EPR Soft vs. Normal EPR

[Joe Bezz]

I am using a ResMed10 with EPR set to 'soft' Can anyone explain the difference between the 'soft' setting and the 'standardl' setting?

[Crimson Nape]

It controls the ramp slope from exhale to inhale pressure when using EPR. Soft brings it up smoothly, whereas standard is immediate. The closest thing I can think of for an analogy, would be turning a light on and off.

[Joe Bezz]

Thank you! Which do you prefer and what would make me chose one over the other?

[GuyScharf]

The ResMed AutoSet has a "Response" mode that can be set to "Soft" or "Standard". This mode controls how rapidly the Autoset responds to needed pressure changes -- how quickly it responds to apnea events in increasing pressure, or in reducing pressure in the absence of events. I used the Soft setting myself with an AutoSet. It made the pressure increases more gentle and less disturbing for me.

I am not aware of the Response mode having any effect on EPR. If it does, that's news to me but is certainly possible (and I would appreciate a reference).

Now, if you have a ResMed AirCurve 10 VAuto, there is a setting called Trigger that will affect how quickly the machine switches between EPAP and IPAP (known effectively as EPR and Pressure in an AutoSet). And there are other settings that can be used to control how steep the switch, etc. But none of those settings are available on the AutoSet.

[OpalRose]

I found this when googling...

AutoSet Response mode

ResMed’s AutoSet algorithm now allows for additional customisation of therapy with the new AutoSet Response mode, which offers all the benefits of the enhanced AutoSet algorithm with gentler pressure increases for additional comfort.

For patients who are sensitive to faster changes in pressure during therapy, AutoSet Response can be set to either Standard or Soft. If set to soft, patients will receive gentler pressure rises during therapy.

[G. Szabo]

Do we know the difference between Soft and Standard settings on the ResMed Autoset's algorithm behaviour when the pressure needs to be reduced? Alternatively, do we have any control over how quickly the device is trying to reduce the pressure?

There are plenty of examples showing that while the pressure needed to be increased significantly to deal with some undesirable overnight events, nevertheless, after a while, the Autoset algorithm was able to lower the pressure and maintain it for long periods without any subsequent events. Perhaps these observations are related to the position of the patient, and whence it is changed, there is no need to maintain the elevated pressure anymore.

Is there a difference in this respect between the algorithms of different manufacturers of instruments with Autoset function?

Importance:
Some non-apnea-related medical conditions demand the lowest average pressure feasible while maintaining some efficiency (for instance, AHI<5) of the CPAP treatment. Hence, a quicker decline would result in a lower average pressure during treatment.