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EPR setting and purpose
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wyogirl Offline

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Post: #1
EPR setting and purpose
Hi.
I have a question on the EPR exhale setting.
The Dr. has my EPR set at 3 "so it would be comfortable".
What is the difference between the 1, 2 and 3 settings? Is 3 less pressure than 1 and 2, or more pressure?
I have been using an APAP for 1.5 years and my centrals seem to be getting worse. I read on the board that lowering my EPR might help lower my centrals. I was going to change my EPR setting and document the results, but wanted to first understand more about what the EPR does for us.
Thank you so much for help with this question.
04-08-2016 09:24 PM
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palerider Offline

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Machine: s9 vpap auto
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Location: Dallas(ish)

Post: #2
RE: EPR setting and purpose
1, 2 or 3 cm pressure reduction on exhale, respectively.
04-08-2016 09:35 PM
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surferdude2 Offline

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Other Comments: Late stage 2 emphysema

Sex: Male
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Post: #3
RE: EPR setting and purpose
The purpose of the EPR is to reduce the pressure as you exhale. The numbers represent 1 cm H2O. You'll have to experiment to see if your idea will help you since results can vary among different people.

Dude
04-08-2016 09:39 PM
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wyogirl Offline

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Post: #4
RE: EPR setting and purpose
Thank you both for the reply. It makes it clearer in my mind.
Goes along with why more CO2 left in the brain reduces CAs.
When I first got my sleep study results and saw I had both OAs and CAs, I did a lot of research. I came upon a website that claimed to be able to reduce CAs by learning how to exhale less air than you inhale - same principle. I tried to practice it, but could never get used to it awake......so impossible asleep - ha!
04-08-2016 10:14 PM
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surferdude2 Offline

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CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #5
RE: EPR setting and purpose
Incidentally, your flow generator will not go below 4 cm H2O. When you consider that your pressure has been set at 5-9 then you will actually be experiencing 4-6 when exhaling, if your EPR is set at #3.

Dude
04-08-2016 10:26 PM
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Crimson Nape Offline

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Machine: ResMed S9 Autoset
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Post: #6
RE: EPR setting and purpose
One side note. An EPR of 3 means that your exhale pressure is reduced up to 3cmH2O below your current inhale pressure. The lowest your S9 can go is 4cmH2O. I see that your pressure setting is 5-9cmH2O. This means that at a starting pressure of 5cm your exhale pressure is 1cm less (4cm) than inhale pressure. Only when you get to an inhale pressure of 7cm does your EPR setting of 3 become fully functional. So based on your setting of an EPR of 3 your exhale pressure will remain 4cm from 5cm to 7cm inhale pressure and only increase to 6cm when you get to your 9cm maximum pressure.

I've found that at my moderate pressure of 10-11 the EPR causes me more problems that it helps. It probably is more effective at the higher end of CPAP pressures. I hope I never have to speak from experience about its virtues at higher pressures.

Statistics prove that people who have more birthdays live longer.
04-08-2016 10:38 PM
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FrankNichols Offline

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Post: #7
RE: EPR setting and purpose
(04-08-2016 10:14 PM)wyogirl Wrote:  learning how to exhale less air than you inhale - same principle. ha!

I couldn't resist the image of the evil Aunt in Harry Potter inflating and floating away...

I don't quite see how you can exhale less than you inhale without serious issues shortly...

I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
04-09-2016 10:21 AM
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justMongo Offline

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Post: #8
RE: EPR setting and purpose
By weight, one should exhale more "air" than on inhales.
O2 in + a carbon added by energy generation = CO2 out.
Product weighs more that intake via the lungs.

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.
04-09-2016 10:45 AM
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surferdude2 Offline

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Posts: 1,077
Joined: Jul 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #9
RE: EPR setting and purpose
Not to mention that exhaled air approaches 100% RH.

I think most comments on exhale vs. inhale are concerned with the time taken for each. For those affected with emphysema, a longer exhale time helps the lungs operate more effectively as to gas exchange. I think it is generally accepted that an exhale time that is 1.5 times as long as the inhale time is considered normal. Also a slight back pressure help the lungs exchange gasses more effectively.

You may attempt to change that ratio consciously but when you drift off to sleep, all bets are off.

Dude

ps. The idea that CPAP may be beneficial to emphysema sufferers has been studied and proven but not widely prescribed AFAIK.
(This post was last modified: 04-09-2016 11:25 AM by surferdude2.)
04-09-2016 11:18 AM
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OpalRose Offline

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Post: #10
RE: EPR setting and purpose
What is the significance of a shorter exhalation time than the inhalation time? I ask because as I'm reading this thread, I'm wondering if mine is abnormal. Dont-know

I feel fine, and lung function is normal per my Doctor, but my exhale time is always less than inhale time. Sometimes almost even, but usually less.

Does using EPR/flex settings affect this? Thinking of turning Flex setting of 2 off to see.

OpalRose
04-09-2016 12:47 PM
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