Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Does the EPR have to be increased or decreased to treat hypopnea and RERA?
#1
Does the EPR have to be increased or decreased to treat hypopnea and RERA?
people with mainly hypopnea and RERA nearly always display considerable flow limitation, which is treated better with the exhale pressure relief (EPR) feature on your Resmed.

Does the EPR have to be increased or decreased to treat hypopnea and RERA

Post Reply Post Reply



Donate to Apnea Board  
#2
RE: Sleep study mostly Hypopneas?
A higher EPR seting (3) provides more pressure relief than a low setting (1). Since you are using a pressure of 11-15, you can try EPR 3 and your inhale/exhale pressure range will be 11/8 to 15/12. As you can see, these are bilevel pressure notations, and that is exactly what your Autoset is in fact, a bilevel with pressure support limited to 3-cm. Pressure support helps to boost inspiration and make expiration easier which improves ventilation volume. This in turn is a solution for flow limitation, RERA and hypopnea.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#3
RE: Sleep study mostly Hypopneas?
(10-05-2019, 10:49 AM)Sleeprider Wrote: A higher EPR seting (3) provides more pressure relief than a low setting (1).  Since you are using a pressure of 11-15, you can try EPR 3 and your inhale/exhale pressure range will be 11/8 to 15/12.  As you can see, these are bilevel pressure notations, and that is exactly what your Autoset is in fact, a bilevel with pressure support limited to 3-cm.  Pressure support helps to boost inspiration and make expiration easier which improves ventilation volume. This in turn is a solution for flow limitation, RERA and hypopnea.

How would this affect the Centrals that I get if I put my pressure support at 3?
Post Reply Post Reply
#4
RE: Sleep study mostly Hypopneas?
(10-06-2019, 09:50 AM)jerry1967 Wrote:
(10-05-2019, 10:49 AM)Sleeprider Wrote: A higher EPR seting (3) provides more pressure relief than a low setting (1).  Since you are using a pressure of 11-15, you can try EPR 3 and your inhale/exhale pressure range will be 11/8 to 15/12.  As you can see, these are bilevel pressure notations, and that is exactly what your Autoset is in fact, a bilevel with pressure support limited to 3-cm.  Pressure support helps to boost inspiration and make expiration easier which improves ventilation volume. This in turn is a solution for flow limitation, RERA and hypopnea.

How would this affect the Centrals that I get if I put my pressure support at 3?

For some people a higher EPR or Pressure Support can raise the level of Centrals. But you won't know until you try
Post Reply Post Reply



Donate to Apnea Board  
#5
RE: Sleep study mostly Hypopneas?
(10-06-2019, 09:50 AM)jerry1967 Wrote:
(10-05-2019, 10:49 AM)Sleeprider Wrote: A higher EPR seting (3) provides more pressure relief than a low setting (1).  Since you are using a pressure of 11-15, you can try EPR 3 and your inhale/exhale pressure range will be 11/8 to 15/12.  As you can see, these are bilevel pressure notations, and that is exactly what your Autoset is in fact, a bilevel with pressure support limited to 3-cm.  Pressure support helps to boost inspiration and make expiration easier which improves ventilation volume. This in turn is a solution for flow limitation, RERA and hypopnea.

How would this affect the Centrals that I get if I put my pressure support at 3?

I'm not aware of any chart ever being posted by you.  How are we supposed to know if CA events are a significant issue if you don't give us a little help? We know that your sleep test had no centrals, and this is the first mention of CA you have ever made.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#6
RE: [split] Does the EPR have to be increased or decreased to treat hypopnea and RERA?
SR, I believe his question to be generic/rhetorical.  That is, he isn't saying he HAS centrals, or suspects that he might, just wants to know the reasoning behind dropping pressure support in order to control CAs.  I could be wrong...
Serial Tapist
Post Reply Post Reply
#7
RE: Sleep study mostly Hypopneas?
(10-06-2019, 01:51 PM)Sleeprider Wrote:
(10-06-2019, 09:50 AM)jerry1967 Wrote:
(10-05-2019, 10:49 AM)Sleeprider Wrote: A higher EPR seting (3) provides more pressure relief than a low setting (1).  Since you are using a pressure of 11-15, you can try EPR 3 and your inhale/exhale pressure range will be 11/8 to 15/12.  As you can see, these are bilevel pressure notations, and that is exactly what your Autoset is in fact, a bilevel with pressure support limited to 3-cm.  Pressure support helps to boost inspiration and make expiration easier which improves ventilation volume. This in turn is a solution for flow limitation, RERA and hypopnea.

How would this affect the Centrals that I get if I put my pressure support at 3?

I'm not aware of any chart ever being posted by you.  How are we supposed to know if CA events are a significant issue if you don't give us a little help?  We know that your sleep test had no centrals, and this is the first mention of CA you have ever made.

I did have centrals in my sleep test and I still get them with Oscar. I have posted many graphs on here and was told to lower my EPR to 0 or 1 which I have and it did not make any difference. I was told I need a special machine. ASV I guess it is called. Until I get this machine should I use 1 or 3 as my EPR?
Post Reply Post Reply



Donate to Apnea Board  
#8
RE: [split] Does the EPR have to be increased or decreased to treat hypopnea and RERA?
Jerry 
which gives you the lowest overall AHI?
then which manages the centrals better?

The general rule if you had no initial centrals that they are treatment-emergent centrals.  These are usually caused by the better breathing that you are getting from your CPAP.  Higher EPR or Higher PS provides a higher degree os washing the CO2 out of your system.  It is the higher concentration of CO2 at your chemoreceptors that provides the primary drive to breathe.  In some individuals, this increased washing out of the CO2 decreases the drive to breathe causing central apneas.  One "fix" to this is to decrease the washing effect by decreasing the PS or EPR, often to zero.  That lacking you decrease the washing effect by decreasing pressure.

Do note that decreasing PS or EPR and/or decreasing pressure may increase obstructive events.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#9
RE: [split] Does the EPR have to be increased or decreased to treat hypopnea and RERA?
My first two sleep tests didn't show and central but when I had to have a new test because of switching insurance centrals showed up. Being older and on new medicine, I think affect my breathing and causes the central. 

Nothing I can do about the medicine for right now so I am trying to get the best sleep I can..
Post Reply Post Reply
#10
RE: [split] Does the EPR have to be increased or decreased to treat hypopnea and RERA?
My AHI keeps getting worst, I am up to 30 now with 8 of them central, with no Opstuctions.
Post Reply Post Reply



Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Can CO2 drive Hypopnea? Arik 4 160 02-14-2020, 10:02 AM
Last Post: SarcasticDave94
  Increased Aerophagia "air into stomach" + Short Breath in past week. whysleep 2 127 02-06-2020, 04:32 PM
Last Post: whysleep
  Increased Pressure, now waking up a ton??? Greg543 22 817 01-23-2020, 10:22 AM
Last Post: Sleeprider
  Dr Barry Krakow's theory of apnea vs hypopnea vs flow limitation? JoeyWallaby 7 366 12-22-2019, 08:15 AM
Last Post: ApneaQuestions
  OSA too mild to treat with CPAP? other sleep issues? SleepyTexasGirl 28 892 12-16-2019, 11:03 AM
Last Post: SorryIamNormal
  [CPAP] In OSCAR....What is the difference OBSTRUCTIVE AIRWAY " OA" vs HYPOPNEA "H" robertpsimpson 16 685 12-03-2019, 08:13 PM
Last Post: Dogjudge
  Installing Humidifer Increased Pressure rowlandb 2 190 11-15-2019, 01:51 AM
Last Post: 70sSanO


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.