EPR versus BiPap

My sleep doctor, after the most recent sleep study, want's to put me on a bipap. Thing is, she wants to put it on a setting of 14/18. I'm on a ResMed CPAP right now that is set at 18 with EPR at max. Is there really a point in going to a bipap from that?

Why the need? Aerophagia maybe?

But there is a little bit of difference between the 3 EPR drop and the 4 cm drop that is proposed with those settings.
To me 4 is more comfortable than 3 but isn't like 3 is horrible but then I don't have any aerophagia issues or centrals to worry about. I use 4 or 5 PS (the difference between inhale and exhale) just for the comfort factor.

Also I did try EPR at 3 (CPAP mode on my S9 VPAP) and used my Bilevel machine with PS of 3...while there wasn't a huge difference in how it "felt" I thought I felt a little difference in the timing of the reduction and the response time back up to inhale. Not a deal breaker difference though and it may have been mostly in my head.

Oh...one other thing...maybe the doc is thinking might need more than 20 cm at some time in the future...the bilevel machine will go to 25.

Maybe. I just hate to spend that kind of money on it right now on a maybe. But I guess that's how medicine works in America, isn't it?

You get EPR or "Easy Breathe" with ResMed VPAP anyway. I started out with CPAP at 15. Went up to 17. At that point my doctor prescribed BiLevel for me. My current pressure is 22/18 with EPR at 2. So that essentially means 22/16 with EPR setting.

The IPAP (higher number) controls hypopneas. The EPAP (lower number) controls apneas. If your current pressure on CPAP is controlling apneas but not hypopneas, you need a higher IPAP. If you are getting close to 20, you may need BiLevel to control both hyponeas AND apneas.

VikingGnome wrote:You get EPR or "Easy Breathe" with ResMed VPAP anyway. I started out with CPAP at 15. Went up to 17. At that point my doctor prescribed BiLevel for me. My current pressure is 22/18 with EPR at 2. So that essentially means 22/16 with EPR setting.

you keep saying that, ignoring the fact that you're *wrong*.

EPR is not available on resmed vpaps in vpap mode, only in cpap mode.

easy breathe is NOT the same as EPR.

EPR is a limited bi-level function, it would be redudant, and *stupid* to have it on vpap mode.

palerider wrote:

VikingGnome wrote:You get EPR or "Easy Breathe" with ResMed VPAP anyway. I started out with CPAP at 15. Went up to 17. At that point my doctor prescribed BiLevel for me. My current pressure is 22/18 with EPR at 2. So that essentially means 22/16 with EPR setting.

you keep saying that, ignoring the fact that you're *wrong*.

EPR is not available on resmed vpaps in vpap mode, only in cpap mode.

easy breathe is NOT the same as EPR.

EPR is a limited bi-level function, it would be redudant, and *stupid* to have it on vpap mode.

Then what do you thiink "Easy Breathe" is? By manual it functions the same a EPR. Here is the Table of Contents of the Clinician Manual for all ResMed VPAP models. Note Page 5 discusses EPR.

If you are paying out of pocket consider buying used here on the forum or from Craigslist.

VikingGnome wrote:Then what do you thiink "Easy Breathe" is? By manual it functions the same a EPR. Here is the Table of Contents of the Clinician Manual for all ResMed VPAP models.

1) that's not nearly all vpap models, some that aren't listed, VPAP ST-A, VPAP Adapt, VPAP COPD, VPAP Tx.

2) was was very recently pointed out, here: viewtopic.php?f=1&t=101012&p=942808&hil ... he#p942706 easy breathe is a pressure SHAPING technique that changes the abruptness of the transition between epap and ipap, pictures of an example are in a post by robysue that are referenced in that post.

easy breathe is something that is *ADDED TO* EPR, but it is NOT EPR, and it is not a pressure REDUCTION, like EPR is.

and, it's not available on the ST, or Vauto modes of the VPAP ST or the VPAP Auto.

and none of them offer EPR in any VPAP mode, because it's redundant.

Guest wrote:If you are paying out of pocket consider buying used here on the forum or from Craigslist.

I'm not paying out of pocket, but I'm sure there will still be a deductible. At least a few hundred.

VikingGnome wrote:You get EPR or "Easy Breathe" with ResMed VPAP anyway. I started out with CPAP at 15. Went up to 17. At that point my doctor prescribed BiLevel for me. My current pressure is 22/18 with EPR at 2. So that essentially means 22/16 with EPR setting.

The IPAP (higher number) controls hypopneas. The EPAP (lower number) controls apneas. If your current pressure on CPAP is controlling apneas but not hypopneas, you need a higher IPAP. If you are getting close to 20, you may need BiLevel to control both hyponeas AND apneas.

My whole point was that, with the EPR on my current CPAP, I'm already around 18/16, so what's the point in going to a bipap that is also 18/16?

ATXFerret wrote:My whole point was that, with the EPR on my current CPAP, I'm already around 18/16, so what's the point in going to a bipap that is also 18/16?

Have you asked your doc that question?

ATXFerret wrote:

VikingGnome wrote:You get EPR or "Easy Breathe" with ResMed VPAP anyway. I started out with CPAP at 15. Went up to 17. At that point my doctor prescribed BiLevel for me. My current pressure is 22/18 with EPR at 2. So that essentially means 22/16 with EPR setting.

The IPAP (higher number) controls hypopneas. The EPAP (lower number) controls apneas. If your current pressure on CPAP is controlling apneas but not hypopneas, you need a higher IPAP. If you are getting close to 20, you may need BiLevel to control both hyponeas AND apneas.

My whole point was that, with the EPR on my current CPAP, I'm already around 18/16, so what's the point in going to a bipap that is also 18/16?

the only real advantage of going to a bipap at 18/16 is that you can twiddle with the behavior of the epap >ipap>epap transition, making it more or less sensitive, changing the timing, etc. not a big deal for the average patient, but it can be a big deal for someone with obstrucive/restrictive lung conditions.

VikingGnome wrote:The IPAP (higher number) controls hypopneas. The EPAP (lower number) controls apneas.

Could you provide a reference for that statement, please? I'm interested in learning more.