends a bunch of time near the upper limits.
She saw a sleep dr 2 mo ago, but he dismissed making any changes since her compliance and low AHI were good. He actually said she didn't need therapy (WTF?!)

Equip: Dreamstation2 + nasal pillows; PS= Min 7.0, Max 16.0 

Any suggestions?

   

   

TY, MHR

[OpalRose]

I used a Respironics machine for 7 years, and they are pretty slow to react to apneas.
You almost have to set the minimum pressure closer to the 95% number in order for the algorithm to be where it needs to be.

The clear airways aren't that many and will probably lessen as time goes on.  Concentrate on Obstructives, and set the minimum pressure to 9.  Change the Flex setting from 3 to 2.

Question:  Did she have a sleep study and did it show centrals?  

A see some clustering of apneas, but not too bad.  She may be tucking her chin to her chest and cutting of air,  some folk experience this if sleeping with a too tall pillow or on their back.  Something to be aware of.

If your wife can tolerate it, turn the ramp feature off or set it closer to the minimum...
Maybe set to 7 for 10-15 minutes.

[Motorheadrulz]

Her study did not show very many centrals; but mainly obstructives. Her biggest problem is on exhalation.
She will change the ramp, but declined on the pressures & EPAP. She has nasal surgery next month, so she doesn't want to fudge anything for now.

TY!

[Sleeprider]

I looked at that chart and could only wish your wife was using a Resmed Autoset. With the Philips machines exhale is always the problem because Flex returns pressure before inspiration begins, which means pressure is increasing as exhale ends. Rather than follow respiration, the Philips leads, and the higher Flex at 3 is not helping. Set it to 2 and increase minimum pressure to get closer to the "zone".

[Motorheadrulz]

Will pass on the info. Thx guys!