No EPR for me. thanks...

I have noticed that when I use my APAP with no EPR I get AI at 0.0 or 0.1 or 0.2. If I use EPR it's still pretty good, but more like 1 or 2. I also woke this morning on my own, so I know I had to have gotten some good sleep! I just thought I would share, in case it would help someone here.

2girlsmom wrote:I have noticed that when I use my APAP with no EPR I get AI at 0.0 or 0.1 or 0.2. If I use EPR it's still pretty good, but more like 1 or 2. I also woke this morning on my own, so I know I had to have gotten some good sleep! I just thought I would share, in case it would help someone here.

That info implies that when EPR drops to the lower pressure, it is letting some small OSA events thru.
When in auto mode you can't preset the pressure so the solution (not that you will want to do it) is

1) go to cpap mode with EPR & tune CMs up until AI drops below 1.0 with EPR on
2) Set EPR to a lower setting (assuming you are not already at a setting of 1

What your experience tells me is that EPR, where pressure drops on exhale, isn't a good idea
in AUTO mode (& in my opinion never was going to be helpful in AUTO mode because of exactly
what you are finding).

Cheers

DSM

#2 PS meant to ask what EPR setting you had active (1, 2 or 3 ?)

2girlsmom wrote:I have noticed that when I use my APAP with no EPR I get AI at 0.0 or 0.1 or 0.2. If I use EPR it's still pretty good, but more like 1 or 2. I also woke this morning on my own, so I know I had to have gotten some good sleep! I just thought I would share, in case it would help someone here.

I find the same thing with epr in cpap mode. I prefer auto set without epr in order to get h.i to it's lowest as well. I'd rather have no epr and a lower pressure rather than epr with a higher pressure to compensate for the higher tendency towards h.i.

I don't need EPR even running all night at 12, so it occurred to me to just switch it to SETTLE ONLY and then be done with it. I have noticed I am not hitting 12 as much with EPr off too, so that is great... I am so happy to finally be getting the best therapt possible!

by the way, EPR was only at 1 before, and it's made a big difference to just switch it to SETTLE ONLY.

2girlsmom wrote:I don't need EPR even running all night at 12, so it occurred to me to just switch it to SETTLE ONLY and then be done with it. I have noticed I am not hitting 12 as much with EPr off too, so that is great... I am so happy to finally be getting the best therapt possible!

by the way, EPR was only at 1 before, and it's made a big difference to just switch it to SETTLE ONLY.

Just to confirm my understanding, 'settle only' is the same as RAMP but used in Vauto mode ?.

Are you able to set a time that settle applies ?

Tks

DSM

My settle time is 15 minutes. The EPR is on at 1, I just really like it while settling in and going to sleep for some reason. I don't wake a ton or have trouble exhaling against the pressure at night but like it set to 1 for settling. And yes, settle only for EPR is what it is in auto mode, in cpap mode it's ramp only.

Interesting, 2girlsmom. I also got the Resmed Autoset II and slept with it for the second night last night. Your positive experience was part of what motivated me to just suck it up and pay the whopping out-of-pocket with my insurance. But I got the machine that I want and I'm happy.

However, while I have noticed a big improvement in comfort, I've still gotten AHI of 7.5 and 8.5 the last two nights (with almost all of that HI; AI is still below 1). The EPR and Easybreathe on the Autoset II feels very, very comfortable and natural. I definitely like the feeling of it. But since I'm already starting at a couple CM pressure below where I was with straight CPAP, I suppose I don't really need it. And I would definitely like to get that AHI as low as possible. I'm going to follow your lead tonight and drop the EPR to just Settle mode. As always, thanks for sharing!

ziggy, glad you were able to get the auto. Keep in mind it may take a few nights to adjust so give things time to settle down--maybe take off EPR and wait a week before changing anything else. Everyone here says to change one thing at a time. Let me know how it goes.

Also, what pressures are you running at and what was your titrated pressure?

2girlsmom wrote:ziggy, glad you were able to get the auto. Keep in mind it may take a few nights to adjust so give things time to settle down--maybe take off EPR and wait a week before changing anything else. Everyone here says to change one thing at a time. Let me know how it goes.

Also, what pressures are you running at and what was your titrated pressure?

I'll do that with the EPR. I was titrated at 7, and the DME set the range at 5-20. However, I had already found on the CPAP that 10-11 was the most effective pressure so I changed the range to 8-20 before the first night. The range is now 8-20 and the reported pressure on the LCD screen was 11.2 the night before last and 10.4 last night. I actually don't understand exactly what that reported pressure means. Is that the average? The highest pressure it went to? What is that?

The Australian version of the Autoset II doesn't even have EPR and I really don't see why anyone would actually need it. I'm sure EPR in APAP mode was purely a "me too" to match AFLEX on the Respironics models.

The EasyBreathe technology renders it surpflous IMO. My APAP ranges between 10-15cmH2O and I have never evperienced the slightest discomfort when exhaling.

Since I switched from the Activa to the SwiftLT, my AHI has plummetted to 1 or less and my Leak is never higher than 0.02 with 0.00 being commonplace.

This post is valuable info for me because I wondered why I did better on straight cpap as opposed to Apap.
I have a Respironics machine but I think the principle may still apply on what dsm said.
I did my best at 10 on straight cpap w/ or w/out cflex with ahi of under 1.
On apap at a range of 9-12 I had ahi of around 3.0 but that was with cflex on.
I am going to go back to apap tonight at that 9-12 range with cflex off and see how that goes.

Just another piece of the puzzle trying to find the best combo.

Luke

Yeah, that seemed to improve things last night. I set the EPR for Settle only and ended up with an AHI of 5.9 -- AI 0.8 and HI 5.1. Hopefully that continues to improve.

One interesting thing. I woke up a few times during the night and checked my numbers each time. It was worse at the beginning of the night. The first time I checked my numbers, after about 3 hours of sleep, the AHI was at 7.5. It got progressively lower until morning, when it was 5.9. I don't know if that's typical for me (I don't usually wake up that often, let alone check my numbers each time I wake up), but it seems like the bulk of my events are at the beginning of my sleep. Weird.

Ziggy, glad you AI lowered nicely. I'd stay there a bit--I had AI last night of 0.0 again but HI of 3.9, haven't d/l my data yet but I feel awesome despite going to bed at 1am and waking up at 4am to tell my husband goodbye (he's going out of town for the weekend for the army) and then being woken up around 7:30 by the kids... so basically 6.5 hours broken up and I feel way better now than when I slept all night on straight CPAP for 8-9 hours. Unless my HI gets over 5 consistently I'm not going to worry about it. Resmeds tend to be more sensitive when counting those.

also, you should probably get the software and reader, it will show you what is really going on. how are your leaks looking?