EPR setting on ResMed machine. I don't fully understand.

[Chuck Connors]

Does anyone have a good handle on EPR and if so, can you explain it to me? Is this simply a comfort feature on the machine? I'm always looking for ways to maximize my sleep therapy. Thanks. -Chuck-

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EPR is a ResMed feature that stands for Expiratory Pressure Relief.

EPR™ (expiratory pressure relief) is an effective alternative to continuous positive airway pressure (CPAP) therapy. It features several options that enable you to reliably and predictably control patient therapy while delivering a higher level of patient comfort.

There are 4 possible settings for EPR on a machine:

OFF
Setting 1 = mild comfort (1 cm H20)
Setting 2 = medium comfort (2 cm H20)
Setting 3 = maximum comfort (3 cm H20)

[jen4700]

I would like to know the answer too. Also, I'm using Auto and no matter how my pressure changes during the night there is still the same IPAP / EPAP difference. Is this different than EPR?

[LSAT]

EPR simply makes it easier to exhale. A setting of EPR 3 reduces the pressure by 3 on exhale. If, for example, your pressure setting is 12 with EPR 3...you would be inhaling at 12 and exhaling at 9. It IS a comfort feature.

[Lizistired]

It's just a comfort feature. It reduces the pressure the given amount on exhale. In cpap mode, you can also adjust the speed of the pressure return, but not in apap.
In my avatar where the red AHI graph drops is when I finally turned off the EPR.
DME's seem to set it at 3 when they set up your machine.
I felt like the machine was telling me when to breathe.
It's an individual thing. I would try it off and then increase it to see what works best for you.

[Pugsy]

I would like to know the answer too. Also, I'm using Auto and no matter how my pressure changes during the night there is still the same IPAP / EPAP difference. Is this different than EPR?

EPR is not available on the VPAP machines unless you are using straight cpap mode.
The pressure support between IPAP and EPAP works similar to EPR but obviously you have a large range than EPR's 3 cm range.
The pressure support range when using VPAP pressure support feels similar to EPR but it isn't exactly the same. The timing is a bit different.

EPR is normally deemed a comfort feature so that the reduction in pressure during exhale allows for an easier adjustment to the pressures. Some people like it, some people need it, some people could care less about it, some people hate it.
I happen to like it. I did try using straight cpap mode so I could test out EPR. While I could do okay without it, I rather liked it because it seemed more like my natural breathing and it was more comfortable. I like the VPAP auto even more because I can use 4 or 5 pressure support and that is extremely easy to breathe with. Pretty much feels like normal breathing without the machine.

[RandyJ]

I never found EPR to be comfortable at any setting, so I didn't use it.

I like bipap, though.

[archangle]

In my opinion, EPR may have some effect, good or bad on your therapy. Since pressure drops on exhale, you might get more tidal volume. (Deepness of breath.) It could conceivably make your apnea better or worse. The pressure changes may make your mask "pump" up and down and could cause some leak problems.

That said, it's mostly for comfort in my opinion. Try it, see what setting works best for you.

[Matt2h]

Right. I'm trying to understand the pros and cons of this as well. When I got a machine, I thought that I definitely wanted this feature to make therapy more comfortable. Last night, however (first night trying cpap), I felt like when I used it i could hear myself breathing out more. The variations in pressure level for inhale vs exhale were audible and it was psyching me out a little. I think another commenter wrote that he felt like the machine was telling him when to breathe. Is this a common experience? What are the cons of EPR?

I was using a dreamweaver nasal mask. I felt like I was trying to breathe through a face full of silicone and yet if I (re)moved the mask, it was striking how much air was actually coming out.

I have mild OSA, according to my home sleep study, and.. it's a long story but I'm actually trying this on my own. So it's also true that I'm guessing at the required pressure.

I may try the P10 nasal pillows mask also.

[palerider]

Right. I'm trying to understand the pros and cons of this as well. When I got a machine, I thought that I definitely wanted this feature to make therapy more comfortable. Last night, however (first night trying cpap), I felt like when I used it i could hear myself breathing out more. The variations in pressure level for inhale vs exhale were audible and it was psyching me out a little. I think another commenter wrote that he felt like the machine was telling him when to breathe. Is this a common experience? What are the cons of EPR?

It's a common experience (that just has to be ignored) on Respironics machines, because their 'Flex' pressure relief raises the pressure when it thinks you're about done exhaling, and this confuses some people.

EPR doesn't raise the pressure till you start to inhale, and it doesn't matter anyway, because both EPR and *flex follow you're breathing, just ignore the machine, and breathe.

As far as cons, the added ventilation of EPR can, in a small subset of people, cause too much CO2 to be removed from the blood and that can cause an increase in legitimate central apneas. Which isn't a real problem, unless you get a LOT of them. (hold your breath for 10 seconds... that's a central apnea, no biggie, you can do that frequently without any bad side effects.

but I'm actually trying this on my own. So it's also true that I'm guessing at the required pressure.

Read the newbies sticky in the announcements section,

Fill in your equipment in your profile.

Read the link in my sig, start your own thread, and post some charts.

We'll help you.