Resmed EPR Settings Question

Slinky · Post by **Slinky** » Thu Jan 18, 2007 10:08 am

Which is the highest expiratory relief mode on a Resmed, 3 or 1???

Right now my EPR is set at 3. Before I try resetting it to 2 I'm curious whether I am setting it for MORE expiratory relief or less.

Thanks!!

Wulfman · Post by **Wulfman** » Thu Jan 18, 2007 10:31 am

I'm sure it's numbered like Respironics' machines in that 3 is the most relief and 1 is the least.

Den

Slinky · Post by **Slinky** » Thu Jan 18, 2007 11:18 am

Thanks, Wulfman. It will be interesting to see how several days to a week at an EPR of 2 compare w/this past week at an EPR of 3. We'll see if I need more or less relief for exhalation.

dsm · Post by **dsm** » Fri Jan 19, 2007 5:17 pm

Slink,

IIRC the 1 2 & 3 correspond with 1 CMS, 2 CMS & 3 CMS relief.

Cheers

DSM

Guest · Post by **Guest** » Fri Jan 19, 2007 7:17 pm

Thank you, Doug. My new pressure is 8 so with an EPR of 3, my exhalation pressure is currently 5 cms. So with low AI but still high HI do you think that an EPR setting of 2 bringing my exhalation pressure up to 6 cm might help?

I know others have mentioned here that w/a inhalation pressure of 8 most people shouldn't need any exhalation pressure relief. But given I have COPD I figured I should proceed cautiously.

I'm using the CL2 nasal cushion and as best I could determine the allowed leak rate at 8 cms it looked like the Standard mask setting might be more in line w/the CL2 cushion than the Swift. The first night at the Standard setting made no discernable difference altho last night (2nd night) there was. BUT I also slept in 3 separate sessions of a little over 2 hours each so I'm not sure but that I may have missed or had some delayed REM that could account for the lower HIs last night. I'm thinking 5-7 days should be enough before I lower the EPR setting to 2 to see if that improves my HIs if the mask setting makes no difference.

pedroski · Post by **pedroski** » Sat Jan 20, 2007 12:05 am

Which is the highest expiratory relief mode on a Resmed, 3 or 1???

Hi Slinky,

3 is the highest.

Peter

dsm · Post by **dsm** » Sat Jan 20, 2007 12:39 am

[quote="Anonymous"]Thank you, Doug. My new pressure is 8 so with an EPR of 3, my exhalation pressure is currently 5 cms. So with low AI but still high HI do you think that an EPR setting of 2 bringing my exhalation pressure up to 6 cm might help?

I know others have mentioned here that w/a inhalation pressure of 8 most people shouldn't need any exhalation pressure relief. But given I have COPD I figured I should proceed cautiously.

I'm using the CL2 nasal cushion and as best I could determine the allowed leak rate at 8 cms it looked like the Standard mask setting might be more in line w/the CL2 cushion than the Swift. The first night at the Standard setting made no discernable difference altho last night (2nd night) there was. BUT I also slept in 3 separate sessions of a little over 2 hours each so I'm not sure but that I may have missed or had some delayed REM that could account for the lower HIs last night. I'm thinking 5-7 days should be enough before I lower the EPR setting to 2 to see if that improves my HIs if the mask setting makes no difference.

Slinky · Post by **Slinky** » Sat Jan 20, 2007 5:04 am

Well, I'll tell you, DSM, after having had the RemStar Auto w/C-Flex loaner for close to 3 weeks, despite it didn't have much of a chance to show its stuff due to an ill-fitting mask and no heated humidifier several days (thanks to my DME, snort!), I liked the RemStar.

But - I like my Elite too. I wish we could combine the best qualities of both in a new line of xPAP machines! Since HIs and leaks seem to be my biggest problems I'm glad I've got and am using my Elite.

My sleep was much more fragmented on the Auto.

And, Peter, thank you too for your response. If it weren't for you guys and gals on this forum I sure wouldn't have the nerve to "experiment" like this. I should be able to accomplish more faster than trying to check every little detail w/my sleep pulmo who is okay w/this experimenting as long as I give each "tweak" at least a week and "tweak" gradually, no sudden drastic changes.

dsm · Post by **dsm** » Sat Jan 20, 2007 3:48 pm

Slinky

If I could get the best of each machine into one it would be

1) I really like the Respironics construction quality - IMHO it is the best of all
this includes the motherboard designs, the quality of components etc:

2) The PB silverlining software ease of use (EncorePro is a cow to install & change, AutoScan is good but Silverlining best)

3) The PB ability to put a quality solution into a small package - they win hands down & repeatedly

4) The Resmed mask menu - I don't bother trying to understand leak data on other brands

5) The Resmed HI accuracy

6) The Respironics heated humidifier (easier to fill than the Resmed one & the PB one is merely a clone of the respronics one)

Point being that each brand has good & not so good features.

But thnkfully we do have a good range to choose from.

DSM

Slinky · Post by **Slinky** » Sat Jan 20, 2007 3:53 pm

Thanks for that, DSM!!! I really wish I had the opportunity to try each of the different brands equivalent machines, just out of curiosity, just to see which one I really like best. The Puritan Bennet is one that I've wondered about but it is so hard to find meaty info from users on anything but the Resmeds and Respironics. *sigh*

Gotta go, granddaughter is gonna fry me if I'm late for the concert and her solo!!!!!

rested gal · Post by **rested gal** » Sun Jan 21, 2007 12:14 pm

Hi Slinky,

Hope your granddaughter's solo went wonderfully well!

And that your treatment is, too!

As for this:

dsm wrote:Over time and with lots & lots of independant testing I have concluded that Resmed machines (as untouchable as they seem to be here at cpaptalk (just look at the brainless *idiots* who call them Resmads)) are far more accurate when it comes to HI data. But this topc tends to start wars with some other regulars who get offended anytime someone praises some aspect of Resmed. Fact is I am impressed by both brands & it is a horses for courses choice BUT Resmed record HI data far more accurately than others.

Go for it

DSM
(let the predictable & regular attacks begin - I'm ready

Not an attack...just my opinion:

I don't know what "lots and lots of independent testing" means when a person is simply trying out a few machines at home. I don't know if conclusions about one machine being "more accurate" than another brand (regarding hypopnea reporting) would hold water -- no matter which direction it swirls down the drain.

As I understand it:

1. the sleep medicine profession itself doesn't agree on a single definition for "hypopnea."

2. each cpap manufacturer uses their own definitions for events.

If those two points are true.... then it's no wonder to me that events reported from one brand of machine (and the consequent HI reports) will be different. It's also no wonder to me that most people can get equally good treatment from either brand, regardless of whether one reports a higher HI and the other a lower.

That was the case for me when I used various resmed and Respironics machines, with their software...the resmed machine consistently reporting a higher AHI for me than Respironics machines...but receiving good treatment from either, going by how rested I felt in the mornings. The differences between the two brands in AHI, AI, HI that I saw did not lead me to conclude that one was reporting accurately and the other wasn't.

Slinky, my only caution about what you're reading here, helpful as much of it can be, is that blanket pronouncements such as: "BUT Resmed record HI data far more accurately than others" doesn't necessarily make it so.

As for the way some people approach testing machines at home, there's an older thread you can click below which might be enlightening. I'd pay special attention to the posts by a Guest on page 6 of the thread, who begins a reply to DSM with these words:

"The seemingly different data reported by both machines is likely accurate in both cases."

Dec 24, 2005 subject: Doing my own sleep study - surprising results Page 6

I'd also pay particular attention to the posts by ozij, neversleeps, and a Guest on page 7:
Same topic, page 7

Another interesting thread about different brands reporting different AHIs:
Jan 02, 2006 subject: is Resmed any good

Slinky · Post by **Slinky** » Sun Jan 21, 2007 12:28 pm

Ahhh, RG! Many thanks. There is little I accept as gospel. But there are those whose experience and opinions I do apply more credence to. In the end I have to do the exploration myself as much as possible. Only way to find out what works best for me. And that as you know isn't necessarily what is or has worked best for someone else.

Granddaughter's trumpet solo went well. I've been try to get her to try Bert Kempfert's rendition of Echo In The Night but haven't been able to find the darn sheet music for it.

Hey, if you remember what a crochety ole witch I was when I first started PAP therapy is going pretty well, but still needs a lot of tweaking to get "there", that hallowed ground of totally restful sleep!

rested gal · Post by **rested gal** » Sun Jan 21, 2007 1:04 pm

Slinky, so happy to hear the solo went well! I played the horn (French horn) in jr high and high school band. Many fond memories of those musical years!

Slinky wrote:There is little I accept as gospel. But there are those whose experience and opinions I do apply more credence to.

I figured you were able to sift through information with an intelligent eye. Hey, much of what I opine about is off the mark, too, but this is about the only way any of us can work on making our own treatment better -- digging into the message board to read about others' experiences.

Hope you keep seeing improvement.

dsm · Post by **dsm** » Sun Jan 21, 2007 4:11 pm

RG,

I guess you have evry right to question peoples testing & observations. But as in the thread on the APAP research where you questioned the French groups methodologies only to find out from SAG that any issue you raised had been dealt with and built into the research done by the Barcelona group & yet you still appear to ignore those researcher's efforts & regard them as flawed. (if not them please correct me as I remain under the impression you have not changed your stance despite SAG's posts). The point I am raising is the extent to which you as a lay person, disregard the efforts of global medical researchers and paint a picture here that you know better. What hope do my humble tests have if you choose to disagree with the outcomes.

Cheers

DSM

rested gal · Post by **rested gal** » Sun Jan 21, 2007 7:34 pm

DSM, you're mixing together two threads about two different things.

In this thread I was addressing only an "accuracy" conclusion you drew from your own home experiments.

If you want to talk about the Barcelona study it might be less confusing to address that over in the thread it appeared in:

viewtopic.php?t=16570
Jan 15, 2007 subject: An APAP Shootout (sort of) on Academic Journal