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[CPAP] Resmed EPR?
#1
My doctor is accustomed to using Philips machines (System One C Flex +) and is not familiar with Resmed Airsense 10.

However I wish to use the Resmed, it is the recent product.

The difference is between the two machines is the EPR in the Resmed machine. Philips machines does not have EPR function, or uses a different name.

If my doctor precribe pressure 10, humidity 5 for the Philips machine (System One C Flex +), what setting should I use on the Resmed Airsense 10 EPR?

Should I turn the EPR off? or set it to 1? (or 2, 3?)

or should I just use the Philips machine?

Any advice?

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#2
The EPR settings different for everyone as they can effect therapy, some people do fine with an EPR of 3 while others turn it off completely. You can get the Sleepyhead software and track your results and make adjustments as needed. When I got My A10 I set the moisture to 3 same as my PR system one 60 and thought my humidifier was broke as I wasn't using any water. I found out that the A10 has 8 settings vs 5 on the PR. I am running at 6 now and all is fine. You don't want to make changes on a daily basis make a change and give yourself a week to adjust to it. eventually you will find the perect set of settings that give your best rest and optimum therapy.
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#3
Hi hs8738, welcome to Apnea Board.

The expiratory pressure relief (EPR) on Resmed machines drops the pressure by 1, 2 or 3 points as you exhale. The Philips machines have a similar system called Flex, which comes in various varieties such as A-Flex and C-Flex. I'm not familiar with the details, but they achieve much the same thing. EPR or Flex shouldn't have too much impact on your actual therapy, as they are primarily comfort settings. However some people have found that a high EPR setting combined with a high pressure can in fact cause central apneas.

You can find some more detailed information on the various flex types in our wiki:

http://www.apneaboard.com/wiki/index.php?title=A-Flex
http://www.apneaboard.com/wiki/index.php?title=C-Flex
http://www.apneaboard.com/wiki/index.php...lief_(EPR)

By the way, Philips now has the most recent machine on the market - the Dreamstation.
DeepBreathing
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#4
Hi hs8738,
WELCOME! to the forum.!
EPR is a comfort feature, You can try it to see how well you do with it, some people like it and some don't. Hang in there for more responses to your post and much success to you with your CPAP therapy.
trish6hundred
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#5
I tend to see EPR as "bilevel junior". It offers up to 3.0 cm H2O "pressure relief" on exhale. Well, in my book, that is bilevel and presents the need to consider the exhale pressure (EPAP) that maintains the airway against obstructive events, and allows the inhale pressure (IPAP) to address hypopnea, flow limitation and RERA.

Bilevel titration is easier than you might think. A CPAP pressure of 10, means that 90 percent of the time, 10 cm is adequate to prevent obstructive apnea. Using EPR is NOT just comfort; it actually drops your EPAP pressure to 7.0 and may allow obstructive events to occur. It's okay! If you enjoy the comfort of pressure support (the difference between IPAP and EPAP in bilevel), as most of us do, just increase the CPAP pressure until obstructive events are no longer significant.

What this means is you may be able to leave CPAP pressure at 10 with EPR at 3 for comfort, but if you experience significant OA or H events, you will need to increase the CPAP pressure until those fade away. You could end up with a pressure of 13 (EPAP 10/IPAP13), or you might tolerate the prescribed pressure without events. However EPR does fundamentally change CPAP titration, and as long as you understand it, and respond appropriately, you'll be fine as well as more comfortable. EPR is limited bilevel, which is why Philips Respironics limits AFlex and CFlex that only provides 2 cm pressure relief max. There are other differences, but I think the Resmed approach can be very comfortable, and it addresses the comfort issues that make some people fail CPAP and makes them need more expensive bilevel.
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