Epr and flow limitations

[Ynot]

Flow limitation decreases when I turn epr on. I’ve seen this talked about in this forum. Why is this? As a sidenote, this always happens regardless of the pressure so the difference isn’t because of the pressure change in the examples I put.

Why exactly does epr reduce flow limitations?

[Julie]

Does it matter why it happens?

I would just set the min. pressure a bit higher and maybe it will help.

[Ynot]

Yes, it does matter why, quite a lot. It's important to actually understand the issue to solve it I think. Can you see the examples I put? I tried to attach images but I don't see them

[Pugsy]

Can you see the examples I put?

No

viewtopic/t183806/Attachment-storage-is ... MENTS.html

[palerider]

Flow limitation decreases when I turn epr on. I’ve seen this talked about in this forum. Why is this? As a sidenote, this always happens regardless of the pressure so the difference isn’t because of the pressure change in the examples I put.

Why exactly does epr reduce flow limitations?

Without sleeping in a FMRI machine, you won't know.

maybe with a camera up your nose.

[Ynot]

Flow limitation decreases when I turn epr on. I’ve seen this talked about in this forum. Why is this? As a sidenote, this always happens regardless of the pressure so the difference isn’t because of the pressure change in the examples I put.

Why exactly does epr reduce flow limitations?

Without sleeping in a FMRI machine, you won't know.

maybe with a camera up your nose.

Idk, I've seen people talk about epr helping them with flow limitation online. There might be a logical explanation. For example, it might just make breathing more natural. Perhaps constant pressure disrupts normal breathing patterns for some people which leads to flow lim. Maybe, it allows more exhalation and thus a larger tidal volume which leads to fuller more natural breaths that reduce flow lim. (I don't see tidal volume changing in the Oscar graphs tho when i put epr). Maybe someone has insight on this.

[Miss Emerita]

There's some information about FLs here:

https://www.apneaboard.com/wiki/index.p ... limitation

No amount of pressure support will help FLs that originate in the nose, so I want to focus on the ones that originate further down in the airway, where the tissues that line it can sometimes sag and limit the flow of air when we inhale.

We think of EPR as a drop in pressure at the start of exhalation, but it is by the same token an increase in pressure at the start of inhalation. The general term for pressure increases at the start of inhalation is "pressure support" (PS). EPR limits PS to 3; other machines (like mine) can offer greater amounts of PS.

The explanation I've read about why PS helps with FLs is that the pressure differential supports inhalation and thereby smooths it.

All that said, I don't know that there's a fully satisfactory explanation for why the pressure differential -- rather than a higher static pressure -- is so effective. I do know that it is, after reading many charts where PS is added or subtracted.

[palerider]

Flow limitation decreases when I turn epr on. I’ve seen this talked about in this forum. Why is this? As a sidenote, this always happens regardless of the pressure so the difference isn’t because of the pressure change in the examples I put.

Why exactly does epr reduce flow limitations?

Without sleeping in a FMRI machine, you won't know.

maybe with a camera up your nose.

Idk, I've seen people talk about epr helping them with flow limitation online. There might be a logical explanation. For example, it might just make breathing more natural. Perhaps constant pressure disrupts normal breathing patterns for some people which leads to flow lim. Maybe, it allows more exhalation and thus a larger tidal volume which leads to fuller more natural breaths that reduce flow lim. (I don't see tidal volume changing in the Oscar graphs tho when i put epr). Maybe someone has insight on this.

You wanted to know "Why EXACTLY does it allegedly make a difference.

I answered, you don't like the answer.

[Ynot]

It's weird that I've seen people saying that epr helps flow limitation, but I haven't seen anyone explain why. Btw, are we going to be able to attach images soon? Is this something that happens often?

[Ynot]

There's some information about FLs here:

https://www.apneaboard.com/wiki/index.p ... limitation

No amount of pressure support will help FLs that originate in the nose, so I want to focus on the ones that originate further down in the airway, where the tissues that line it can sometimes sag and limit the flow of air when we inhale.

We think of EPR as a drop in pressure at the start of exhalation, but it is by the same token an increase in pressure at the start of inhalation. The general term for pressure increases at the start of inhalation is "pressure support" (PS). EPR limits PS to 3; other machines (like mine) can offer greater amounts of PS.

The explanation I've read about why PS helps with FLs is that the pressure differential supports inhalation and thereby smooths it.

All that said, I don't know that there's a fully satisfactory explanation for why the pressure differential -- rather than a higher static pressure -- is so effective. I do know that it is, after reading many charts where PS is added or subtracted.

Yeah, no increase in static pressure improved the flow limitation chart, but epr almost fully flattened it. I guess static pressure being unnatural is detrimental to normal breathing rythm for some, and leads to flow limitation not being resolved, or something along those lines. Do you have a bipap? Which types of machines offer greater amounts of ps. Would pressure support benefit everyone if it were properly administered?

thanks

[Pugsy]

Btw, are we going to be able to attach images soon? Is this something that happens often?

Don't go holding your breath.
Until past members, who posted a lot of images attached, go in and remove/delete those images and clean out the storage we won't be able to routinely attach files. Problem is most of those members haven't bothered to come back here so the storage remains full.

We have had this problem for a couple of years now and I don't see any improvement in the near future.

Accept it and learn how to host your images elsewhere. For the first 10 years that I was a member here we couldn't attach any files....we learned how to deal with it and I suggest you do the same. It's not rocket science.

[Pugsy]

Would pressure support benefit everyone if it were properly administered?

No.

Not everyone benefits from using PS/EPR and for some it can actually cause a significant problem.

[Ynot]

https://imgur.com/a/e4cxcVE

Here's an imgur link to the pictures, lmk if you can't see them. Lmk what you think also

[Ynot]

Would pressure support benefit everyone if it were properly administered?

No.

Not everyone benefits from using PS/EPR and for some it can actually cause a significant problem.

I posted pics btw

[Miss Emerita]

Yes, your flow limitations are definitely better with EPR (as are mine). Do you feel better during the night or during the day? For some people reducing FLs make for a more restful night and rested day; for others it makes no real difference.