EPR turned off

Hello. I have the Resmed AutoSet II and was able to access the clinician's menu thanks to this site I wanted to turn off the alarm that sounds when there is a major leak (it scares the dog and I pretty much know when the thing is leaking!), Anyway, is there any reason that the RT would have the EPR turned off? I thought that one of the major benefits of this machine was to be able to use the EPR in the auto setting.
Would there be any harm in me turning it on and would I notice the difference? My AHI is 16. In about 3 weeks the RT will be contacting me to read the data on my machine for insurance purposes etc. Thank-you

If your equipment order (script) didn't include an EPR setting the RT wouldn't have turned EPR on. Its your therapy, do as you please. If you want to try EPR go ahead and try it. Understand that the download printout will reveal that you have turned EPR on. But who's to say the RT will even remember what your setting was supposed to be? Or that he/she will even look at the download other than the compliance data? As far as whether you will notice any difference or not - again who is to say? Only you will be able to answer that when you try it. You might well notice the difference. There's only one way to find out.

What is your Leak rate? A high AHI "could" be the result of or contributed to by a high Leak rate. Whilst these xPAPs can compensate quite nicely for leaks w/in a reasonable range (up to 24 L/M if I remember correctly) a high Leak rate does mess w/your pressure needs and if this AutoSet is being used to more closely determine your pressure need(s) you could end up w/a pressure higher than what you actually need which can cause even higher leaks and AHIs and it becomes a vicious cycle.

I'm also not sure what effect, if any, EPR would have on the determination of your pressure needs if this AutoSet is being used to more closely titrate your pressure needs.

Thank-you for your quick response. I did not know that EPR had to be indicated in the rx. I was concerned that if I made a change the RT might know that it was not something she did, especially if she refers back to the rx.(which you addressed). I don't want to compromise my insurance reimbursement in any way so "I'll jump through their hoops for now".

I used the same machine I have now for 2 weeks through a sleep center and the readout after 53:13 hours of usage indicated a leak rate of 0.18l/sec (leak 95% centile)-I have no idea what that means, whether that was high or low but, that was also using a nasal mask vs. the full face mask I have now. As I haven't had my data read yet, I don't know the current leak rate.

My AHI of 16 was determined at the initial sleep study. I did not return to that same sleep center for a titration study (its a long story) so that is why this other center gave me a trial on their machine. During that trial my AHI was 3.7 events per hour.

My current rx is for a setting of 4-12. During the trial the max pressure was 16 and the minimum was 4.

Ah, gotta LOVE these Resmeds. You can access your Leak rate & etc. W/O accidentally or intentionally changing your therapy sessions by a simple button press IF access to the advanced patient menu has been turned on. Try this:

Press the Left and Right buttons and hold for 3-4 seconds. Efficacy Data will appear on the LCD screen. From there on in it is a simple matter of pressing the Left button to Enter, the Right button to Exit, the Up button to return to the previous screen and the Down button to proceed to the next screen.

If Efficacy Data doesn't appear on the LCD screen then access to the advanced/detailed patient menu hasn't been turned on. To turn that access on you have to be able to access the Clinicians Menu. In the Clinicians Menu you CAN accidentally or intentionally change your therapy sessions - which is NOT such a good idea during this trial period. However, if you want to turn that access to Efficacy Data menu on and we tell you how to access the Clincians Menu I am going to STRONGLY SUGGEST that you have a pen and paper handy and WRITE DOWN everything that shows up on each LCD screen BEFORE you make ANY changes or proceed to the next screen or push any button! That way, if you do accidentally - or intentionally - change any of your therapy settings you will KNOW what to set them back to correctly. I would STRONGLY suggest if you opt to go this route that you change ONLY the SmartData to ON. That will grant you access to the advanced/detailed patient menu. I seriously doubt that the RT will notice whether SmartData was turned on before or after you got this loaner AutoSet.

95th percentile means the pressure (or leak rate) AT OR BELOW which you spent 95% of the night.

Once you've completed this "loan" of this AutoSet I hope you are fortunate enought to be able to convince the local DME supplier to provide you w/one. But if not, INSIST on the Resmed S8 Elite w/EPR or the newer Resmed S8 II Elite w/EPR. Other than not being an APAP they'll give as good therapy AND the same data and data access.

Good luck!!!

Hello again. Sorry if I was not clear-I have completed my trial period and did obtain a resmed auto set !! despite being convinced by a RT and sales person at 2 DMEs that I should get the regular CPAP. I get very lucky: I had reached "out of pocket" costs for the year so with my machine and mask did not have to pay any copays and only had to pay $100 for the autopap (whew!!) but I had to do this all by today as my deductible starts all over again. It pays to advocate for yourself!! (this comes easily for me as I am a caseworker in my profession)

I am nervous about making any other changes esp after your last post, until the RT is satisfied that I am compliant with my therapy. I guess she will meet with me the first time in about 2 more weeks. I have only changed the mask setting on my machine and turned off the alarm. So, she will probably see I accessed the clinician's menu-we'll see. I am going to push for her to obtain a rx for the EPR. Thank-you for all of your help

caffeine please wrote:I thought that one of the major benefits of this machine was to be able to use the EPR in the auto setting.

Well, its not a generic major benefit per se... some users see a significant treatment benefit from having EPR available (usually in terms of being able to get used to using xPAP), for others it makes no difference one way or the other, and some users are disturbed by the change in blower speed as EPR "works" (S8s are very quiet, but some users are just hypersensitive to ambient noise change, even when the sound pressure levels are very low)

The overall AHI number you indicated is fine (anything 5.0 or lower is consdiered "normal "sleep) and the leak reat is OK (I suggest aiming for 0.10 or lower over time) so it seems that you are already doing OK.

Cheers,

Bill

So I've been using my S8 Elite II for two weeks now, I feel I've really lucked out with good equipment after just being diagnosed. I think it helps to be in Canada -- the government pays a portion of the CPAP equipment, and the rest is usually covered by whatever insurance you get at work. So my DME suggested the top of the line Resmeds since I won't have to pay a dime. Took me about a week to get used to the Swift LT but now I really feel quite comfortable to it and don't at all feel the CPAP is hard to use. I've been tracking my efficiency data daily and have also tried fiddling with the pressure settings. My DME had me set at 7.0 but I've tried a couple nights on 8.0 and also 9.0, but my AHI's don't seem to change much. They always vary, sometimes as low as 5.0 but others up to 10.0. Tonight I took a lie down for only 30 minutes and the unit reported an AHI of 6.0 (AI was 0). What do you guys think of these numbers?