How to get used to EPR setting?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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jlsmithseven
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How to get used to EPR setting?

Post by jlsmithseven » Mon Jan 30, 2023 6:23 pm

Hi,
So when I started therapy in Nov. 2021 they put me on 4-20cm with every comfort item setting checked. Shocker right. Anyways, I've slowly started optimizing my pressures with help of others here. I start on either 7 or 8cm and let it go to about 11cm if it needs to. I was on EPR 3 forever and slowly transitioned to EPR 2 and it just feels so much better and I have way less central apneas this way. Only issue is the EPR3 setting helps my aerophagia a lot better. I tried going to EPR 1 on various settings and it just feels like way too much. How do some people not use EPR at all, I feel like I can't exhale and just need to keep inhaling big breaths.

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ChicagoGranny
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Re: How to get used to EPR setting?

Post by ChicagoGranny » Mon Jan 30, 2023 6:34 pm

jlsmithseven wrote:
Mon Jan 30, 2023 6:23 pm
How do some people not use EPR at all, I feel like I can't exhale and just need to keep inhaling big breaths.
That is when you are awake and trying to consciously control your breathing. Try to distract your mind from your breathing. When sleeping, odds are you will breathe gently and rhythmically.

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jlsmithseven
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Re: How to get used to EPR setting?

Post by jlsmithseven » Mon Jan 30, 2023 7:07 pm

ChicagoGranny wrote:
Mon Jan 30, 2023 6:34 pm
jlsmithseven wrote:
Mon Jan 30, 2023 6:23 pm
How do some people not use EPR at all, I feel like I can't exhale and just need to keep inhaling big breaths.
That is when you are awake and trying to consciously control your breathing. Try to distract your mind from your breathing. When sleeping, odds are you will breathe gently and rhythmically.
Right I understand that part. I've used RAMP Only a few times, but I feel like it leads to more events than just using FullTime EPR 2. I know therapy pressure drops 2cm each breath and it doesn't with it off. Essentially I read that if I start with 8cm pressure and EPR 2, I might as well just do 6cm pressure with EPR off and it's the same thing correct?

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Miss Emerita
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Re: How to get used to EPR setting?

Post by Miss Emerita » Mon Jan 30, 2023 9:06 pm

jlsmithseven wrote:
Mon Jan 30, 2023 7:07 pm
I know therapy pressure drops 2cm each breath and it doesn't with it off. Essentially I read that if I start with 8cm pressure and EPR 2, I might as well just do 6cm pressure with EPR off and it's the same thing correct?
Not quite the same. With EPR, you get a little boost when you inhale. For some people, that helps with flow limitations and hypopneas, which in turn helps them sleep better.

Without seeing a chart, it’s hard to know how to advise you. If you’re having only a few obstructive events, you could try lowering you maximum pressure a little to help with aerophagia.
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ozij
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Re: How to get used to EPR setting?

Post by ozij » Mon Jan 30, 2023 11:04 pm

jlsmithseven wrote:
Mon Jan 30, 2023 6:23 pm
I was on EPR 3 forever and slowly transitioned to EPR 2 and it just feels so much better and I have way less central apneas this way.
How did you transition "slowly" from EPR=2 to EPR=3?

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palerider
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Re: How to get used to EPR setting?

Post by palerider » Mon Jan 30, 2023 11:10 pm

ozij wrote:
Mon Jan 30, 2023 11:04 pm
jlsmithseven wrote:
Mon Jan 30, 2023 6:23 pm
I was on EPR 3 forever and slowly transitioned to EPR 2 and it just feels so much better and I have way less central apneas this way.
How did you transition "slowly" from EPR=2 to EPR=3?
You grab the knob, and *VERY VERY SLOWLY* turn it from 3 to 2. :lol: :lol: :lol:

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ozij
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Re: How to get used to EPR setting?

Post by ozij » Mon Jan 30, 2023 11:14 pm

palerider wrote:
Mon Jan 30, 2023 11:10 pm
ozij wrote:
Mon Jan 30, 2023 11:04 pm
jlsmithseven wrote:
Mon Jan 30, 2023 6:23 pm
I was on EPR 3 forever and slowly transitioned to EPR 2 and it just feels so much better and I have way less central apneas this way.
How did you transition "slowly" from EPR=2 to EPR=3?
You grab the knob, and *VERY VERY SLOWLY* turn it from 3 to 2. :lol: :lol: :lol:
:lol:

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robysue1
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Re: How to get used to EPR setting?

Post by robysue1 » Tue Jan 31, 2023 5:24 pm

jlsmithseven wrote:
Mon Jan 30, 2023 6:23 pm
I was on EPR 3 forever and slowly transitioned to EPR 2 and it just feels so much better and I have way less central apneas this way. Only issue is the EPR3 setting helps my aerophagia a lot better. I tried going to EPR 1 on various settings and it just feels like way too much. How do some people not use EPR at all, I feel like I can't exhale and just need to keep inhaling big breaths.
You just explained why EPR is so important to many PAPers: EPR allows many PAPers to exhale more comfortably and more completely instead of feeling like the machine is forcing them to inhale more and more and more air---air that they don't want or need to inhale.

Some PAPers, including me, have so much trouble exhaling normally even with EPR = 3, that we wind up being switched to a bilevel machine where the difference in pressure between inhalation and exhalation can be set to more than 3 cm. For example, my current AirCurve 10 VAuto settings have a PS = 4, and I need that much of a drop in pressure in order to not feel like the machine is forcing me to inhale more air than I want or need to inhale.

There is no reason for you to think that you need to reduce EPR from 2 to 1 with a goal of eliminating it entirely. Use the EPR setting that works for you: If the aerophagia is manageable and the number of centrals is way down when you use EPR = 2, then just keep EPR = 2: If it ain't broke, don't fix it.
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