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S9 EPR Settings - Any Thoughts
#1
Hello,

Does anyone have suggestions (what works for them) for the best use and settings for the EPR function of the S9?

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#2
Back when I was having a struggle with aerophagia, I moved my EPR from 2 to 3 to see if it would help. I can't say conclusively that it did help because I also reduced my max pressure from 16 to 14 but the two changes plus a chinstrap solved my issue. I know of no reason not to use an EPR of 3. It seems reasonable that one would prefer breathing out against less pressure. Perhaps some more experienced user can provide reason for using 2.
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#3
It's definitely trial and error.

More EPR tends to be more comfortable, but not to everyone. Some people find it makes their AHI or other numbers better or worse.

I'd recommend starting without it unless you find it difficult to exhale against the pressure, or if you're having other problems with pressure.
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#4
(10-17-2014, 02:38 AM)Lloyd61 Wrote: Hello,

Does anyone have suggestions (what works for them) for the best use and settings for the EPR function of the S9?
EPR does not work for me, mess up with my breathing rhythm, for some its godsend
You have to figure whats works for you
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#5
At first it mattered then I didn't care. Lower EPR number probably gives me lower AHI by a few tenths.

For me it makes very little difference but mattered more when I was new to CPAP.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#6
I see on your sidebar your min pressure is set to 5. If that's so, then for you there is no difference between 1, 2 or 3 because the lowest the machine will go is 4. What you might consider is raising your minimum to be a little closer to your average pressures. I don't know what that is, but for instance if it's 10, then you might raise the minimum to 8. Then by specifying 2 on your epr, you would get an exhale of 6. Or 3, and you would get an exhale of 5.

There is an issue when the minimum and the maximum are far apart that with a higher epr you can get a strange, almost like an air-hammer response when the machine goes from exhale to inhale. You will not see that at your pressures however.
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#7
(10-17-2014, 02:38 AM)Lloyd61 Wrote: Hello,

Does anyone have suggestions (what works for them) for the best use and settings for the EPR function of the S9?

For whatever reason, I chose EPR set to 3 which turns out be be a reduction of 3 cmH2O on exhalation. Works great for me. A setting of 4 for CPAP pressure seems awfully low to me; I would almost dare to say non-therapeutic to be honest. I am set Autoset 9 - 17 cmH2O and I can see that on some nights that range is fully made use of and on others I sit at around the 9 cmH2O mark all night. Go figure. The last comment my sleep doc had for me after I presented him with all the data in graphical format? "I think I am going to push for APAP for all of my patients and urge them to educate themselves as to what the results mean". You will find clinicician's manuals galore on here. My advice is to read them all at least three times and ask questions. My AHI tends to rest less than 1.0 most of the time, especially since getting a better fit on my Mirage Quattro full face mask. Am still tired as hell but I think the cause is severe back pain due to trauma and the meds used to treat them and try to get me some sleep (sic).
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#8
When I got my S9 my sleep doc suggested I use the EPR; I tried but finally gave it up as a lost cause. After sleeping for so many years without this function on my CPAP machines, I could never adjust to it.
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#9
(10-17-2014, 11:39 AM)retired_guy Wrote: I see on your sidebar your min pressure is set to 5. If that's so, then for you there is no difference between 1, 2 or 3 because the lowest the machine will go is 4...

That is partly true. The lowest a machine will go when set to a minimum pressure of 5 is 5, even though if the min is set to 4, the machine can go as low as 4. The whole idea of setting a min pressure is so that the machine can't go below it, even if the possible setting range is 4-20. EPR does not violate the min setting.

Assuming a min pressure of 5, if your APAP dips below 8 cm, then the EPR set to 3 = 3 minus the diff between current pressure and minimum set pressure (not the lowest capability of the machine), so if your current pressure is 7, an EPR of 1 acts like 1, and EPR of 2 acts like 2, but an EPR of 3 also acts like 2, because it can't go below the minimum setting of 5.

At least according to that "new higher math" we learned in first grade.

But if your pressure rises, and mine sometimes rises to ~14-16, the EPR of 3 will bring that down, on exhalation, to 11-13 for a setting of 3.

So, below 8 for a min setting of 5, your EPR is reduced accordingly. At 6, it will act as if the EPR is 1, but only at 6. Above 8, it will react at an EPR level of 3.

I think. Huhsign
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#10
EPR at 3
pressure at 15
hose temp at 80 degrees
water temp at 5.5
Ramp 20 minutes

these are my settings and it feels natural to me, by the time pressure is at set point I am asleep. Did not notice any changes in AHI with me according to the numbers when i was searching for the best settings.
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