I need a way to get higher exhaled pressured relief (EPR)

[Pugsy]

You should turn this around on them. "One steady pressure is training wheels. When you become skilled at riding CPAP, you can stay upright on the bicycle in fluctuating winds."

Training wheels implies childish and that really pisses me off.
What I object to is "training wheels" analogy of any sort.

[ChicagoGranny]

Training wheels implies childish and that really pisses me off.
What I object to is "training wheels" analogy of any sort.

Training wheels are a mistake. My children and grandchildren were taught using balance bicycling. You take the pedals off and lower the seat so that both feet touch the ground. The kids learn to balance quicker at a younger age. Then you put the pedals on, and they learn to pedal quickly and want the seat raised to a normal level. My great grandchildren will start soon.

https://en.wikipedia.org/wiki/Balance_bicycle

[Arlene1963]

I found that with 2 distinct pressures (one for inhale and one for exhale) that I actually slept about an hour longer. For me that extra hour made a huge difference in how I felt.

So exhale relief is a comfort feature....and in my book we need to be comfortable to sleep and if exhale relief helps us fall asleep faster...that's the goal of the therapy...sleep. Anything that helps us attain that goal is fair game to do or use.
Some people actually need it. They simply can't exhale against the pressure and they can't go to sleep fighting the pressure.

Some people think that if something is "only a comfort" feature that it isn't part of the therapy but I don't feel that way. Being comfortable is a necessary part of therapy IMHO.

My exact experience after experimenting with turning EPR off and then back up to EPR3 over a few months.

It would be interesting to see what variables affect how different people respond to varying EPR levels. Looking at tidal volume, minute ventilation, respiratory rate ....that's one of the reasons I enjoy looking at SH charts posted here and trying to see if there are any common features in what folks report.

[ChicagoGranny]

that's one of the reasons I enjoy looking at SH charts posted here and trying to see if there are any common features in what folks report.

+1

[allen081644]

Google -- 'VIDEO FOR how I can change the exhale setting on my?????? 'I learned from my vendor that they are not legally allowed to change the settings to something other than what your prescription specifies. I went online, like I am telling you to do, and changed my exhale setting to a level that was comfortable for me. You will probably have to make a couple changes to get it the way you like it.

[metal36]

Okay, here is my update. I have slept with CPAP for 4 nights at home. Three nights at 8cm, with EPR of 3cm. Then the last night at 10cm with EPR of 3cm. The first night I was experimenting with the machine a lot, so I deleted the data. I used an average of 7.8 hours. (Mind you, that I spent about 10 hours in bed each night). I had on overall AHI of 9.2.

So 9.2 is a lot higher than what was seen in either of my sleep studies. And I do feel more tired using the CPAP. My conclusion is that present usage is just making things worse.

One thing I noticed is that I am not sleeping prone, even though I sleep prone a lot without CPAP. This is because the nasal pillow presses a little on the head pillow, which transfers some forces that cause more obstruction of the sinuses. So if CPAP is going to be viable in that position, I definitely need a higher pressure. So my inclination is to go to my doc and tell him to give me the AirCurve Auto BPAP model, so that I can get:

1. A wide pressure support to increase the volume of my shallow breaths
2. A very low EPAP setting (as low as 3cm with that model) so I can exhale as much of my lungs as possible.
3, An auto feature that makes me more able to sleep in prone position, where I need more pressure.

I also noticed what I wonder may be a malfunction. If I inhale very slowly, I can feel at one instant the pressure dropping (I presume the EPR kicking in), even though I am not finished with the inhale. As I then continue the inhale, that momentary pressure drop goes away. But I think it is enough to possibly wake me. I wonder if this is just the algorithm misinterpreting a very slow breath and reaching the peak of inhalation.

Also, one night I slept without auto climate control or auto tube temp. This night I had rainout. The nasal pillow was making a lot of noise, which I think must have been water being blown around inside. Also, the pressure was going haywire. I think the presence of water must have in some way confused the machine. I had to stop using the CPAP that night, at that point.