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TURNED EPR OFF! - Michael Shaw - 09-16-2019
[attachment=15536] So on August 2, 2019 I turned my EPR OFF. Results are attached. AHI and total time in apnea were significantly reduced. I have attached my chart. So the reason I turned off the EPR was for and experiment to see if it would reduce the number of times that I wake up during the night. Of course Oscar does not track that but I have gone from waking up 2-3 times a night to 1 time a night. Comments/additional insights are always appreciated! And of course I feel the need to say, "These are my results your results can and will vary!"
RE: TURNED EPR OFF! - Michael Shaw - 09-16-2019
Oh I forgot to mention my EPR was set to 3.
RE: TURNED EPR OFF! - mesenteria - 09-16-2019
Ain't success grand?
If it continues to go swimmingly, you should eventually see some improved signs of general well-being, maybe even some notable improvements in memory, mood, how often you have to rise to go to the washroom at night...who knows. Those arousals you were experiencing were very likely holding you back some.
RE: TURNED EPR OFF! - Sleeprider - 09-16-2019
From what I'm seeing here, your pressure was set to 7.0 to 17.0 with EPR 3. Event rates have steadily improved and you find turning off EPR is less disruptive to your sleep. There is not a remarkable change in event rates, but your 95% pressure has stabilized at a lower level since this change and maximum pressure seems to be lower. For some reason flow limitations have stabilized at a pretty low rate since 8/1. Most importantly, this is working for you, and your results are excellent. Glad to hear comfort and better sleep has followed, and that is really the objective.
Leaves me wondering what a minimum pressure of 10 with EPR at 2 or 3 would be like from a comfort point of view.
RE: TURNED EPR OFF! - sheepless - 09-16-2019
that's great. I would note that you had some low ahi days before August 2, beginning after July 25th. I'm curious if you did anything else before July 26 that might have also helped bring down your ahi or do you think it was all due to turning epr off? I guess you could test that by turning it back on but unless you're really curious, why mess with a good thing?
RE: TURNED EPR OFF! - Michael Shaw - 09-23-2019
The only thing I did that I can contribute to the AHI level decreasing was turning off the EPR which was originally set at 3.
RE: TURNED EPR OFF! - Michael Shaw - 09-26-2019
I forgot to mention that one of the reasons I turned the EPR off was because of Jason's (TheLankyLeft27) video https://www.youtube.com/watch?v=84LkXFETkt8 it is at time stamp 8:30 that he starts talking about turning EPR or Flex off. For me it appears to have been good advice.
RE: TURNED EPR OFF! - DaveL - 09-28-2019
Michael thanks for your comment and link. Good video.
I'm going to turn EPR off.
Dave
RE: TURNED EPR OFF! - Sleeprider - 09-28-2019
While I agree with LeftyLankey on Flex "being more trouble than it's worth" or "super-dumb", I strongly disagree that EPR is the same animal. We have effectively reduced flow limitations and hypopnea with the use of EPR, and of course in many cases improved comfort. While the super-dumb Flex is often poorly times and makes matters worse, EPR is a true bilevel limited to 3-cm and follows the user's breathing, rather than predicts it.
I respect what is being attempted in this video, but the settings need to be considered on a case by case bases, and if you have worked with knowledgeable people on EPR to reduce flow limits or hypopnea, chances are you will make a mistake by accepting this one answer for all approach in this simplified video. LeftyLanky is also very familiar with bilevel, and that is what an Autoset does in a limited way. We know some people will develop CA events or discomfort with ERP, so individual consideration of its use is important. That said, I think more people benefit from EPR than are disadvantaged by it. If it works for you, you probably already know it. Flex on the other hand predicts trigger and cycle on a Philips CPAP and is often poorly times or results in inadequate support of the airway. This problem is compounded by the slow or non-response of a Philips Auto to flow limitation.
Bottom line, if you are setting up a machine for the first time, this is a great video. If you have worked with EPR and Flex and know what works for you for comfort and efficacy, this video is mostly targeted at making new users familiar with CPAP controls.
RE: TURNED EPR OFF! - DaveL - 09-28-2019
Thank you.
Great explanation.
I don't want to hijack this thread. I appreciate the OP's post.