Does EPR make a noticable difference?

For those of you with machines with EPR (or have used EPR in the past), does it make a noticable difference when exhaling? My pressure is set at 8, but i was having lots of difficulty exhaling. The next step is the EPR.......going in on Tuesday for a new machine. Not sure what they will give me, but tech. said it would have EPR...thanks!

I am completely addicted to my EPR.
I've had it on since day one. (nearly 2 years now)
It makes it comfortable to breathe out.
Otherwise, I feel like I'm on a car trip, riding next to the dog.

So, does the EPR work on CPAP mode only? What are your pressures?

EPR can be a miracle, or it can be useless or even counterproductive.

How long have you been doing CPAP? You should rapidly adapt and probably won't even notice a pressure of 8 after a few weeks, even without EPR.

With a pressure of 8...I wouldn't think most people would need EPR. It's usually people with higher pressures that have trouble exhaling against high pressures. The EPR reduces the pressure by 1-3 on exhale. Use of EPR sometimes causes a higher AHI.I.

My pressure is at 8, and the 2 nights that I turned off EPR and the ramp, I slept 1-2 hours. Put the EPR at 2 and the ramp back on and have slept much better. I do believe that once I become more accustomed to the device I can probably trun off the EPR.

EPR is a very personal thing--what works for one may not work for another.

My best advice would be to try EPR at different settings and look at your data. If you are more comfortable with an EPR setting, USE IT. You may need to teak your pressure up a bit to compensate for it, or you may not. That's the beauty of having data to look at.

There is no need to try and get used to your machine without EPR if you feel that you are struggling to breathe out....it's there for your comfort, and comfort is what allows us to continue to use our machines.

I played around with my EPR settings and discovered that I slept best and had the best AHI using my EPR at 3. Find your own sweet spot. It takes a bit of playing with the settings, but it is well worth it in the long run.

Weezy

I have a ResMed S9 with H5i humidifier, set for 7.0cm2 and I don't use EPR at all. I did when I first got it and my AHI's were high so I stopped using it and the AHI's dropped like a rock. I may try again someday, but if it's not broke...

I was using straight 8 mbar CPAP for nearly three years. I _could_ live with that, but felt that 8 was the personal max and _wanted_ the pressure to be lower. On one occasion the sleep lab set the pressure to 9 mbar and I could not bear that at all and came back after two weeks begging to bring it back down to 8 mbar. Then I had 7 mbar for about 8 months. That was even better. But now I have the S9 autoset and I tried EPR in settings 1 up to 3. The AHI values might be a _tad_ higher sometimes with EPR3, but I sleep so much better and have much less problems with mouth leaking. Even EPR2 does not cut it for me and EPR1 is nearly useless. So I would say, yes it can make a _big_ difference!

If 8 mbar are "o.k." might also be different for different folks, because the reasons for OSA are different and also the weight is often not the same. My BMI is about 26.3 and maybe for someone with a BMI above 30 a higher pressure is needed _and_ a pressure of 8 might still feel low? But not for me. 8 seems to be the max I can bear.

I just tried to _lower_ the Auto range for my machine from 6 - 10 to 5 - 8 (not in one step) and it's even better from the values and from my sensation -- still with EPR3.

Regards
Joyce

Thanks for all the responses.
I have been using the machine for 3 weeks. I can not get used to the exhale. It feels like I am having to work at getting my breath out. I too am getting 2-3 hours of sleep per night, max...... I will go to the DME on Tuesday, as they will have a machine with EPR for me to try. I know 8 seems low to many, but I too feel it is my max. I guess we are each different....and have to find what works for us

chopper06 wrote:Thanks for all the responses.
I have been using the machine for 3 weeks. I can not get used to the exhale. It feels like I am having to work at getting my breath out. I too am getting 2-3 hours of sleep per night, max...... I will go to the DME on Tuesday, as they will have a machine with EPR for me to try. I know 8 seems low to many, but I too feel it is my max. I guess we are each different....and have to find what works for us

That is certainly true.

What you need to know is -
for example IF 8 is the pressure which eliminated ALL of your events but when the pressure drops to 7 or 7.5 you begin to have events again. You need to watch your data and make notes of how you feel to find this out.

When using EPR at a pressure of 8 and the EPR reduces the exhale pressure to say 7 or 7.5 you are not doing yourself any good. You will then need to increase your inhale pressure to compensate for that drop. You may need to increase your pressure to 9 or 10 even.

Does this make any sense to you? I hope it does cuz that is what happens and many do NOT realize they are still having events and desats ALL nite long. Then wonder why their machine isn't doing anything for them.

Monitor your data daily until you get to the right setting for YOU. A data capable machine is required for this. It is not practical to bring the card to the DME daily and they will not be checking it daily even IF your machine has a modem.

Remember - "If it is to be - it is up to me". unk.

Good Luck

I do think the EPR is helping my conscious, and possibly subconscious, mind adapt to this new contraption on my face. Last night I believe I encountered "REM rebound" since I slept longer than I can recall for quite some time with very vivid dreams (something I almost never do), and was quite groggy for a while after waking up.

Hi Gumby,
I am actually confused by your post. When I had my sleep study, my events were eliminated when pressure was set at 8. When I was at 5, 6, and 7 I had events. When I went up to 9 I also had events.
I thought the key was to keep your airway open (during inhalation). If my pressure is set at 8, why will the EPR bring it down?
Thanks for your help.......

So, does EPR affect pressure setting?

chopper06 wrote:Hi Gumby,
I am actually confused by your post. When I had my sleep study, my events were eliminated when pressure was set at 8. When I was at 5, 6, and 7 I had events. When I went up to 9 I also had events.
I thought the key was to keep your airway open (during inhalation). If my pressure is set at 8, why will the EPR bring it down?
Thanks for your help.......

Because EPR does in fact reduce (drop) the pressure by 1,2,or3. Do a search of the forum if you are still confused but it will put you in the pressure arena you mentioned above.

It sounds like you are also having centrals. Did you forget to mention that? Do you have a copy of your sleep study? Your prescription?