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EPAP pressure
I just bought a used resmed S 9 auto CPAP because I spilled water on my respironics and need to mail it off for warranty repairs. I have read some pretty complex threads on this on this forum. One comment really confused me. It said that the EPAP pressure is most important to handle apneas. Sorry but that makes no sense to me. Maybe I misunderstood. Also I am doing my best to set up the new used machine but the res med interface is much more complex. I am pretty interested to try the auto feature though. My settings on the Phillips unit are 13 mm pressure and cflex+ is set at two. (There is only one through three). Sounds like cflex is similar to EPAP? But the rest med settings for EPAP are more complex.

So, maybe more than one question here. I am going to give the new unit a try tonight. I want to Get it set up properly before I mail off the PR.
First post BTW but I have been reading this forum for a couple of years now. Thanks for all the help
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[Image: s9-autoset-models.jpg]

Which S9 Auto ... AutoSet or Esape Auto

The AutoSet can set as fixed pressure machine in CPAP mode or in AutoSet mode with two pressure settings, minimum and maximum and the machine adjust pressure within the range

Respironcis CFlex provide some pressure relief, ResMed EPR more like bilevel pressure support but does not drop pressure more than 3 cmH2o

Either set the new machine as the old machine in CPAP mode at pressure 13 or if trying the AutoSet mode, maybe 10-15 and see how things pan out. Monitor the data on the screen sleep report and you can download SleepyHead, the download link is at the top of this page


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I would set the EPR to 2 and see how that goes. The numbers correspond to the drop in pressure for exhale. So if you breathe in at 13, on 2 it will drop to 11.

If someone was discussing EPAP, it was probably in reference to a bilevel CPAP or an ASV machine. What you have doesn't really deal with that. Well, it does, but not to the degree it would make a difference.

Some feel that exhale relief increases their apnea events. Some feel it decreases them. Some feel no difference at all. Some people cannot tolerate the Respironics x-Flex method of exhale relief and some cannot tolerate Resmed's EPR. Then there is how the Icon handles it and how the other machines handle it.
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(08-12-2014, 09:46 PM)twdc33 Wrote: My settings on the Phillips unit are 13 mm pressure

Hi twdc33,

Good to hear from you.

If you mean 13 mm Hg that would equal about 17.7 cm H2O, and a good upper pressure limit would be at least 18 cm H2O.


The reason EPAP is most critical in preventing obstructive apneas is because the most most vulnerable time for an obstructive apnea to start is at the very end of exhalation and before IPAP begins, when we are finished exhaling and our airway is most relaxed, or at the very beginning of inhalation when a small amount of vacuum is created and air starts to move through our airway. If an apnea starts then the APAP machine may not transition back to IPAP until too late to help prevent the obstruction from completely blocking the airway.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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Thanks all for your help. This has been a two year journey of constant tweaking to try and get a consistent good nights sleep. Last night I seemed to sleep pretty well with the first night of the resmed. However as the day progressed I totally konked out At work. My apneas index was as little higher than usual (6) but I thought I slept OK. One thing I am not used to is the central score which was about the same as the osa score. Maybe not bad for first night on the variable unit? High end of the range was 12.5 which is about what I had the respironics on. I guess I am safe at this point to mail my PR off for repair. Have to say i liked not having the pressure on full blast all night. I think that made for as moire peaceful night even if apneas were up. Thoughts?
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CA's will often climb a little when you first do something new. Changing machines counts. But then they usually go away in a night or so.
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That makes sense. Thanks. I really appreciate having someone to talk to about this. The wife is easily bored with it understandably.
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(08-13-2014, 06:29 PM)twdc33 Wrote: That makes sense. Thanks. I really appreciate having someone to talk to about this. The wife is easily bored with it understandably.
Hi twdc33,
WELCOME! to the forum.!
Good luck to you with your new machine.
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As I tweak.... Currently I am waking up numerous times a night with the resmed. I was wondering if I raised the minimum ipap if it would help. I do not however see a way to set minimum ipap on this machine in auto mode. Did d I miss something? Now I just have it set on constant mode but I miss the lower pressures with the auto.
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You can change (via the setup) the Mode from "CPAP" to "Autoset," then specify a minimum and maximum pressure. I wouldn't go crazy go nuts with this to begin with though. Maybe set the minimum 2 points below your current CPAP setting, and the maximum to 2 points above the CPAP setting? Something like that until you get some results to work with.
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