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Two AirSense 10 Auto Qs: EPR and Min Pressure
#1
Two AirSense 10 Auto Qs: EPR and Min Pressure
I ditched my DME yesterday and purchased a AirSense 10 AutoSet on Amazon for much much cheaper. I'm still fighting with the insurance to cover it but they've been fighting me both ways, whether I have a quote from the DME or invoice from Amazon. Just piddly stuff like "REJECTED needs model number". Kind of annoying. 

Anyway, since I don't have a DME anymore I set up the machine manually yesterday, and my sleep didn't go very well. I just have two questions. First, what's a normal EPR level? And what does the level signify? If I set it to 3 is that 3cmH2O of relief when breathing out? And should I just set that to the max?

Second, there's a youtube channel called Free Cpap Advice (username LankyLefty23 or something like that) that has good machine and mask reviews, and he says he's a registered sleep tech.  In a video that 5-20cmH2O is a bad pressure, because if you really need about 9cmH2O to keep your airway open the machine will take a while to ramp up from 5-9, and you're potentially having apneas during that time. On average my pressure was 9.7cmH2O for the last 21 days of treatment. Should I be bringing my minimum pressure up to something like 7 or 8 so it wastes less time getting to that pressure? I tried that last night and distinctly remember waking up, but the pressure wasn't annoying or anything. I even fell back asleep without stopping the machine to get it to do the ramp up again. Is that higher minimum generally good advice or should most people just stick to the widest range and let the machine do all of the work?
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#2
RE: Two AirSense 10 Auto Qs: EPR and Min Pressure
You want to narrow the range but you want to do so with the knowledge of your machine is responding to your apnea.
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#3
RE: Two AirSense 10 Auto Qs: EPR and Min Pressure
(03-06-2019, 03:16 PM)brody287 Wrote: I ditched my DME yesterday and purchased a AirSense 10 AutoSet on Amazon for much much cheaper. I'm still fighting with the insurance to cover it but they've been fighting me both ways, whether I have a quote from the DME or invoice from Amazon. Just piddly stuff like "REJECTED needs model number". Kind of annoying. 

Anyway, since I don't have a DME anymore I set up the machine manually yesterday, and my sleep didn't go very well. I just have two questions. First, what's a normal EPR level? And what does the level signify? If I set it to 3 is that 3cmH2O of relief when breathing out? And should I just set that to the max?

Second, there's a youtube channel called Free Cpap Advice (username LankyLefty23 or something like that) that has good machine and mask reviews, and he says he's a registered sleep tech.  In a video that 5-20cmH2O is a bad pressure, because if you really need about 9cmH2O to keep your airway open the machine will take a while to ramp up from 5-9, and you're potentially having apneas during that time. On average my pressure was 9.7cmH2O for the last 21 days of treatment. Should I be bringing my minimum pressure up to something like 7 or 8 so it wastes less time getting to that pressure? I tried that last night and distinctly remember waking up, but the pressure wasn't annoying or anything. I even fell back asleep without stopping the machine to get it to do the ramp up again. Is that higher minimum generally good advice or should most people just stick to the widest range and let the machine do all of the work?

Brody-

Welcome aboard! It looks like you've met one of the key guys here (briefly) Fred Bonjour....  To start off, I'd recommend you click the link below which will take you to your initial thread and his recommendation.  Follow the links below his signature to find how to organize your SleepyHead charts (soon to be Oscar charts).   The heavy-hitters here are going to want to see your charts. They will give you recommendations based upon what you post. Follow the organization tips listed under Fred's signature.

http://www.apneaboard.com/forums/Thread-...-Diagnosed


The EPR is a "comfort thing" and most people have it set to 3.  It reduces the pressure on your exhalation.  On your pressure charts, you'll see two lines:  the red line is the inhalation pressure and the green line is the exhalation pressure.   Normally you'll see most people with 3 cm h20 less pressure on the exhalation; EPR set to 3.

When you get around to posting your charts, I'd recommend using the above thread.   They like to keep all your stuff all in one thread in order to have your complete history.

I hope this helps a bit to get you started.  I'm very new at this and am learning just as you are.  Best of luck and congrats on getting your new machine!

edit: ooops... I see Fred just posted a brief reply above. (very brief). I would follow my suggestions above. Then guys like Fred, SuperSleeper or Sleeprider will give you suggestions based on the charts you post. Good luck!


Welcome
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#4
RE: Two AirSense 10 Auto Qs: EPR and Min Pressure
G'day Brody. Just following up on the previous responses, which both gave very good advice.

While theoretically an auto machine can treat you with he pressure range set wide open (4 - 20) the treatment is likely to be sub-optimal for the reasons stated. It's also the case that many patients are disturbed by large changes in pressure. Hence it is a good idea to narrow the range so that you get better treatment with fewer pressure changes. Taking this to the extreme you could have one fixed pressure which some people find more comfortable. I prefer to see a range as wide as necessary and as narrow as possible. Smile

The EPR drops the pressure as you exhale. It's called a comfort setting, but some people (especially new to the therapy) really struggle to exhale against pressure (a sensation I describe as "drowning in air") so it's more than just for comfort. The EPR helps overcome that problem. However it does have a downside in that people who are susceptible to central apneas can find the number of centrals goes up when EPR is turned on.
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#5
RE: Two AirSense 10 Auto Qs: EPR and Min Pressure
Just to add what the others have said but first welcome.


EPR is exhale pressure relief which means whilst you are breathing out the Resmed will drop the pressure By the epr number so if your pressure is 9 and epr is 3 on exhale the pressure will drop to 6 to make it easier to breeth out.


However if your minimum pressure is set to 5 like yours is the epr cannot drop by 3 as the minimum pressure your machine will give is 4 so when you start your night on breathing in (ipap) the pressure is 5 on breathing out (epap) the pressure can only drop to 4 so you do not get the full benefit of EPR also at such low pressures many users feel starved of air


I would suggest you set your minimum pressure to 7 or 8 leave the max at 20 and turn off ramp. Next download Sleepyhead a link is in my signature and then post some graphs but make sure you have an SD Card in the machine when you sleep
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