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S9 Elite EPR Settings
#1
Question 
I checked and didn't see any treads on this, so here goes.
I am trying to better understand the EPR settings and their values.
Please remember that I have NOT had any training on how to use my machine and interpret its data! No one has taken the time to instruct me, until I found this forum which has been a tremendous help !I've been a hosehead for 12 months and slowly sorting things out.
I have my EPR settings at "Full Time" and a setting at "3".
Is this the norm or is there a way to figure what's best for you?
Any suggestions and help would be appreciated.
Thanks.
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#2
Bompa, the EPR roughly (or exactly, I can't remember) translates to Exhalation Pressure Relief. In practice, that means your machine attempts to synchronize a reduction in pressure (in your case, 3 cmH2O) to each time you exhale, making it easier to breath against the PAP pressure. It then returns the reduced pressure to your currently used pressure, or to the constant CPAP pressure, whichever is applicable, at the beginning of your next inhalation. Or so the theory goes.

EPR1 means 1 cmH2O of pressure reduction, EPR2 means 2 cmH2O, etc. In my experience, mine was initially set at the EPR3, and I woke frequently during the night with a feeling I couldn't get enough air to breath. I changed my EPR to 1 after a few nights, and immediately those awakenings disappeared. Apparently my machine and I did not "sync". ResScan indicates I have short inhalations and LONG exhilations. Perhaps that was the reason, I don't know, but the change made a big difference for me. Probably I should simply turn it off, but I haven't done so yet.

EPR is simply for your comfort. It can be either "on", at a given setting (1,2 or 3), or "off", as you find most comfortable. It provides no theraputic benefit, of which I am aware, other than it may make compliance better if it is helpful to you. You are free to try it any way you please and see which is best for you.

You didn't say whether you had a sleep study, but if you did, the original setting probably is because that is what the sleep tech felt was most comfortable for you.

Good luck, and best wishes on taking control of your therapy!
Breathing keeps you alive. And PAP helps keep you breathing!
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#3
As JumpStart stated EPR is a comfort feature some swear by it and some don,t use it.

Expiratory Pressure Relief (EPR)
http://www.apneaboard.com/wiki/index.php?title=EPR
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#4
By using the EPR settings could the pressure decrease maybe help cause leaks? Just a thought.
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#5
(03-15-2012, 11:44 AM)Bompa Wrote: By using the EPR settings could the pressure decrease maybe help cause leaks? Just a thought.

anything can cause and not cause anything. if the pressure going down and up from comfort settings could cause leaks, then using an automatic machine in general could cause leaks because it usually goes up and down to higher and lower numbers than the comfort settings. if your leaks are very constant every night, i guess you could test it off and on to see if the leaks go up and down. if your leaks are not very constant every night there would be no way of testing it. personally i don't see it affecting leaks and if it does i'll still keep using it.
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#6
(03-15-2012, 11:44 AM)Bompa Wrote: By using the EPR settings could the pressure decrease maybe help cause leaks? Just a thought.

Are you having leaks? Have you reviewed them on ResScan to see when they occur, e.g., only at bedtime or immediately prior to awakening? Are the leaks large (over 24 L/min, which is shown as a red line on the Leaks graph in ResScan)? Have you tried more than one mask? Do you have the sleep doc who originally prescribed the machine, or another one, available for another consultation? How about the entity who sold you your machine - can they provide any help? All this information would be helpful in finding a solution to whatever problem you are having.

Breathing keeps you alive. And PAP helps keep you breathing!
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#7
(03-15-2012, 12:59 PM)JumpStart Wrote:
(03-15-2012, 11:44 AM)Bompa Wrote: By using the EPR settings could the pressure decrease maybe help cause leaks? Just a thought.

Are you having leaks? Have you reviewed them on ResScan to see when they occur, e.g., only at bedtime or immediately prior to awakening? Are the leaks large (over 24 L/min, which is shown as a red line on the Leaks graph in ResScan)? Have you tried more than one mask? Do you have the sleep doc who originally prescribed the machine, or another one, available for another consultation? How about the entity who sold you your machine - can they provide any help? All this information would be helpful in finding a solution to whatever problem you are having.
I have tried to find out how to attach an image so I could show you the results but can't find out how.
Anyway my Leaks occur throughout the night and somestimes go as high as 35 or higher. I have tried several masks and as I said before no one has offered to help explain to me what the readings mean and how to interpret them. Without your help here I would still be in the dark.
I'll just have to keep experimenting.


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#8
Bomba, when you first open ResScan, after selecting the patient and downloading any data, and selecting a day to review, you will normally see the data under the Statistics tab. Under Viewing Range on the top of that page (below the tabs), you can select a period of days. Pick any recent 10 or so days for which you have data, and you will see them all highlighted in the Browser on the left pane of your screen. Then look at the data highlighted in blue on the main screen, which will include Usage, AHI & AI, Leak and Pressure. What numbers does it show for AHI, and, for Pressure and Leak, the median, 95th percentile, and maximum?
Breathing keeps you alive. And PAP helps keep you breathing!
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#9
(03-15-2012, 02:08 PM)JumpStart Wrote: Bomba, when you first open ResScan, after selecting the patient and downloading any data, and selecting a day to review, you will normally see the data under the Statistics tab. Under Viewing Range on the top of that page (below the tabs), you can select a period of days. Pick any recent 10 or so days for which you have data, and you will see them all highlighted in the Browser on the left pane of your screen. Then look at the data highlighted in blue on the main screen, which will include Usage, AHI & AI, Leak and Pressure. What numbers does it show for AHI, and, for Pressure and Leak, the median, 95th percentile, and maximum?

For the period 3/4/2012 to 3/14/2012 the numbers are:
AHI - 2.7
Pressure - 12.0
Leak:
Median 0.0
95th Percentile - 27.6
Maximum 34.8
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#10
I think your numbers are fine what matters most if you,re feeling good and sleeping with the mask throughout the night.
AHI below five which is a sign the therapy is working and leak can be a bit lower probably getting Mr green smiley face which indicate therapy is working and not compromised.
May be the mask cushion need replacing and also a chinstrap help with mouth leak minimizing treatment air escaping through the mouth.
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