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Couple of Questions - Resmed S10
First, I'd like to sincerely thank the board for my early education.
Because of you..
I was knowledgable enough to ask for the machine & mask I researched and wanted.
Was lucky enough to get an auto machine even though I am currently fixed pressure.
Was wise enough to ask for EPR to be turned on, the RT looked surprised said they don't normally turn that on and it wasn't on my script, but she would have to take machine in back and "make that change", and would make an exception, just for me, since I asked. Lol.
I had the guts to argue for and get a copy of my prescription when the DME lady at the doctors office said we don't normally give them to patients. I mumbled about it being a patient right and Hippa laws and got it right away.

My question is this...
Can someone explain the EPR levels on the Resmed S10 auto?
Currently set at level 2, is level 1 higher pressure or lower?
Are the EPR levels fixed or calculated pressures?

I am a week in, and I am having terrible sealing problems on my mask, and 99.9% sure I am doing everything right. I think my pressure is just too high (12). Have watched almost every video there is on youtube about the mirage quattro twice. My mask feels like it's trying to blow off my face. I have EPR set on full time, During ramp up no problems, but after an hour and a half in, my mask wakes me with so much pressure and farting noises, it's like I can't keep up. Tonight I'm going to move it to auto and set the min/max to 8/12.

They told me at the sleep center they start you at 5 and just increase the pressure until all your apneas go away. Which is how they got to 12.

My events per hour AHI have gone from 37 to 3, but only logging 4-5 hrs a night, so I figure I can give up a point or two of pressure in exchange for a good nights sleep right? Currently restarting machine to restart ramp in order to go back to sleep.

Thanks in advance,
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Why that mask?

Have you tried any others?

Have you tried any nasal pillows?

Are you a mouth breather when you sleep?

I really like the Pilairo nasal pillow mask. It is very comfortable and
comes with 2 different headstraps.

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Yup, I am a mouth breather.
Haven't tried any otherS.

Sleep center had me try that one the night of my study.
Since you only get one every 6 months, figured I should go with that one first.

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G'day Legcramp, welcome to Apnea Board. Well done on getting the DME under control from the outset!

Here's an (old) link to Resmed's own description of EPR: http://resmedfoundation.org.au/us/assets...c=patients

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Thanks so much!!!

That helps a lot!!!!
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Hi Legcramp,
WELCOME! to the forum.!
Don't be shy about asking to try different masks if the one you are using now doesn't work for you. Some people have to try many different ones 'til they find what works.
You could set your pressure within a range, for example, 8 to 13 CMH2o, and see how you do with that but hang in there, others will have suggestions for you.
Much success to you with your CPAP therapy.
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(03-15-2015, 12:53 AM)Legcramp Wrote: My question is this...
Can someone explain the EPR levels on the Resmed S10 auto?
Currently set at level 2, is level 1 higher pressure or lower?
Are the EPR levels fixed or calculated pressures?

On the Resmed machines the EPR levels correspond to:

  1. = one CM H2O reduction in pressure on exhale
  2. = two CM H2O reduction in pressure on exhale
  3. = three CM H2O reduction in pressure on exhale

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Since you are having problems with the mask sealing, and that is severely disrupting your sleep, I encourage you to talk to the DME about trying some alternative masks. Many new users suffer through this problem, unaware that mask exchanges are free and expected in the first month. If you have not succeeded with the Quattro, then try the Fisher & Paykel Simplus or another mask. Solving the leaks can resolve the AHI and fatigue. It is much more important that you get a good mask fit, than mess with the machine settings. Different masks and sizes will perform differently...try them.

Your AHI is less than 5 and in an acceptable range. Now the challenge is to get comfortable so you can tolerate, even enjoy, a full night of therapy.
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Sites like Supplier #1 will charge a small fee as a mask fit return insurance... So if you buy a mask and don't like it you can get your money back minus return shipping...
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Legcramp, be patient with yourself and getting used to therapy. It can take awhile to find your personal Goldilocks zone.
I don't bother with ramp, and my EPR is set to 3. Here is what I would do. I am not an RT, disclaimer, etc.:

Push the home and knob buttons simultaneously for 3-5 seconds to enter the clinic menu. Turn off auto and put the lower pressure at about say 5 or 6 or 7. Run the mask test function. Get in bed with a book and put your mask on. Read and forget the mask. Relax. If you feel panicky or air hungry, turn up the minimum pressure. When you feel relaxed, and your air is coming in without bothering you, this is a good minimum start point. I'd say 15 minutes being able to forget the mask is a good indicator the pressure is good.

If they put your top pressure at 12, go with that. Later you can check if you might want to bump it up a notch. The sleepyhead data will let you decide that.

Now turn off the mask fit function, set the minimum to your new number, exit the clinical menu, and run the machine normally, while reading. Confirm you feel fine at this setting, and then turn out your light and go to sleep.

You want to feel relaxed and not like you are in a battle with this mask/machine hydra. The mask itself can take getting used to as you adjust straps a millimeter here or there. Give yourself a week and look at the data. Others here are very good at walking through the data info. Just keep at it and take your time.

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