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Finally after 8 years trying to improve Usage
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zonk Offline

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Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
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CPAP Pressure: 9/13
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Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #11
RE: Finally after 8 years trying to improve Usage
(09-02-2015 04:44 PM)Caldera Wrote:  Should I try 3?
Its very hard for anyone to say what works for you, based on what worked for them
You'll need to discover and work it out for yourself .... everyone have different needs and wants

EPR can be of some help, if someone having problem exhaling against pressure or swallowing air
As, with anything else, half of population use it and swear by it, the half don't use it and swear at it

The question was about 'improving compliance' ... if EPR can improve compliance, then its a good thing to have

EPR at level 3 cmH2O ... will drop pressure at exhale by 3 cmH2O
BIPAP pressure support is quite different to CPAP EPR and to make EPR lookalike pressure support in some ways, you'll need to set CPAP pressure 3 cmH2O higher to compensate for the 3 cmH2O drop at exhale ... confusing Thinking-about
09-02-2015 07:41 PM
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Sleeprider Online
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Posts: 3,388
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #12
RE: Finally after 8 years trying to improve Usage
Without getting too complicated, the pressure relief will make exhalation easier. This may be more comfortable for you. The only way to know is to try it for several nights then decide if you feel better, and you can check the data to be sure it has not caused significantly more events. Most users like the lower pressure during exhale, but some find the pressure changes disruptive. Give it a try.

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09-02-2015 07:54 PM
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Caldera Offline

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Joined: Aug 2015

Machine: ResMed AirSense S10 Auto
Mask Type: Full face mask
Mask Make & Model: Simplus FFM
Humidifier: Built-in HumidAir
CPAP Pressure: 8 - 12
CPAP Software: SleepyHead

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Sex: Male
Location: YouTah near 7000 ft.

Post: #13
RE: Finally after 8 years trying to improve Usage
I've changed my EPR level and will give it a try for a few nights. Also I'll keep reviewing the data for any increase in events.

thanks
09-02-2015 08:00 PM
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quiescence at last Offline

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Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
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CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

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Location: US

Post: #14
RE: Finally after 8 years trying to improve Usage
so, if you were used to EPR of 0, and getting such good results, you might sneak up on it by going for setting 1 and noting the results. The higher the EPR setting the lower the pressure you exhale against. This will probably change the expiration time to be lower. That isn't bad.

You currently have about the same inspiration time as expiration time (I:E = 1.0). Notice the readings at the new setting you have selected. At EPR=3, you might get a ratio of I:E of almost 2.0, exhaling twice as fast as your inhale.

When I shifted from CPAP EPR 0 to EPR 2, my IE went from 0.9 to about 1.65. Both were satisfying, but I do think I get more rest at IE of 1.65. I haven't asked around the forum as to whether others have seen the same.

We have seen that, in some cases of clear airway (CA) events, lower I:E ratios seem to result in lower count of CA events.

Note - As others have mentioned, when you shift EPR from 0 to 3, your effective exhale pressure is 3 cmH2O lower and this can lead to more flow limitations, and obstructive events (both H and OA). When adjusting EPR to a greater value, you may be served by also adding some to your pressure setting. Example - you have a CPAP pressure of 10 cmH2O, and want to shift from EPR of 0 to EPR of 2. You will probably be served by adjusting you CPAP pressure to 12, leaving the exhale pressure about as it was originally (10). since your setting is 12 with EPR 0, you might want to see if you feel better by moving to 13.5 and having EPR set to 2. Notice I increased pressure setting by 1.5 and EPR to 2. And take a look at your IE ratios before and after.

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
09-02-2015 11:04 PM
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