EPR

[Paul56]

I tried EPR on my machine last night with a setting of 3.

-In terms of breathing I found it a little difficult to get used to and did not find it more comfortable.

-Also the results this morning in ResScan show 6 apneas... where I have been scooting along all week with zero or one apnea.

I know this is only one evening; however, the results and my experience with it are not encouraging at this point. I don't think EPR... certainly not set to 3 is for me as I seem to do better with no EPR.

Now, is my understanding here correct... "Easy Breathe Technology" and EPR... is "Easy Breathe Technology" a constant while the EPR is user selectable? In other words... is "Easy Breathe Technology" being used even when EPR is turned off?

[bap40]

No when off it is off. Many people find they have to increase their settings to overcome using the EPR. You said you are used it on #3. They would increase their settings by the same number they are using on the EPR. That is my understanding of how it works. If I am wrong I am sure someone else will correct me. I have an A/flex machine but have found I do better without any relief.

[fuzzy96]

actually it stands for --- enough paul- relax no seriously the way i read it it is off when turned off. of course if you yeally want to know you could tee a manometer in line and mask up to se what happens

[Paul56]

EPR really means "Extra Pressure Required".

[freepostg]

I find I do best without any epr and a pressure of 11.6. If I use epr, I have to increase the pressure to approx 12.2 to get the same results. If I increase epr to 2 then my pressure must be turned up to approx. 12.8 to get the same results on resscan. Generally, epr of 1 drops your mean pressure by 1 and epr of 2 drops your pressure by 2 and so on. Some people find epr quite good...it's a personal taste. The important thing is that one must remember to increase their pressure accordingly in order to obtain the same results.

[DreamDiver]

EPR really means "Extra Pressure Required".

The proprietary meaning - "Expiratory Pressure Relief" is used by ResMed for all of their products that have it. The second is "Exhale Pressure Relief" that encompasses all the proprietary methods including 'Breathe Easy, Cflex, Aflex and EPR'. When I think of "expiratory", I think "one-foot-in-the-grave". Exhale seems a lot less hoighty, too.

When I use it, and I'm talking about lots of different machines, I mean Exhale Pressure Relief. Others will mean expressly Expiratory Pressure Relief. There you are, whatever works for you. I like fuzzy96's interpretation too.

[billbolton]

Many people find they have to increase their settings to overcome using the EPR.

Where did you get that from? Do you have any hard evidence to support the many assertion?

Cheers,

Bill

[billbolton]

The important thing is that one must remember to increase their pressure accordingly in order to obtain the same results.

You might have to, but there is no general "must" involved.

I get the same results, within normal variation, with EPR on or off, and across the EPR settings range.

Cheers,

Bill

[Paul56]

Many people find they have to increase their settings to overcome using the EPR.

Where did you get that from? Do you have any hard evidence to support the assertion?

Cheers,

Bill

Hi Bill, I don't know about everyone else and only have one nights worth of data to go on myself; however, since getting the pressure dialed-in I have consistently been having either zero or one apnea reported but last night the software reported 6 apneas... and I am feeling the difference today.

I did a search on the forum yesterday and found an old posting by "Rested Gal" that when using EPR she increased her pressures according to the EPR level selected. Sorry, no link to the post... but it is out there.

[billbolton]

Sorry, no link to the post... but it is out there.

There's quite a difference between some and many!

Cheers,

Bill

[rested gal]

I did a search on the forum yesterday and found an old posting by "Rested Gal" that when using EPR she increased her pressures according to the EPR level selected. Sorry, no link to the post... but it is out there.

Perhaps it was this one:
viewtopic.php?p=289264#p289264

Where I wrote:
Personally, if I were going to use a cpap machine that has EPR, and I were going to use EPR, I'd set the cpap's regular pressure one or two cms higher than I'd been prescribed. So that the drop I received during exhaling with EPR would not be as likely to allow my throat to close off with an apnea at the end of the exhalation and prevent getting another breathe (sp. "breath") STARTED in a timely fashion...a scenario which could happen over and over again if my prescribed pressure was right on the cusp, so to speak, of keeping my throat at least partially open (so that inhaling could be STARTED) during the pause before starting to breathe in again.

Using the example of the fellow who needs 10 to prevent full apneas at the end of exhaling, if I were him and were going to use a cpap machine with EPR, I'd set my pressure at 12 if I were going to use EPR 2 or 3. I'd set the pressure at 11 if I were going to use EPR 1.

But that's just me, and I'm not a doctor or anything in the health care field.

What I'd do "if it were me", and what works best for me, might not for another person. The fact that I get better treatment if I adjust the pressure up to account for EPR's drop doesn't mean other people using EPR need to do that to get good treatment. I'm just "someone" who does need to do that if I use an S8 Elite with EPR turned on.

As Bill correctly pointed out:

There's quite a difference between some and many!

[Snoredog]

{duplicate text deleted, cpaptalk is constipated tonight}

[Snoredog]

I tried EPR on my machine last night with a setting of 3.

-In terms of breathing I found it a little difficult to get used to and did not find it more comfortable.

-Also the results this morning in ResScan show 6 apneas... where I have been scooting along all week with zero or one apnea.

I know this is only one evening; however, the results and my experience with it are not encouraging at this point. I don't think EPR... certainly not set to 3 is for me as I seem to do better with no EPR.

Now, is my understanding here correct... "Easy Breathe Technology" and EPR... is "Easy Breathe Technology" a constant while the EPR is user selectable? In other words... is "Easy Breathe Technology" being used even when EPR is turned off?

When Respironics came out with CFLEX, Resmed sponsored a "study" using a Mom & Pop 3-bed Sleep Center in Vancouver to show it was adverse to your therapy. TIME and millions of machines later has since proven that study and them wrong.

When no one bought their bogus study results they responded with EPR touting it as being better. Time and experiences similar to yours has also proven them wrong again. While they do the same thing as Cflex by lowering pressure on exhale, Cflex is based upon your particular breathing pattern, detected by their digital autotrak technology and then lowering the pressure momentarily at the beginning of exhale bring it back up to therapy pressure before the end of exhale. Resmed's stays lower throughout the exhale process until inspiration begins.

The Exhale pressure is what actually maintains your airway splint, just like straight CPAP does. It is similar to EPAP on a bilevel.

Now, had EPR worked as Resmed advertised it, summarized with the detection of "SDB" like an apnea, FL or snore, EPR is supposed to back off pressure relief towards therapy pressure. Only problem with that theory is by use of EPR for comfort you reduce the splinting ability of therapy pressure.

For example, let say you went to the sleep lab and had a titration. They found your ideal pressure to be 10 cm. They most likely used a Respironics machine with No EPR to titrate you. Now you bebop down to the local Resmed DME and pick up a Elite with EPR. They set it to 10 cm what your prescription was for, you get home and turn EPR=3. You essentially just lowered your therapy pressure by 3 cm. Use EPR=2 and you lowered your prescription pressure by 2 cm.

Fact is people that used it like you did found the same thing and ended up disabling it. Using that feature you only receive therapy pressure on inhale and/or if there is enough SDB events to cause it to reduce relief back to CPAP pressure. Another complaint was it didn't exactly get the timing down on a person's breathing.

My opinion, is you would be much better off simply using a lower Ramp pressure and timer. Once you are asleep you don't know that EPR exists. Wake up in the middle of the night? Hit the Ramp button again.

Personally, I like Cflex always have, don't care much for the newer Aflex, something about it makes my therapy go down hill quickly, reason I don't think I would tolerate a bilevel machine either.

[Snoredog]

Many people find they have to increase their settings to overcome using the EPR.

Where did you get that from? Do you have any hard evidence to support the many assertion?

Cheers,

Bill

What are you lazy?

do a search here, there is probably only about a hundred posts reporting similar results as Paul's. Why don't you explain to everyone how it works?

Hard evidence? you mean hard evidence like that bogus 3-bed Mom & Pop sleep study done in Vancouver sponsored by Resmed to prove CFLEX didn't work? Now the best test of all (Time) has sorta proven that study to be all wrong now hasn't it? The shoe is on the other foot, it turns out EPR is the feature that offers sub-optimal treatment not Cflex. I still have a copy of that somewhere.

But anyone with half a brain (old stroke joke) can figure out why use of that feature results in sub-optimal treatment. They added it only to compete with Respironics Cflex as they were getting their lunch ate. They were hoping the dumb patient public wouldn't know any better, those that wised up bought Cflex, the others became Resmed dealers.

[billbolton]

What are you lazy?

do a search here, there is probably only about a hundred posts reporting similar results as Paul's.

"only about". which means you didn't even try to look.

In fact I found about 5 prior to posting.