New CPAP user need some help

[Sleepster]

True, there is a LOT of .... jargon.

Here's Apnea Board Wiki on sleep apnea acronyms:

http://www.apneaboard.com/wiki/index.php...Acronyms#E

[zonk]

On CPAP machines it is best to raise the pressure setting an equal amount to compensate for the EPR. If using EPR of 3, best to raise CPAP pressure by 2 or 3. Sleep doctors are just beginning to learn this.

Not according to ResMed: http://www.resmed.com/us/products/s8_eli...s&sec=true

Event Detection Circuit
The Event Detection Circuit is a backup feature of the EPR algorithm.

Changes in a patient's sleeping position or sleep stage (ie, REM sleep) may cause sudden, unpredictable events to occur without the typical preceding flow limitation or snoring. When such an event is detected, EPR immediately suspends, and the treatment pressure reverts to set CPAP. EPR remains suspended until the event concludes and normal breathing resumes.

EPR Timeout
If a patient's exhalation period exceeds 15 seconds, EPR immediately suspends. The treatment pressure reverts to set CPAP and remains suspended until the next inhalation phase is detected.

EPR helps patients experience the highest level of comfort and benefit from their therapy

[Sleepster]

I think you're right, Zonk. The usual practice is to keep the pressure setting the same regardless of the EPR setting. If it were necessary to raise the pressure it would be evidenced by an increase in the OA or hypopnea indices.

[SuperSleeper]

On CPAP machines it is best to raise the pressure setting an equal amount to compensate for the EPR. If using EPR of 3, best to raise CPAP pressure by 2 or 3. Sleep doctors are just beginning to learn this.

Howdy Vaughn, I'm wondering what the thinking is behind raising pressure to compensate for EPR?

It would seem to me that since EPR only affects exhalation pressures and not inhalation pressures, so there would be no need to adjust CPAP pressure, as the delivered inhalation pressure would remain the same on a constant-pressure CPAP, whether EPR was set to 3, 2, 1 or completely off.

[Sleepster]

Howdy Vaughn, I'm wondering what the thinking is behind raising pressure to compensate for EPR?

I've heard the same thing about BiPAP pressures. That the exhalation pressure has to be set to the patient's required prescription pressure, and that the inhalation pressure can be set higher. And that therefore there's no benefit to BiPAP therapy over CPAP therapy.

As far as I can tell this is just bogus, even though we heard it from a doctor on a video that was posted here some time ago.

[archangle]

Iwanttosleep, we need to know what particular machine you have. "ResMed S9" isn't enough info. It should say something like Elite or AutoSet next to the power button.

If you want to sleep on your side, it may help to get one of those long "body pillows" that's about 4 feet long. Grab it between your knees and hug it with your arms.

Sleeping on your back is just fine with CPAP as long as your AHI is low. You might need a slightly higher pressure if you sleep on your back. If back sleeping works best for you with CPAP, do it. Not everyone has worse apnea on their back.

Don't worry about the embarrassment of wearing the mask. At 40, your body will be handing you more and more embarrassment in the near future.

[archangle]

As I understand it, sometimes EPR or bilevel may cause an increase in AHI. The problem is probably that when the pressure drops, the airway may collapse on exhale. It may be necessary to increase the exhale pressure, either by increasing the total pressure, or reducing the difference between inhale and exhale.

I think most people DON'T have this problem, but some people find EPR or bilevel has an unexpected effect.

[SuperSleeper]

As I understand it, sometimes EPR or bilevel may cause an increase in AHI. The problem is probably that when the pressure drops, the airway may collapse on exhale. It may be necessary to increase the exhale pressure, either by increasing the total pressure, or reducing the difference between inhale and exhale.

I think most people DON'T have this problem, but some people find EPR or bilevel has an unexpected effect.

Okay, that sheds more light on this for me. I seem to remember that on some machines, there was an additional calibrating setting that would either speed up or reduce the reaction time for an EPR or bi-level pressure change, which might help reduce airway collapses on exhale when using those two features. Can't remember what that was called, however.

[Sleepster]

As I understand it, sometimes EPR or bilevel may cause an increase in AHI. The problem is probably that when the pressure drops, the airway may collapse on exhale.

If that were true presumably you'd see an increase in the hypopnea or OA index. Instead what you see is an increase in the CA index.

Raising the pressure will probably make that worse. In my case they lowered the pressure to fix the problem.

[iwanttosleep]

I've abandoned the Swift FX (Nose Pillows), and went back to the Mirage FX (Nasal Mask) which the doctors used when I did my CPAP evaluation. HUGE difference. With Swift FX, I was at an AHI of 6 (same as no machine) with the Mirage last night the AHI was 0.3!!! I feel much better. Now I just need to stop playing video games at a normal hour to get a full night's sleep.

:-)