Re: Skipping the rest of my Diagnosis (?)
Posted: Sun Apr 26, 2015 11:02 pm
EPR....Exhale Pressure Relief
where when you start to exhale the machine reduces the pressure by whatever setting you have chosen so that it's not so difficult to exhale. Some people like it, need it and wouldn't do without it and some people simply don't need it.
I used 10 cm pressure for a period of time without any exhale relief at all and then I got a machine with a little more advanced exhale relief and I found I really liked it. Do I absolutely "need" it...no but I found it made my breathing on the cpap machine a lot more natural feeling and easy so I continued to use it simply because I liked it.
Different brands of machines have different forms of exhale relief. For some one method might feel better than another way of offering that relief.
So with the ResMed machines EPR has 3 levels of pressure reduction 1, 2 and 3 with a setting of 1 there is a 1 cm reduction in pressure, a setting of 2 is 2 cm reduction and with a setting of 3 there is a 3 cm reduction.
Example: Suppose your prescribed pressure is 10 cm so the machine is set to 10 cm and you aren't comfortable exhaling against 10 cm so the EPR feature is turned on...at a setting of 1 the pressure during exhale is reduce from 10 to 9 and with a setting of 2 it's reduced from 10 to 8 and at at setting of 3 the pressure will reduce to 7 from 10 upon exhale.
The difference between inhale and exhale is called pressure support. Don't ask me why they call it that ...they just do.
ResMed cpap/apap machines have a maximum Pressure Support (PS) or that 3 cm reduction that EPR offers.
Bilevel machines offer greater than 3cm Pressure support. It is the difference between inhale and exhale that offers this "comfort" feature. For a lot of people that 3 cm pressure support is more than enough to be comfortable with and remember some people use less or none.
Some people find they need more than 3 cm for any number of reasons and that's when bilevel devices (BiPap is a Respironics marketing term for bilevel and VPAP is ResMed's marketing term) are sometimes needed. We have no way to know if you need a bilevel device at this time.
The reason I suggested the ResMed with EPR form of exhale relief is that it feels just like a bilevel machine would feel at 3 cm Pressure Support setting because that's how it works.
Respironics machines go about their exhale relief differently and the most you can get in terms of reduction is 2 cm and it's flow based so if you don't breathe forcefully you might not even get the full 2 cm. It isn't as dramatic of a reduction as the way EPR works. It's not crap though...I used Respironics AFlex relief for years and it's actually quite nice...but then I tend to adjust easily to just about anything.
There's no way for us to know which brand might suit you the best and since we don't even know what your pressure needs are going to be I suggested the ResMed because I know how it works and if you happen to need pressures in the teens I think (based on my past experience on how EPR feels and compared it to how a bilevel machine feels) that the ResMed's way of doing EPR would sort of cover all potential bases as best we can in this situation.
Qualifying for bilevel devices (for insurance to cover the cost) is a lot harder and there's going to be special requirements that need to be met. We don't know if you would meet those requirements or not.
This is where the titration sleep study comes in...you find out exactly what pressure you need and you have a starting point as to which machine you need.
CPAP/APAP machines offer single pressures up to 20 cm.
Bilevel devices offer dual pressures (that's when you have a separate pressure for inhale and separate for exhale) that go up to 25.
CPAP/APAP machines aren't technically bilevel devices but using the exhale relief available they can function to some extent like a true bilevel device and ResMed's exhale relief is more like true bilevel except you can only go to 3 cm difference whereas with a true bilevel you can have 4 or 5 cm (or more) difference between inhale and exhale.
It's the difference that offers the exhale relief.
Remember some people don't need any relief and some people do and some people just like it.
The difference between a 3 cm drop and a 4 cm drop isn't huge in how it feels and I think most people would/could do well with 2 or 3 cm drop.
Hence the recommendation for the ResMed...covering potential bases as best we can without knowing more about exactly what pressures you are going to need.
where when you start to exhale the machine reduces the pressure by whatever setting you have chosen so that it's not so difficult to exhale. Some people like it, need it and wouldn't do without it and some people simply don't need it.
I used 10 cm pressure for a period of time without any exhale relief at all and then I got a machine with a little more advanced exhale relief and I found I really liked it. Do I absolutely "need" it...no but I found it made my breathing on the cpap machine a lot more natural feeling and easy so I continued to use it simply because I liked it.
Different brands of machines have different forms of exhale relief. For some one method might feel better than another way of offering that relief.
So with the ResMed machines EPR has 3 levels of pressure reduction 1, 2 and 3 with a setting of 1 there is a 1 cm reduction in pressure, a setting of 2 is 2 cm reduction and with a setting of 3 there is a 3 cm reduction.
Example: Suppose your prescribed pressure is 10 cm so the machine is set to 10 cm and you aren't comfortable exhaling against 10 cm so the EPR feature is turned on...at a setting of 1 the pressure during exhale is reduce from 10 to 9 and with a setting of 2 it's reduced from 10 to 8 and at at setting of 3 the pressure will reduce to 7 from 10 upon exhale.
The difference between inhale and exhale is called pressure support. Don't ask me why they call it that ...they just do.
ResMed cpap/apap machines have a maximum Pressure Support (PS) or that 3 cm reduction that EPR offers.
Bilevel machines offer greater than 3cm Pressure support. It is the difference between inhale and exhale that offers this "comfort" feature. For a lot of people that 3 cm pressure support is more than enough to be comfortable with and remember some people use less or none.
Some people find they need more than 3 cm for any number of reasons and that's when bilevel devices (BiPap is a Respironics marketing term for bilevel and VPAP is ResMed's marketing term) are sometimes needed. We have no way to know if you need a bilevel device at this time.
The reason I suggested the ResMed with EPR form of exhale relief is that it feels just like a bilevel machine would feel at 3 cm Pressure Support setting because that's how it works.
Respironics machines go about their exhale relief differently and the most you can get in terms of reduction is 2 cm and it's flow based so if you don't breathe forcefully you might not even get the full 2 cm. It isn't as dramatic of a reduction as the way EPR works. It's not crap though...I used Respironics AFlex relief for years and it's actually quite nice...but then I tend to adjust easily to just about anything.
There's no way for us to know which brand might suit you the best and since we don't even know what your pressure needs are going to be I suggested the ResMed because I know how it works and if you happen to need pressures in the teens I think (based on my past experience on how EPR feels and compared it to how a bilevel machine feels) that the ResMed's way of doing EPR would sort of cover all potential bases as best we can in this situation.
Qualifying for bilevel devices (for insurance to cover the cost) is a lot harder and there's going to be special requirements that need to be met. We don't know if you would meet those requirements or not.
This is where the titration sleep study comes in...you find out exactly what pressure you need and you have a starting point as to which machine you need.
CPAP/APAP machines offer single pressures up to 20 cm.
Bilevel devices offer dual pressures (that's when you have a separate pressure for inhale and separate for exhale) that go up to 25.
CPAP/APAP machines aren't technically bilevel devices but using the exhale relief available they can function to some extent like a true bilevel device and ResMed's exhale relief is more like true bilevel except you can only go to 3 cm difference whereas with a true bilevel you can have 4 or 5 cm (or more) difference between inhale and exhale.
It's the difference that offers the exhale relief.
Remember some people don't need any relief and some people do and some people just like it.
The difference between a 3 cm drop and a 4 cm drop isn't huge in how it feels and I think most people would/could do well with 2 or 3 cm drop.
Hence the recommendation for the ResMed...covering potential bases as best we can without knowing more about exactly what pressures you are going to need.