bipap pressure relief vs epr

[Galactus]

You can practice while awake, opening and closing your mouth and moving your tongue to find out where it needs to be to make the seal on the roof of your mouth. Then when going to bed make that seal and give it a whirl. Best of luck.

[Gabby]

The main difference between "regular" exhale relief and bilevel pressure relief is the range. Bilevel PAP can go wider than 3cm while regular CPAP machines cannot.

What changed in your AHI? What kind of event increased? A little of everything? An average increase of less than 1cm is not that bad. How do you feel? That's more important.

Did you make the narrowing change and the EPR change at the same time? If so, then put the EPR back to what it was before you narrowed the range. Don't make too many changes at once or you won't know what is the culprit.

And third, 6 days isn't enough time. Make one change, give it at least 10-14 days. Longer if you can unless you are miserable. Write down what changes you made and when. Keep a sleep diary of what kind of day you had (good/bad stress level, fun/no fun, etc) before you lay down and then note how you feel when you get up.

Thank you Paula02 for some of the information you gave Readyforsleep.
I have taken it on board and I am sure it will be invaluable.
Cheers.

[readyforsleep]

Not sure what I'd do without all of your support.

[PaytonA]

I have a question for you, Ready. What prompted your 16-20 auto range. Was that your doctor's prescription or is that where you have gotten to? Sorry if this was already answered. I must have missed it

[TorontoCPAPguy]

Just to add my two cents worth... I would think that Bipap pressure relief is just the same as EPR excepting that EPR is a fixed range as on my S9 AUTO. It is 1, 2 or 3 and I could never figure out what that meant so I read the manual (last resort, right?) and it simply said it was 1, 2 or 3 cmH2O pressure reduction on sensing exhale. That simple. So BIPAP gives you a wider range or EPR and I would think that one could think of BIPAP as a "Cadillac" with associated features or simply as a blower that is capable of higher blower pressures and therefore permits a wider range of exhale pressure relief. That simple.

[PaytonA]

Actually, there is a little more to it than just a wider range of pressure support available in the VPAP vs the EPR. There are also a several other parameters on the VPAP that can adjust the timing and sensitivity of the pressure transitions as well as the rapidity with which the pressure rises from EPAP to IPAP. I believe that with the EPR these parameters are preset.

The S9 VPAPs have a feature called "easy breathe" that presets the rise time and possibly some other parameters to make the pressure transitions gentler. It is probably on the VPAPs because the pressure support can get pretty hefty. In my case the "easy breathe" really works well.

Best Regards,

PaytonA

[PhyllisBalboa]

There are also a several other parameters on the VPAP that can adjust the timing and sensitivity of the pressure transitions as well as the rapidity with which the pressure rises from EPAP to IPAP.

Can you tell me where these are? In ASV mode or ASV auto mode only? I have the clinical manual, but didn't notice this.

The S9 VPAPs have a feature called "easy breathe" that presets the rise time and possibly some other parameters to make the pressure transitions gentler.

Didn't notice where this feature was either. I'm running in ASV mode, but might switch myself to ASV auto mode if I can't get my settings right.

[readyforsleep]

I have a question for you, Ready. What prompted your 16-20 auto range. Was that your doctor's prescription or is that where you have gotten to? Sorry if this was already answered. I must have missed it

Very good question. My doctor prescribed 11-20 when I first got my APAP in March based on a 2 week trial. At the time I was using nasal pillows and probably mouth leaking. In May I got the simplus and my 95% pressure # went up to 19.6 or so. The machine spends a signifacant amount of time maxed out and my flow limitations are very active. I have been slowly raising my min setting to find a sweet spot. No matter what pressure I have good days and bad days, it always looks like it needs to go over 20 to keep my airway open. I did try a cpap pressure of 16 this summer, had 6 good days then got nervous when my ahi started going over 5, then 8. Quickly went back to apap.

That's a short version of my story. RG has been "strongly encouraging" a nasal mask since May 18th at 1Pm. I have been resisting up till now. As I mentioned my ahi averages 4.3, so maybe this is as good as it gets for me.

[Galactus]

Stop resisting, try a nasal pillow mask, it could change your whole life. You know that MIO commercial where they say "it changes everything" the P10 is like that, give it a try NOW!

[TorontoCPAPguy]

I say... whatever works! I went through a pile of various masks, pillows, nosebag, ffm, etc. and came down to the Mirage Quattro which I swear by now. The big thing as we found out this week is sizing. YOU MUST MUST MUST get that mask sized perfectly or its efficacy is blotto. I have been wearing a large mask fitted to me by a DME five+ years ago and my wife's mediums turned out to be too big for her. So I tried one on. BINGO! What a difference! I had been waking up three or four times a night by a blast of air on my face, a mask 'fart' (pardon) or air blowing onto my wife's face. With the medium, no such problem. Seems to be a virtually perfect fit even when smooshing my face into the pillow (another story for another night). So, that's my two cents worth. Take it for whatever it might be worth.

As to pressure relief, I learned something new today on here. I knew most of the difference but not the entire story. Interesting. I find that EPR set on 3 is just fine for me. After almost a month on total life support with BIPAP running blowing air in and sucking it out one learns to appreciate the privilege of doing it for oneself instead of fighting a machine. They finally had to tie my arms down as I was tearing the mask off and suffocating myself rather than fight it as strange as that might seem.