Does epap effect on cpap and apap

[unidee]

Apnea glossary says: EPAP - (Expiratory Positive Airway Pressure) - The pressure prescribed for the expiratory (breathing out) phase of an individual on Bi-level CPAP therapy for OSA (obstructive sleep apnea).

Does epap effect only with BiPAP machines? Or does it effect to APAP mode (ResMed AirSense 10)?

[Bweekzzz]

Hi Unidee. The Airsense 10 has what I like to call a faux EPAP setting in either APAP or CPAP mode. It's the EPR setting and can be set to 1,2 or 3 and decreases your pressure by 1,2 or 3 when you exhale. It is kind of like a Bi-level, but the Bi-level can be set to a much wider range between IPAP and EPAP. From what i've learned on here the Airsense 10 EPR is much closer to a true Bi-pap EPAP than the Respironics machines Flex setting, but still not a true, true Bi-pap that lets you set a wider range. Hope that helps.

Brian

[unidee]

Great thanks to you! Your answer made me understand the thing I was wondering about. So, if I look charts EPAP is just 3 steps lower than the main pressure. And nobody can increase more steps to it.

And if someone (not me!) suffers that breathing out is hard he or she ought to use BiPAP.

[Bweekzzz]

Right.  Whatever you setting on EPR is will always be the difference between IPAP and EPAP.  If your IPAP pressure in APAP (also Straight CPAP mode) mode at any given time is 13 and your EPR is set to three your EPAP on that breath/area/time will be 3 times lower equaling 10.  Same goes for setting 1 and 2.  If you have EPR set to 0 or off there will be no difference between IPAP and EPAP.  You can only get TRUE bi-level from a bi-level machine, which like I said can be a much bigger range between IPAP and EPAP.  

                                                                       Brian

[Bweekzzz]

I'll let the experts weigh in on the whether they should switch to bi-pap or not.  I'm not really qualified to give the answer to that one, but from what I'v learned so far is that, GENERALLY, yes that would be a possibility if they are having trouble exhaling, but it could also be because they're IPAP pressure is too high and even with the max setting of EPR of 3, it might not be enough of a decrease in pressure on exhale due to the IPAP being too high.  Like I said though, I'll let the experts weigh in on that question.  


                                                                Brian

[SarcasticDave94]

I'd say Brian's correct. When I had moved onto a standard BPAP, it was because of higher pressure required (18 or more), and the complaint that I felt difficulty exhaling. So if you feel like BPAP is needed, complain your little heart out until they surrender.

PS BPAP and me didn't play well. My mixed apnea status needed ASV. Note BPAP may not play well if you've got a moderate or higher central apnea count.

[unidee]

My apnea therapy goes well with APAP. AHI are quite often < 1.0 or < 2. But I asked that because I told to about 6000 finnish cpap users when few of them complained of difficult exhalation. And I didn't know how it worked either. Now I know and the few complainers know. 

I checked that BiPAP costs 3 - 5 times than APAP (Resmed AirCurve 10 vs AirSense 10).

[SarcasticDave94]

Yes, the price difference can be astounding in how different it is. That's the foundation of why most start on CPAP or APAP. And that these cover the therapy needed for over half the apnea sufferers on PAP.

[Gideon]

The other thing to remember is that it is EPAP pressure that splints the airway for OSA. In a plain CPAP without EPR, Pressure = IPAP = EPAP
You may need to accommodate this fact if you change EPR