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Question about EPR on Resmed
#1
Hi. I searched, but didn’t recognize of this was answered;

If I stop breathing during exhalation (prior to inhaling) with the EPR turned on, I believe I read that the EPR will remain engaged until I inhale.  

Now here’s the question; Suppose I’m not inhaling for a while.  With the EPR presumably remaining engaged (due to me not inhaling) will the pressure rise at all, even if it remain three steps behind (due to it being set at 3) where it would be without EPR, or will the presssure not rise at all?
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#2
The pressure will remain at the low value until the machine detects that you have started inhaling at that point the pressure will rise.

You need to remember a CPAP device is not a ventilator so it will not force you to breath. It’s job is to provide positive pressure in your airway to keep your airway open not to ‘blow’ or force air into your lungs. Any pressure changes due to an apnoea will not occur until after you have started breathing again.

The EPR is designed to reduce the machine pressure during exhale for comfort
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#3
Thanks. Allow metinask another way.  If I have an obstruction during EPR, will the overall pressure increase or not during EPR.  So lets say I am at EPR 6 during an obstruction where I would normally be at 9 (at 6 due to engaged EPR).  During the obstruction will my EPR number raise to the point of obstruction clearance (say 10 EPR) and then jump to 13 as soon as I take a breath?
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#4
Short answer is No. But before going into more detail we need to clear up the nomenclature. EPR stands for expiration pressure relief. It's the amount by which the machine reduces pressure when it senses you exhaling. It is a fixed amount (0 - 3) regardless of whether or not you're experiencing an apnea. So if your pressure is currently at 9 (for instance) and EPR is set to 3, then when you exhale, the pressure will drop to 6. It will remain at that value until you start to inhale. So if by chance you have an obstructive apnea right then, the pressure will remain at 6 until you gasp for breath and then inhale at which time the pressure will return to 9. An auto machine will then raise pressure further to ward off the next apnea.

As jaswilliams said, an auto-CPAP is not a ventilator.It doesn't breathe for you or stimulate you to breathe, it simply provides enough pressure to prevent you having obstructive apneas (but some will always slip through).
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#5
Thank you.  Although the diaphragm may not be drawing air, I have been under the impression (perhaps mistaken) that if positive air was being pushed, that air-exchage at the alveolar level would occur.  Does it?  I ask because the answer will inform on my convern about EPR.
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#6
Once the pressure is reached there is no exchange of new oxygen until the lungs exhale and inhale a new supply. Without a new supply the oxygen levels in your lungs start to deplete rapidly. Kind of like a balloon. Once it's blown up no new air enters.
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#7
Thank you. So what I think I am understanding is that EPR can defeat the purpose of the machine during an obstruction since the pressure will not rise

And EPR will have no negative effect when I simply stop inhaling? (is that a CE?)
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#8
(05-29-2018, 07:03 AM)honeybadger79 Wrote: Thank you. So what I think I am understanding is that EPR can defeat the purpose of the machine during an obstruction since the pressure will not rise

And EPR will have no negative effect when I simply stop inhaling? (is that a CE?)


If you feel that you are having obstructions during exhaling, then do one of two things.....turn EPR off or raise your minimum pressure by .5cm at a time until obstructions clear.

If you are not breathing, that is a Clear Airway event not an Obstruction. If you are experiencing a lot of CE, turning EPR to off may help.
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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.
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