Another EPR question….how to transition to no EPR

Hi
So I’ve been on EPR 3 for a little over a year now. I’ve experimented with EPR 2 recently and I find it’s just the right balance and feel better in the morning. Ideally though, I’d like to turn EPR off because of the fluctuations in pressure. I tried EPR 2 before and couldn’t really stand it, so maybe my body is adjusting to it. Anyways I tried EPR 1 last night for a little and it bothered me. Do I have to be on EPR 2 for a year to transition to 1 then to off? What is the best way to go about this.

Just do what you are doing. Down to 2 for a while then 1 for a while then off. It's strictly a comfort item. Some people like it some don't. I have been using EPR 2 for over 10 years. I see no reason tp change.

Thanks, only reason I’d like to change is because I’d like to eliminate fluctuating so much between the pressures. I noticed quite the change in morning energy switching to 2, that’s why I’d like to at least get to 1. Would lowering my pressures help with it?

Just to be sure: what you don't like is the difference between the pressure when you inhale and the pressure when you exhale? In other words, it's the breath-by breath fluctuations you don't like?

The reason I ask is that when people talk about pressure fluctuations, they often mean something different: increases and decreases to the pressure when they inhale. In other words, changes in pressure that occur over many breaths in response to detection of obstructive events or flow limitations.

I don’t like any fluctuations because cpap is meant to keep the airway open and it takes a certain pressure to do that. When pressures for inhale/exhale vary, I feel like my airway is collapsing just enough, which explains why I do better with exhale relief of 2 vs 3. I think I would do great with EPR 1 or off because I’ve dialed in my settings pretty well. If I just raise my settings by 1 min and max, is that essentially doing the same thing?

LSAT wrote: ↑

Fri Dec 16, 2022 9:12 am

It's strictly a comfort item.

Strictly? In some people, EPR reduces flow limitations.

jlsmithseven wrote: ↑

Fri Dec 16, 2022 8:01 am

Anyways I tried EPR 1 last night for a little and it bothered me.

In addition to observing how you feel at different EPR settings, compare your FL graphs.

There wasn't any real change to the flow limit graphs.

jlsmithseven wrote: ↑

Fri Dec 16, 2022 4:16 pm

There wasn't any real change to the flow limit graphs.

There's not always any marked difference in the FL graph with or without EPR. Some people just don't have much FLs. I don't. Never have had much in FLs.

jlsmithseven wrote: ↑

Fri Dec 16, 2022 12:43 pm

I don’t like any fluctuations because cpap is meant to keep the airway open and it takes a certain pressure to do that. When pressures for inhale/exhale vary, I feel like my airway is collapsing just enough,

Then you may be at the exact borderline on the exhale pressure for what you need to keep the airway open. The simple solution is to just raise the minimum pressure, since EPR drops your pressure by whatever value EPR is set to.

jlsmithseven wrote: ↑

Fri Dec 16, 2022 12:43 pm

which explains why I do better with exhale relief of 2 vs 3. I think I would do great with EPR 1 or off because I’ve dialed in my settings pretty well. If I just raise my settings by 1 min and max, is that essentially doing the same thing?

lowering EPR is raising your base pressure. So yeah, raise the minimum, that's the answer to most problems with CPAP, barring a small minority that have relatively rare issues.

As to your max pressure, it very likely should just be set to 20 and completely ignored.

jlsmithseven wrote: ↑

Fri Dec 16, 2022 12:43 pm

I don’t like any fluctuations because cpap is meant to keep the airway open and it takes a certain pressure to do that. When pressures for inhale/exhale vary, I feel like my airway is collapsing just enough, which explains why I do better with exhale relief of 2 vs 3.

EPR creates a stable non-varying difference in pressure between inhale and exhale.

I think I would do great with EPR 1 or off because I’ve dialed in my settings pretty well. If I just raise my settings by 1 min and max, is that essentially doing the same thing?

Yes, as far as changing your minimal exhale pressure goes.

If you feel your exhale pressure is too low, then you can either make the exhale pressure higher, by making EPR lower, or you can raise your minimal pressure and maximal pressure without changing the EPR. EPR stands for Exhale Pressure Relief, it lowers the exhale pressure relative to the inhale pressure by 1, 2 or 3 cms.

My EPR has been at 2 for nearly 13 years.
I, too see no reason to change.
It just feels normal to me.
Channel your inner Goldilocks, and do whatever feels/works best--for YOU.