Epr and pressure settings

[Deweym]

If epr is 3 and pressure is 9-13, would a setting of epr 2 and pressure of 8-12 produce similar results?

[yankees123]

Yes it would

[sheepless]

arithimetically yes. but I'm thinking maybe, maybe not, in terms of efficacy & comfort insofar as epr & maximums are different. while I haven't figured out any pattern to suggest how or why, I can get similar results (e.g., ahi) with a variety of settings. however, I don't think I'm alone in thinking it's best to titrate to the lowest effective pressures & that requires some trial & error.

[Deweym]

Since epr is in effect when air is expelled and the pressure setting is used when inhaling air then wouldn’t it be more accurate to average the numbers to be equal. Epr of 3 with pressure of 9-13, results in an avg of 7.5-11.5. So with an epr of 2 you would need pressure of 8.5-12.5. Does this make sense?

[Crimson Nape]

Mathematically, they would average to those numbers. However, you are not inhaling and exhaling at the same time, so averaging wouldn't be applicable to the pressure range. The exhalation pressure is used to keep the airway open. Having a greater inhale pressure aids in reducing flow limitations.

[sleepyp]

For the treatment of OAs it would as the EPAP largely determines OA treatment, and the EPAP value is the same.
For flow limits, hypopneas, RERAs etc. it depends, maybe. You'd have to trial it, not sure.

[Deweym]

The reason I started this thread was because over the last month I tested several pressure levels with each being a week at a time so as to even out daily anomalies. My best results came in at 10-12, with epr set at 2. Based on my flow limitation numbers I was told that my epr should be 3. So should my pressure be set at 10-12 or something different? Thanks for your responses.

[SarcasticDave94]

Given what you have stated: somehow it was determined your pressure, I'm supposing your high number (to me on an ASV that's IPAP max) is 10-12. You had that paired with EPR 2, and it was suggested you enter EPR 3. Action: change EPR 2 to 3 and do not edit the pressures otherwise. See what happens according to OSCAR.

[Dormeo]

Hello, Deweym. When you have related issues, it's best to keep them in one thread. For other readers, here's how the advice of EPR of 3 came up:

http://www.apneaboard.com/forums/Thread-...ure?page=2

Deweym, could you post a daily chart with the setting of EPR at 3? And could you do two things before you take the screen shot: close the calendar (little triangle to the left of today's date) and include your flow limitation graph. You can squeeze in another graph by grabbing the horizontal gray bars between graphs and pushing them up.

[Deweym]

        I apologize about the thread. I will remember in the future.

Attached are two screenshots. One several days ago with pressure at 7-12 and one last night at 10-12. Both reflect epr of 3.

Your thoughts? I'm thinking of trying 9-12 tonight which might work for me.