Is EPR best avoided?

Pugsy wrote:

. wrote: To me that does not matter because a BiPAP is not the same as EPR. EPR is a limited bi level function, so you would not be comparing apples with apples. EPR uses a slower pressure change (more chance for an obstruction to occur ) whereas a BiPAP is a ventilatory device providing a faster response to expand and contract lung volume.

Really now?
Okay, here's a little test for you.
Spot EPR here...EPR is 3 and PS from a bilevel device is set at 3. Using your rationale find the EPR flow rate.
And BTW not all bilevel devices work like ventilators. In fact most do not.

I wish you luck and strength in your fight against the forces of ignorance and stupidity.

palerider wrote:I wish you luck and strength in your fight against the forces of ignorance and stupidity.

Oh, I am not going to fight anyone.
I hold no illusions that any of this will sink in and get anyone to actually think for a minute about just how far out there their logic is and how incorrect their thinking might be. They believe what they want to believe and really don't want to learn.
I am not going to argue about it ...just challenge anyone to find the one that is EPR because it is so frigging different than bilevel if you think that EPR and bilevel are two different animals.
Apples to apples 3 cm EPR to 3 cm PS...which one is which and if they are so frigging different they should be able to spot it.
That's all I am offering here. Proof of just how "different" they are or aren't.

Some people don't want to learn or change their archaic beliefs. I am not going to waste my time trying to get them to change.
It's not worth the effort or the headache or causing my blood pressure to rise.

Can a CPAP with an EPR at 3 provide the same therapy as a Bilevel machine at a similar setting at more than twice the cost?

Uncle_Bob wrote:Can a CPAP with an EPR at 3 provide the same therapy as a Bilevel machine at a similar setting at more than twice the cost?

That's not the question raised. You are trying to change the discussion to address cost instead of function. The discussion wasn't about cost or justifying the expense or anything to do with money.

You said that EPR and PS were 2 totally different animals.

Uncle_Bob wrote:To me that does not matter because a BiPAP is not the same as EPR. EPR is a limited bi level function, so you would not be comparing apples with apples. EPR uses a slower pressure change (more chance for an obstruction to occur )

All I am asking is can you spot EPR on the above examples since you think it is so different from PS?

Pugsy wrote:

. wrote:Can a CPAP with an EPR at 3 provide the same therapy as a Bilevel machine at a similar setting at more than twice the cost?

That's not the question raised. You are trying to change the discussion to address cost instead of function. The discussion wasn't about cost or justifying the expense or anything to do with money.

I wonder if he's ever ashamed at how stupid his posts are?

but, yes, a cpap with EPR at 3 provides the same therapy as a vpap auto at pressure support of 3, as long as ipap is 20 or less, at half the cost.

so, if you've been prescribed a bilevel with pressures under 20 and pressure support of 3 or less, perhaps the question that should be asked is "why"?

palerider wrote:yes, a cpap with EPR at 3 provides the same therapy as a vpap auto at pressure support of 3, as long as ipap is 20 or less, at half the cost.

so, if you've been prescribed a bilevel with pressures under 20 and pressure support of 3 or less, perhaps the question that should be asked is "why"?

And I agree and that's often why I will tell someone who is oscillating between ResMed AirSense/S9 cpap/apap and Respironics private purchase and don't have any idea what their pressure might be is to swing for the ResMed even if it is a little more money because that EPR/PS of 3 might come in handy. It's always better to have something and not need it than need it and not have it.

You and I both know the innards are all the same anyway...ResMed just wants to charge a small fortune for the plain VPAP firmware and they can get away with it. There's no reason in the world for the plain bilevels (or for that matter those really high dollar specialty) machines to cost as much as they do other than they charge what the market will bear.

At any rate...my question wasn't about justification of the cost difference...only the difference in function of EPR at 3 vs PS of 3 which I gather no one yet can spot any difference or they would have spoken up instead of deflecting to the cost difference discussion.

Do not forget that a bipap, and to a smaller extent, EPR, flex, whatever, may help reduce or eliminate aerophagia.
Just a tiny FYI . . .

chunkyfrog wrote:Do not forget that a bipap, and to a smaller extent, EPR, flex, whatever, may help reduce or eliminate aerophagia.
Just a tiny FYI . . .

Yeah but some people think it's a a bad thing to want or need to be comfortable so I guess they think that people with aerophagia issues should just grow a pair and suck it up. They look down on anything considered a "comfort" feature.....well aerophagia is a comfort problem. Using EPR to help with aerophagia discomfort is okay but it's not okay to use exhale relief for some other comfort reason? The logic doesn't hold up. Why is it okay to use exhale relief for aerophagia but not okay from simply liking it? Two different standards for a "comfort" issue.

Uncle_Bob wrote:

Jay Aitchsee wrote: It's a little more complex than that, depending on the nature, type, and cause of the Sleep Disordered Breathing and type of machine one has. Generally speaking

I was just referring to my own situation (words such as "I" and "my" etc) basic obstructive sleep apnea with prescribed CPAP.

Uncle_Bob wrote:Good for you. I wonder if you are itching to try an EPR of 4, 5 or 6?

Jay Aitchsee wrote:I would, as a matter of fact, but I don't have a bi-level machine.

To me that does not matter because a BiPAP is not the same as EPR. EPR is a limited bi level function, so you would not be comparing apples with apples. EPR uses a slower pressure change (more chance for an obstruction to occur ) whereas a BiPAP is a ventilatory device providing a faster response to expand and contract lung volume.

EPR also turns itself off during an apnea (which you possibly allowed to happen by turning ON EPR in the first place), in doing so its reacting to an apnea rather than preventing it. Not good.

In your first post in this thread you said,

Uncle_Bob wrote:EPR is a comfort feature. Not all xPAP machines even have it. I've would personally question my doctor if he wrote out an Rx with an EPR...
Getting off ramp and EPR is a sign of xPAP therapy maturity without having to juggle around with your pressure
~UB

Which implies that using EPR is a sign of xPAP therapy immaturity and one should strive to be rid of it as soon as possible. Several people, including myself, have taken exception to that implication in this thread.

Now, how about answering Pugsy's question and supporting your statements above regarding how EPR works compared to a bi-level with references? Remembering that EPR is a ResMed feature, I would appreciate references to the workings of ResMed devices only, please.

Thank you.

palerider wrote:

Pugsy wrote:

. wrote:
but, yes, a cpap with EPR at 3 provides the same therapy as a vpap auto at pressure support of 3

Thats all that was required. It should never hurt to ask a question, this is a place for learning is it not?

Also from our hosts web site cpap.com ...

So, if EPR reduces the expiratory pressure by a controlled 1, 2, or 3 centimeters, what is the difference between EPR and BiPAP (tm) or Bilevel?

Bilevel machines are categorized as "ventilatory devices". They use rapid pressure changes to expand and contract lung volume. EPR uses slower pressure changes, so there is little ventilatory effect. However, EPR does feel very much like a Bilevel to the patient.

Maybe you can direct your childish insults to the Goodmans and then see how long you last here?

Uncle_Bob wrote:

palerider wrote:

Pugsy wrote:

. wrote:
but, yes, a cpap with EPR at 3 provides the same therapy as a vpap auto at pressure support of 3

Thats all that was required. It should never hurt to ask a question, this is a place for learning is it not?

Also from our hosts web site cpap.com ...

So, if EPR reduces the expiratory pressure by a controlled 1, 2, or 3 centimeters, what is the difference between EPR and BiPAP (tm) or Bilevel?

Bilevel machines are categorized as "ventilatory devices". They use rapid pressure changes to expand and contract lung volume. EPR uses slower pressure changes, so there is little ventilatory effect. However, EPR does feel very much like a Bilevel to the patient.

Maybe you can direct your childish insults to the Goodmans and then see how long you last here?

I never even knew the little tird was just a child .... why, why that explains everything!

Thanks for the info.