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EPAP pressure
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twdc33 Offline

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Posts: 14
Joined: Aug 2014

Machine: respironics remstar pro
Mask Type: Full face mask
Mask Make & Model: red med air
Humidifier: unsure
CPAP Pressure: 12.5
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #1
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
08-12-2014 09:46 PM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #2
RE: EPAP pressure
[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

Welcome
08-12-2014 10:09 PM
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PaulaO2 Offline
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Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #3
RE: EPAP pressure
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.

PaulaO2
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08-12-2014 10:25 PM
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vsheline Offline

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Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #4
RE: EPAP pressure
(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.

http://www.convertunits.com/from/mmHg/to/cmH2O

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.
(This post was last modified: 08-15-2014 10:27 AM by vsheline.)
08-13-2014 04:40 AM
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twdc33 Offline

Members

Posts: 14
Joined: Aug 2014

Machine: respironics remstar pro
Mask Type: Full face mask
Mask Make & Model: red med air
Humidifier: unsure
CPAP Pressure: 12.5
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #5
RE: EPAP pressure
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?
08-13-2014 05:12 PM
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retired_guy Offline

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Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #6
RE: EPAP pressure
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.
08-13-2014 06:15 PM
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twdc33 Offline

Members

Posts: 14
Joined: Aug 2014

Machine: respironics remstar pro
Mask Type: Full face mask
Mask Make & Model: red med air
Humidifier: unsure
CPAP Pressure: 12.5
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #7
RE: EPAP pressure
That makes sense. Thanks. I really appreciate having someone to talk to about this. The wife is easily bored with it understandably.
08-13-2014 06:29 PM
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trish6hundred Offline

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Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #8
RE: EPAP pressure
(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.

trish6hundred
08-13-2014 08:32 PM
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twdc33 Offline

Members

Posts: 14
Joined: Aug 2014

Machine: respironics remstar pro
Mask Type: Full face mask
Mask Make & Model: red med air
Humidifier: unsure
CPAP Pressure: 12.5
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #9
RE: EPAP pressure
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.
08-14-2014 09:27 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #10
RE: EPAP pressure
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.
08-14-2014 09:44 PM
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