Yesterday, 10:46 AM
Why I don't like EPR
I know EPR is almost universally recommended here, but I want to share why I personally don't like it (for me). This is not meant to persuade anyone to stop using EPR. That's my point entirely, use what works for you! Others may be struggling with EPR and see this and find benefit.
1) Comfort - yes, the main reason EPR is recommended is comfort. I don't find it comfortable... at all. Pressure in and the lack of pressure out feels odd to me. The mask gets an inflating/deflating rhythm going that I don't like at all.
2) Leaks - that same rhythm tends to cause more leaks for me
You can think of EPR as pressure support setting your IPAP higher to eliminate flow limitation, but for me I would rather just raise the EPAP.
In fact, I find the flow rate (not the pressure) even at 4cm to be uncomfortable.
VCOM lowers the flow to something I can tolerate and reduces leaks. This alone can reduce central apneas. There is no inflating/deflating bounce in the mask. A slight pressure relief on inhalation feels more comfortable to me. I would love if these machines would just let us set IPAP and EPAP wherever we want (within reason).
Feel free to disagree with me. If EPR is helping you, that's great. I have seen people "working up" to higher EPR though and to me it makes no sense. If EPR feels weird to you don't use it. There are 4 phenotypes that play into sleep apnea and we are all a different mix. Even just in anatomy no two of us are the same.
1) Comfort - yes, the main reason EPR is recommended is comfort. I don't find it comfortable... at all. Pressure in and the lack of pressure out feels odd to me. The mask gets an inflating/deflating rhythm going that I don't like at all.
2) Leaks - that same rhythm tends to cause more leaks for me
You can think of EPR as pressure support setting your IPAP higher to eliminate flow limitation, but for me I would rather just raise the EPAP.
In fact, I find the flow rate (not the pressure) even at 4cm to be uncomfortable.
VCOM lowers the flow to something I can tolerate and reduces leaks. This alone can reduce central apneas. There is no inflating/deflating bounce in the mask. A slight pressure relief on inhalation feels more comfortable to me. I would love if these machines would just let us set IPAP and EPAP wherever we want (within reason).
Feel free to disagree with me. If EPR is helping you, that's great. I have seen people "working up" to higher EPR though and to me it makes no sense. If EPR feels weird to you don't use it. There are 4 phenotypes that play into sleep apnea and we are all a different mix. Even just in anatomy no two of us are the same.
Breathe through your nose
Reduce sugar and processed food
Soft collar and seal your mouth
Reduce sugar and processed food
Soft collar and seal your mouth
