Expiratory Pressure Relief settings for ResMed AirSense 10

Need help setting up my EPR settings for ResMed AirSense 10 Autoset. This machine replaces a Remstar Plus C-Flex, which was able to lower the pressure during exhale to make that easier. The Remstar was set to 8, with a minimum of 5, and just ramped up top that level. The AirSense 10, however, is supposed to find the correct pressure automatically, up to the 8 maximum. It just goes up to 5.3 when I first put it on. The machine came with EPR disabled.

So how do I set EPR? The default is 1, but I don't know 1 what? If I turn it on, do I have to change the min and max pressure settings to somehow compensate? I just want the same lowering of pressure when I exhale. Thanks for any advice!

CPAPblows wrote:So how do I set EPR? The default is 1, but I don't know 1 what? If I turn it on, do I have to change the min and max pressure settings to somehow compensate? I just want the same lowering of pressure when I exhale. Thanks for any advice!

EPR lowers the pressure directly how ever many cm's it's set for. 1, 2 or 3.

it can cause more apneas if your pressure is set to just barely above what you need, for instance, if you need 8cm of pressure, and start having apneas at 7.5cm, (this is just an example, the human body is rarely so precise) and you set your epr to 1, then you'll have a pressure of 7 at the start of an inhale, and may have more apneas.

so, to prevent apneas there, you'd need to raise your pressure to 9, epr 1.

it's just a comfort feature, and it can't lower pressure below 4. the 5.3 starting pressure you mention is very low.

the best advice about EPR, since it's a patient comfort feature, is just to play with it, and see how it feels to you, and what feels best. it will provide up to around twice the exhale relief that cflex would at its max setting.

Thanks so much for your reply. You say, "so, to prevent apneas there, you'd need to raise your pressure to 9, epr 1." My concern is, though, that the AirSemse 10 isn't normally set to an exact pressure, but automatically finds the correct one, supposedly. So would it automatically compensate for the difference caused by enabling EPR? When I tested it, I was awake, so I have no idea about its normal operating pressure when I'm asleep. My original sleep study recommended 8. It seems like changing the maximum pressure threshold wouldn't make any difference with such a unit, except to change its maximum output.

So would it be correct fo simply turn up the maximum pressure by 1, if the EPR is enabled and set to 1?

CPAPblows wrote:\ So would it automatically compensate for the difference caused by enabling EPR? ...
So would it be correct fo simply turn up the maximum pressure by 1, if the EPR is enabled and set to 1?

no, it doesn't automatically compensate. it simply operates within the limits set for it.

it'd probably be a good idea to raise both the minimum and maximum pressures... but, again, experiment, download the data in sleepyhead, and see what's happening.

Ok. So originally, the device was in Auto pressure mode, the Max Pressure was (8), and Min Pressure (5). I turned EPR on, and set it to 2. Then I set the Max Pressure (10), and Min Pressure still (5) = since it can't go below 4. Does this seem like a good place to start?

CPAPblows wrote:Ok. So originally, the device was in Auto pressure mode, the Max Pressure was (8), and Min Pressure (5). I turned EPR on, and set it to 2. Then I set the Max Pressure (10), and Min Pressure still (5) = since it can't go below 4. Does this seem like a good place to start?

I think you should simply try different epr settings and see how they FEEL to *YOU*, instead of picking something arbitrarily.

it's meant to be experimented with, and then pick what you think feels best.

Thanks again for your help! I'll Post a Reply after I check out a few EPR settings.