What do I expect with EPR "on"?

[JJR]

I changed three settings on my machine:
1. Mask = full face (it was still on nasal pillow because no one told me there was a setting to change)
2. Auto Start (no one told me that was a setting, I heard that a relative had it, and when I saw the setting I changed it to Auto)
3. EPR on

I looked back a couple weeks to the different graphs, but I don't seem to have a "typical" night to compare to the one night with EPR on.

This is the first EPR night:

2019-12-29.PNG (133.92 KiB) Viewed 3470 times

The events between 3 and 4am are typical, I often get an obstructive event that triggers the bladder-fill response, and I wake up with the machine blowing me up like a balloon, so I get up and go pee. Maybe the EPR smoothed that out so I didn't wake up?

One night does not a trend make...

[joeljjk11]

EPR just makes using the machine more comfortable and like more natural breathing, it is a comfort setting. Some people like it and some do not, I use EPR of 1 because that is what I find the most comfortable.

[Dog Slobber]

What's your average AHI before making the change?

2: There is SmartStart.......

There are also a few different "Autos":

• Auto for Humidity control
• Auto for Heated tube temperature
• Auto for Ramp

Not sure which Auto you turned on.

3: With EPR on, you should find it easier to exhale against the pressure. It can be 1, 2 or 3, looks like you have it set to 1. If you like you can increase it.

It sure looks like your minimum pressure is set too low. Your machine is jumping up to 9-10 immediately and rarely goes below. It looks like you're having some events because the device can't address them fast enough.

The reason you might be waking up is because you're having events not being addressed.

I would reformat your charts to include snores and Flow Limitations. Increase you're minimum pressure to 9 or 10, then see how it goes. Consider increasing EPR to 3.

Try that out for a few days and see how it goes.

[zonker]

I changed three settings on my machine:
1. Mask = full face (it was still on nasal pillow because no one told me there was a setting to change)
2. Auto Start (no one told me that was a setting, I heard that a relative had it, and when I saw the setting I changed it to Auto)
3. EPR on

I looked back a couple weeks to the different graphs, but I don't seem to have a "typical" night to compare to the one night with EPR on.

This is the first EPR night:

2019-12-29.PNG

The events between 3 and 4am are typical, I often get an obstructive event that triggers the bladder-fill response, and I wake up with the machine blowing me up like a balloon, so I get up and go pee. Maybe the EPR smoothed that out so I didn't wake up?

One night does not a trend make...

first, thanks for starting your own thread on this.

i can't add much to what dog slobber has said. however, it's usually a good idea to change one thing at a time. it's easier to know what works and what doesn't.

good luck!

[LSAT]

Increase your pressures to minimum 9 and max 20....EPR is a reduction in pressure on exhale. If EPR was set to 2, you would exhale at 2 less than your inhale. It looks like you currently have your EPR set.

[Dog Slobber]

Increase your pressures to minimum 9 and max 20....EPR is a reduction in pressure on exhale. If EPR was set to 2, you would exhale at 2 less than your inhale. It looks like you currently have your EPR set.

Normally, I would suggest this and there are times when the machine caps at his maximum of 15. But, he did mention in his OP that the machine blows him up like a balloon. I'm hopping that by increasing his minimum the machine won't need to go to 15.

[JJR]

Thanks, I’ll have to experiment after New Years, we’re going out of town the next couple days, can’t use OSCAR till we’re back.

[zonker]

Thanks, I’ll have to experiment after New Years, we’re going out of town the next couple days, can’t use OSCAR till we’re back.

hey! your on cpap. you've got no business leading a real life and going out of town!

tsk,tsk. kids these days.

[chunkyfrog]

"Nobody tells us"---all.
Ignorance is not bliss, but it can be profitable.
Patients are often kept in the dark, intentionally.
Fight back--be informed.
It is your RIGHT.
My EPR is set to 2, meaning when I exhale, the pressure drops by 2 cm h2o so I can breathe out easier.

[Miss Emerita]

A couple more thoughts for when you get back. Could you turn off the pie chart (in Preferences) and calendar (small triangle to the left of the date)? That will make more information visible. And you might want to try turning the ramp off, or shortening the time. That way you’ll get the benefits if therapy sooner each night. Many people find they don’t really need the ramp to fall asleep.

[JJR]

Agreed, ramp can be shorter for me.

By Auto, I mean when you start breathing, the machine turns on. Remove the mask and it turns off when it senses you’re not breathing through it. Not a huge deal, but saves stretching my arm out and groping for the button.

[palerider]

Agreed, ramp can be shorter for me.

By Auto, I mean when you start breathing, the machine turns on. Remove the mask and it turns off when it senses you’re not breathing through it. Not a huge deal, but saves stretching my arm out and groping for the button.

That's called "smartstart" and I quite like it.

[Okie bipap]

I also use the "Smart Start" option. This makes it possible for me to get into bed and get settled before I hook the hose to my mask and start the machine. I turn the machine off manually and don't rely on the auto off.

[JJR]

This was last night. Not a totally fair comparison, I took some antihistamine before bed for allergies and cough, so I probably slept more heavily than average.

[Dog Slobber]

As been suggested before, you should probably increase your minimum.

You have a very active Flow Limitation trace, as soon as you're asleep your pressure jumps from 5 to 8ish, and rarely falls below. If you're concerned about increasing your minimum, move up slowly. See how it goes.