Whether or not to use EPR and, if used, how to set (2024)

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Whether or not to use EPR and, if used, how to set

Nicholas

Whether or not to use EPR and, if used, how to set (3)



Whether or not to use EPR and, if used, how to set (4)Posts: 62
Threads: 9
Joined: Apr 2017

Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: The one that comes with my ResMed machine
CPAP Pressure: 10 - 16
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Texas

#1

05-27-2017, 09:13 PM

Whether or not to use EPR and, if used, how to set

What are the pros and cons of using EPR?

Do *you* use it? Why or why not?

If used, how does one you determine the setting - is it just trial and error based on what feels comfortable?

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Gideon

Whether or not to use EPR and, if used, how to set (9)


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Whether or not to use EPR and, if used, how to set (10)Posts: 12,827
Threads: 295
Joined: Dec 2016

Machine: ResMed Aircurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10 / Amara View
Humidifier: ResMed Aircurve 10 VAuto / Resmed Climateline
CPAP Pressure: BiPAP VAuto 11-25 PS 5
CPAP Software: OSCAR

Other Comments:

Sex: Male
Location: Michigan, United States

#2

05-27-2017, 09:36 PM

RE: Whether or not to use EPR and, if used, how to set

Typically EPR is a comfort setting, your choice. Comfort is almost always trial and error.

Note your CA score before and after setting it. We will ask for EPR to be reduced or turned off if we see signs of complex apneain your data.

If you haven't it never hurts to post your Sleepyhead charts and ask. Please keep all in a single thread and see my sig for how to.

Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter

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Crimson Nape

Whether or not to use EPR and, if used, how to set (14)


Wiki Editor
Whether or not to use EPR and, if used, how to set (15)Posts: 15,054
Threads: 188
Joined: Oct 2014

Machine: AirCurve 10 Vauto
Mask Type: Hybrid
Mask Make & Model: F&P Evora FFM
Humidifier: Not Used - Side Cover
CPAP Pressure: 5-12 PS 5
CPAP Software: OSCAR

Other Comments: OSCAR Team Member

Sex: Male
Location: Georgia - U.S.A.

#3

05-27-2017, 09:43 PM

RE: Whether or not to use EPR and, if used, how to set

The EPR is listed as comfort feature however I found that using it has reduced the frequency and magnitude of my Flow Limit. Using EPR has the possibility of increasing your CA's due to CO2 washout. Another potential problem is the EPR will lower your back pressure on exhale to the extent that your airway closes. Again, this doesn't affect everyone. The Resmed can not go below 4cm, Setting the EPR to 3 will only come into full reduction when your pressure reaches 7cm. Using the EPR 3 setting at 7cm and below will only allow your exhale pressure to be 4cm.

I'm unaware of any guideline as to the initial setting. Basically, try a setting number and if you have problems, reduce the value.

I hope this may help.

Crimson Nape
Apnea Board Moderator
Project Manager for OSCAR - Open Source CPAP Analysis Reporter
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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srlevine1

Whether or not to use EPR and, if used, how to set (19)



Whether or not to use EPR and, if used, how to set (20)Posts: 1,505
Threads: 136
Joined: Sep 2015

Machine: ResMed Airsense Autoset (S10)
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage Activa LT
Humidifier: Internal to S10
CPAP Pressure: 12-15.6 EPR=3
CPAP Software: ResScanOSCAROther Software

Other Comments: ResMed Oximeter Package with Nonin XPOD 3012LP

Sex: Male
Location: Westlake Village, California USA

#4

05-27-2017, 09:46 PM (This post was last modified: 05-27-2017, 09:48 PM by srlevine1. Edit Reason: clarification)

RE: Whether or not to use EPR and, if used, how to set

I have significantly less events (mostly hypopneas) using EPR = 3. This appears to give me the best results for my case. It appears to have reduced my leak rate ... and I found sleeping on my side produced a lower score than sleeping on my back.

With EPR off, I see my AHI average around 4.2
With EPR at 3, I see my AHI range from 0.3 to 1.2 and average 0.8.
For me it was trial and error to check the results using 2-week periods. Then I went backwards from 3 to off to confirm the results.

"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius

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cands

Whether or not to use EPR and, if used, how to set (25)



Whether or not to use EPR and, if used, how to set (26)Posts: 63
Threads: 1
Joined: Jul 2016

Machine: Resmed Airsense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: Philips Amara View
Humidifier: Inbuilt
CPAP Pressure: 12.4 - 17.2
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Australia

#5

05-28-2017, 01:28 AM

RE: Whether or not to use EPR and, if used, how to set

I stuck with EPR of 1 for many weeks when I started therapy. My AHI averaged out at .48

I then tried EPR of 2. The difference was incredible. I was a lot more comfortable, my central component of the AHI didn't increase and my average AHI went down to .32 over the next 140 day.

Then I thought: 'why not try EPR of 3?' Although it seemed breathing was easier, my sleep was not as restful and I gave it up and went back to 2 after three nights.

Trial and error, find your 'sweet spot'. Worked for me!

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Timur

Whether or not to use EPR and, if used, how to set (30)



Whether or not to use EPR and, if used, how to set (31)Posts: 97
Threads: 2
Joined: Jan 2016

Machine: Airsense 10 Elite CPAP
Mask Type: Nasal mask
Mask Make & Model: Dreamwear Nasal Cushion Mask
Humidifier: Yes
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Canada

#6

05-28-2017, 06:19 AM

RE: Whether or not to use EPR and, if used, how to set

(05-27-2017, 09:43 PM)CrimsonNape Wrote: The EPR is listed as comfort feature however I found that using it has reduced the frequency and magnitude of my Flow Limit.

Same here, my flow limitations are significantly reduced when I use a higher EPR setting, and this makes breathing much easier for me. Does anyone know why using higherEPR reduces flow limitations for some of us?

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Sleeprider

Whether or not to use EPR and, if used, how to set (35)


Wiki Editor
Whether or not to use EPR and, if used, how to set (36)Posts: 28,380
Threads: 88
Joined: Dec 2014

Machine: Resmed Aircurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10 and P30i
Humidifier: Resmed Climateline
CPAP Pressure: Vauto 9.6-18, PS 4.4
CPAP Software: ResScanOSCAR

Other Comments: गुरु

Sex: Male
Location: Murrysville

#7

05-28-2017, 09:00 AM

RE: Whether or not to use EPR and, if used, how to set

Nicholas, it seems different people react differently to EPR. Some find it comfortable and that it helps hypopnea, others may find it causes CA events. What is important to realize, is that it reduces EPAP pressure by 1-3 cm. You previously used CPAP pressure at 9.0 with no EPR. It is possible that with EPR at 3, resulting in a pressure of 9/6 (IPAP/EPAP), you may have more obstructive event. The solution to obstructive event increases is to increase minimum pressure. If you find EPR gives you clear airway events, you may need to back off on EPR to a lower setting until you can adapt to the pressure changes.

The best way to approach it is to just try it, and see what works for you. It may not have an effect on your results, or it may have significant effect.

Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Optimizing Therapy
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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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Nicholas

Whether or not to use EPR and, if used, how to set (41)



Whether or not to use EPR and, if used, how to set (42)Posts: 62
Threads: 9
Joined: Apr 2017

Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: The one that comes with my ResMed machine
CPAP Pressure: 10 - 16
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Texas

#8

05-28-2017, 09:45 AM

RE: Whether or not to use EPR and, if used, how to set

So, from what I gather from the responses so far, it seems EPR not only affects comfort but can also potentially affect results for some users. So, it seems one should try out it for both reasons.

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Crimson Nape

Whether or not to use EPR and, if used, how to set (46)


Wiki Editor
Whether or not to use EPR and, if used, how to set (47)Posts: 15,054
Threads: 188
Joined: Oct 2014

Machine: AirCurve 10 Vauto
Mask Type: Hybrid
Mask Make & Model: F&P Evora FFM
Humidifier: Not Used - Side Cover
CPAP Pressure: 5-12 PS 5
CPAP Software: OSCAR

Other Comments: OSCAR Team Member

Sex: Male
Location: Georgia - U.S.A.

#9

05-28-2017, 09:54 AM (This post was last modified: 05-28-2017, 09:55 AM by Crimson Nape.)

RE: Whether or not to use EPR and, if used, how to set

Nicholas,
You are correct, Sir. It can't hurt and can provide additional insight to your therapy.

Crimson Nape
Apnea Board Moderator
Project Manager for OSCAR - Open Source CPAP Analysis Reporter
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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Gideon

Whether or not to use EPR and, if used, how to set (51)


Wiki Editor
Whether or not to use EPR and, if used, how to set (52)Posts: 12,827
Threads: 295
Joined: Dec 2016

Machine: ResMed Aircurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10 / Amara View
Humidifier: ResMed Aircurve 10 VAuto / Resmed Climateline
CPAP Pressure: BiPAP VAuto 11-25 PS 5
CPAP Software: OSCAR

Other Comments:

Sex: Male
Location: Michigan, United States

#10

05-28-2017, 10:12 AM

RE: Whether or not to use EPR and, if used, how to set

and post your Sleepyhead charts. Based on your profile of 4-20 it is likely we would recommend raising your min to ???? (that's what the charts are for)

Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
OSCAR - The Guide
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize ChartsOptimizing Therapy

Find

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