Exhale Pressure Relief (EPR) - Could you do without?

heck no, got have it..
set on three..

still a struggle..

Have it, not turned on.

If you got it use it. Why not? It makes the experience more comfy. I started at 1 (i.e. -1 cmH2O) and now use it at 3. Seems to work great for me. Love it. My AHI is pretty close to 0.0 most nights and always under 1.0 at the highest (and I am shocked when that happens).

Or, in the alternative you could just inhale and not bother exhaling but I'm not sure what would happen in that situation. Just make sure the curtains are nailed down.

And do not sleep facing away from your partner on your side. Jeez.

Y'know gang. I've been through 5 machines with EPR in the past few months... and I would almost swear that each and every one provided a different level of exhalation relief based on the same setting of 3 (i.e. -3 cmH2O)!! The wee ResMed Escape that MediGas screwwwwwwwed me for sits in the family room unobtrusively and set at -3 but it still seems to shove a load of air into me when I exhale. The S8 Autoset II's were much better and I could swear that the S9 Auto's don't do a thing at all but reduce the pressure overall. Go figure.

I am most comfy with the S9 Auto's but that doesn't mean that they are working the way they are supposed to be.

Again.. why NOT use EPR? If it sustains a better night of sleep, why not? Next step is to get my SaO2 up into the mid ninety's to see if that helps.

Fredman wrote:I am just wondering if you could do without EPR if you already have it? Have you ever tried using a unit that does not have EPR? Obviously, everyone is different and may or may not be able to adjust easily without EPR.

I have always had it with my machine, even originally titrated with the same machine. Now, I qualify to purchase a new unit and I am intrigued by the two units produced by Fisher and Paykal the SleepStyle 254 or the ICON Auto both utilize the Sensawake algorithm that senses when you are waking and lowers the pressure. It appears that neither of them have EPR.

I am not sure if not having EPR will be a deal breaker or not even if Sensawake, I am hoping will help me stay asleep at night. I appreciate your thoughts on this...thanks!

I have to ask the obvious question!
Can't you turn it off at your machine and try it, or is it always on whether you like it or not??

Rogue Uvula wrote:

Fredman wrote:I am just wondering if you could do without EPR if you already have it? Have you ever tried using a unit that does not have EPR? Obviously, everyone is different and may or may not be able to adjust easily without EPR.

I have always had it with my machine, even originally titrated with the same machine. Now, I qualify to purchase a new unit and I am intrigued by the two units produced by Fisher and Paykal the SleepStyle 254 or the ICON Auto both utilize the Sensawake algorithm that senses when you are waking and lowers the pressure. It appears that neither of them have EPR.

I am not sure if not having EPR will be a deal breaker or not even if Sensawake, I am hoping will help me stay asleep at night. I appreciate your thoughts on this...thanks!

I have too ask the obvious question!
Can't you turn it off at your machine and try it, or is it always on whether you like it or not??

Apparently I can turn off the C-Flex (EPR). Certainly that will provide me with part of the answer. The second part is if I can do without C-Flex, will Sensawake possibly provide a better experience? I generally wake up to the machine blowing hard and having to hit the ramp button...So if C-Flex is not an issue, I am willing to try the Fisher and Paykel units with Sensawake.

I got the S9 Elite because I requested EPR --Otherwise I would have gotten an S8 Escape.
I cannot image not having it.
It takes my 14 cm down by 3 cm, and works WITH me on this sleeping business.

I have never used EPR even though my 2 machines support it.

I haven't tried EPR because after 15 months I still can't get AHI down to a reasonable level. I don't have any problem exhaling (even with my minimum pressure set to 17), and I don't want to add another variable to the mix.

Fredman wrote:

Rogue Uvula wrote:

Fredman wrote:I am just wondering if you could do without EPR if you already have it? Have you ever tried using a unit that does not have EPR? Obviously, everyone is different and may or may not be able to adjust easily without EPR.

I have always had it with my machine, even originally titrated with the same machine. Now, I qualify to purchase a new unit and I am intrigued by the two units produced by Fisher and Paykal the SleepStyle 254 or the ICON Auto both utilize the Sensawake algorithm that senses when you are waking and lowers the pressure. It appears that neither of them have EPR.

I am not sure if not having EPR will be a deal breaker or not even if Sensawake, I am hoping will help me stay asleep at night. I appreciate your thoughts on this...thanks!

I have too ask the obvious question!
Can't you turn it off at your machine and try it, or is it always on whether you like it or not??

Apparently I can turn off the C-Flex (EPR). Certainly that will provide me with part of the answer. The second part is if I can do without C-Flex, will Sensawake possibly provide a better experience? I generally wake up to the machine blowing hard and having to hit the ramp button...So if C-Flex is not an issue, I am willing to try the Fisher and Paykel units with Sensawake.

That is what the Sense Awake is for. If your pressure gets high enough to wake you up it lowers so you don't wake up. It stop the waking up to a hurricane blowing in your face or you mask farting on your face.

I think that on the S9 elite it can be turned down or even off.
Just not sure whether it is patient or 'clinical' adjustment--As long as I'm comfortable, it doesn't matter to me;
but it is good to know that I can check how I can deal with it-- if I were to consider a travel or emergency machine without it.
But, since BCBS won't spring, that would be out of pocket 100%. Well, not this year. . .

My use and need for pressure relief technology became evident during the titration phase of my sleep study in 2003.

The technician told me the next morning to be sure that the Rx stated that I required a pressure relief capable machine. They found that my best responses were on a setting of '2' (for a Respironics machine), and he also advised me of the different acronyms used by manufacturers for pressure relief technology so that I would not be confused.

Both my legacy Remstar and the M Series were on settings of '2,' and since I was doing so well I decided not to change the setting.

When I recently purchased the PR1, I was curious about A-Flex, and decided to give it a spin. Yuck...I didn't even make through one night. I found the pressure changes and delay very disconcerting.

I'm back on C-Flex (2), but just for giggles, I may try dropping it back to '1' just to see how I tolerate it, and whether it has any impact on my stats.

I used my old machine last night with the EPR. I really woke up a lot more without the Sense Awake. I like the epr but if I had to make a choice I would have to go with the sense awake.

jdm2857 wrote:I haven't tried EPR because after 15 months I still can't get AHI down to a reasonable level. I don't have any problem exhaling (even with my minimum pressure set to 17), and I don't want to add another variable to the mix.

I have an S9 and I need to have the EPR set to 3 to keep my AHI down. I do not feel that I have to use it as my pressure is low at 7-8 cm but if I do not use it i see an increase in centrals (at least the last time i checked).

I agree with the idea of throwing in to many variables too soon or all at once. But after 15 months you might want to give it a try

I used CPAP for many years before C-Flex or EPR were available. I used C-Flex a couple years three machines back, but eventually learned that I slept better without it. My most recent two machines support EPR, but months of experimentation clearly showed that I have fewer apneas and sleep better overall without it, so I don't use it.