what is the EPR?

[drubin007]

I have been faithfully logging my numbers for the past few days evert morning

Even adjusted my headgear last night thinking that would help my leak numbers (looks like it made it worse?)

In anye vent, I was looking at the different features on my machine this morning, and I saw a setting for EPR and it is at 3.

Not knowing what that setting is, of course I left it alone. I have been searching under the wisdom at the top of the page, and I cannot find anything that explains what that term means, or what that setting is for?

I apoligize for all of the questions I post, hopefully they will also help other noobs in the journey we are all on and here is what I notice and why I want to tweake it... maybe I am just new, and still adjusting to it all (I know I am). I ramp to my setting (9), changed from 45 mins to 30... (think people here in the past have questioned why I ramp anyways... maybe eventually I can disable that feature).

The machine seems quiet enough as I am going to sleep.. of course getting comfortable as a side sleeper is still not easy, and I need to invest in a cpap pillow one of these days... What I have noticed though and this may be hard to explain is this: I wake up during the night (to use the bathroom) or early in the morning and how do I explain it... I can hear my inhalation and exhalation a lot louder? It is quiet in my room when its bedtime. besides the white noise (ceiling fan), fish tank in the next room, and 2 dogs in the crate on the wifes side of the bed, it stays pretty quiet. If I breathe in or out (thru my nose of course) I can hear the machine working more or less hard depending on my respirations. The machine does not fight me to let air out as best I can tell, and it just seems to be an annoyance more then anything... If I get up to use the bathroom, I turn the machine off before taking the gear off, so when I turn it back on it starts fresh and I do not hear it. Is this related to the EPR setting?

[Hawthorne]

EPR is an exhalation relief feature on Resmeds machines. It drops the pressure slightly (1,2 or 3) when you exhale so that you are not exhaling against your full pressure.

I am not too familiar woth Remsed machines but I understand, from posts on the forum, that each level (1,2 or 3) drops your pressure that many cms to make exhalation easier.

It is strictly a comfort feature. Some people don't like it on at all and you can turn it off. Some like 1, some 2 and some 3.

You says yours is set at 3. You can lower it to 2 and try that for a week to see if there is any difference and then try 1 for a week if you want. As I said, you can even disable it if you like and see how that goes.

You decide what feels best for you. With a titrated pressure of 9, I would think that a setting of 3 would be too high and could affect your therapy. If it were me, I would try 1 or 2.

I'm not sure if the extra noise you hear is related to the EPR setting. Someone who knows more about Resmed machines maybe will respond.

[GrumpyGurl]

Hi,
I know the "noise" you are speaking of, and I really haven't thought much about it. As with any type of motor, there is going to be a change, when a different end result is "asked" for and the mechanism that drives that change kicks in. Ummmm I think, for example, drive a manual shift car.....you press the gas to go faster, the RPMS on the engine wind up, and the SOUND of the engine changes. You shift gears, the engine slows down, and the sound of the engine gradually winds back down, then the process is repeated. So with the CPAP, it's just the two cycle, breath in, motor sound increase, breath out, motor sound decrease. (As far as the EPR setting, mine was initially set to 3, I changed it to 2 and I have had much better results.)

Just my thoughts, the rambling of a now semi-sleep deprived individual.

Oh and the ramp feature, I hated it. I am set at 13.....I put the mask on, hit start, and never even can tell that the air has started unless I pull the mask away from my face.

[TXLadybug]

I turned the Ramp off immediately. My pressure is 11. I have my EPR set at 3, and have had no problems with exhaling pressure, or any noise of any kind. I cannot even tell the machine is on. By the way, one of the things you'll notice when you start sleeping better, you won't need the middle of the night trips.

[drubin007]

thanks for the replies!

So the EPR is for exhaling? I may try changing the setting to 2 tonight to see if there is any difference.

That makes sense, the difference in sounds for exhale and inhale, but I cannot help but wonder why I only hear it during hte middle of the night, as opposed to hearing it the entire time? The only thing I can think of, would be due to the ramp feature. When I first start the machine at night I do not feel the air either, unless I pull the things out of my nostrils and I hear the air rushing. That or I open my mouth and feel the air.

[GrumpyGurl]

Yes the EPR is for reducing the pressure upon exhale. ( I guess I left that out). I think I don't hear it when I first start the machine is because I haven't relaxed and tuned in. I don't seem to notice it until my breathing falls into a steady, regular pattern. I also think at first the machine hasn't adjusted to our breathing pattern.....it seems to take a few breaths for everything to coordinate and start working together.

[ChrisC]

I had my EPR set to 3 (with my pressure of 10cm) and it sent my HI readings absolutely skyrocketing. When I started using the EPR at 3, my HI readings skyrocketed to anywhere from 12-20. Immediately after turning EPR completely off, my numbers plummeted and I now have an AHI of 5-6. The difference was absolutely night and day once I turned off the EPR.

It might be touted as just a comfort setting, but I see a huge difference in my numbers having it on and having it off. As far as comfort goes, I guess I'm lucky to be perfectly fine with EPR and ramp both off.

[Slinky]

Okay, its a fairly safe assumption that you spend half the night inhaling and half the night exhaling. Your pressure need was titrated at 11 cms? With the EPR set at 3 you are getting 8 cms of pressure during exhalation. With EPR set a 2 you are getting 9 cms of pressure on exhalation.

Ramp is all too often set for 45 minutes and to start at 4 cms. Sheesh! Not only is it often difficult for us to breathe comfortably at 4 cms w/a mask on, but, as I remember it w/o checking my Manual, Ramp builds up in 0.2 increments over that 45 minutes to your set pressure.