CFlex setting on Remstar Auto

Sleepless on LI · Post by **Sleepless on LI** » Thu Jul 28, 2005 2:02 pm

Hi, all. Just picked up my Remstar Auto w/CFlex today from the DME (mine to keep!!!). He set the CFlex setting at CFlex 1. However, from reading other threads here, I see some people have theirs set at 2 or 3. What is the difference and should I be at 1 instead of 2 or 3? I am so new to this machine right now that I am probably going to be a bit confused. I ordered the software and reader, too, but it hasn't arrived as of yet. Can hardly wait for that to see if how I'm feeling has any correlation to the fact that my episodes at night have either stopped entirely or greatly decreased.
Thanks for any help you can offer.

Wulfman · Post by **Wulfman** » Thu Jul 28, 2005 2:58 pm

Hi Lori.

Set to 1, there is no relief on exhale, set to 2 there is more relief, and the setting of 3 offers the most relief for exhaling. If they have you at a high pressure setting, you may need some relief. If you're set at a lower pressure, it'll still probably help to have a little relief. It's something that you'll have to determine for yourself.....but at least it's available if you need or want to try it..

Best wishes to you with your new machine and therapy.

Den

WillSucceed · Post by **WillSucceed** » Thu Jul 28, 2005 3:23 pm

Set to 1, there is no relief on exhale, set to 2 there is more relief, and the setting of 3 offers the most relief for exhaling

Close, but no cigar. Set to 1, there is minimal relief, 2 is more relief, 3 is the most relief. These numbers, according to Respironics, do NOT mean that a C-FLEX setting of 3 is 3 points of pressure relief. For example, if your pressure is 10 and your C-FLEX is 3, your exhalation pressure is NOT 7. It is just the most relief that C-FLEX can give no matter what the pressure is set to. 3 just means 'most' relief while 1 means 'least' relief.

If you have a RemStar and you want no relief on exhale, you have to go into the clinical menu on the RemStar and turn C-FLEX off. On the screen, you would see CPAP instead of CFLX.

There are several users on this forum who have commented that at low pressures (6, 7, C-FLEX does not offer much relief at all. This may be because there is not much room to lower the exhalation pressure.

As Rested Girl will be happy to tell you, C-FLEX and I are not great pals. During the process of struggling with C-FLEX, I learned alot about it and how it works. For those for whom it works, it's great; for those for whom it does not, ppfffffttttt!! By the way Rested Gal, please don't hate me for not loving C-FLEX!

Sleepless on LI · Post by **Sleepless on LI** » Thu Jul 28, 2005 3:35 pm

Wulflman, thank you! I hope this machine is as great as everyone says it is. Can't wait to get my software and card reader and see what is going on with my nights. Software should be here Monday. Then I can only imagine the questions I'm going to post on this site...you poor people!

Hi, Will. How are you? Now I have another question (far be it for me not to be loaded with them...). I am set at 10, so the DME put my auto at 5-15. He set the CFlex at 1.
I also just got a Swift with the machine today and don't know if I'll need much relief on exhale. Never had a problem with my Activa and the Breeze, which I got rid of, was eh-okay on exhalation. Seems a bit harder to exhale with nasal pillow systems. But wouldn't it be wise to take as much relief as one can get and just set it on 3 regardless or do you lose something in the therapy if you are making it easy to exhale? Is that a dumb question? I don't know.
If I choose to change the setting from 1 to 2 or 3, would you know how to do this? The DME told me not to change the settings myself, but...he told me the opposite of what everyone else is telling me, which means he is not very familiar with this machine. Do you know how you would change the Cflex from 1?
Thanks!!!

SickAndTired · Post by **SickAndTired** » Thu Jul 28, 2005 3:53 pm

Like Will said, the CFlex setting is in the clinical menu. To get to this menu, unplug the machine, hold down the left & right buttons while plugging it back in, and continue to hold them until the screen stops changing (takes a little longer than I was expecting).

Once you are in the clinical menu, things should be pretty self evident. Use the left & right buttons to move through the various items and use the up & down buttons to change the value for an item.

If the machine is set to one of the auto-pap modes (AFLEX or AUTO, I believe) then make sure that the "Ramp" item is set to 0!!! The RT at my DME was so unfamiliar with the RemStar that she set the ramp to 3 hours and it took me nearly a week to figure out, with the help of the software, that I wasn't being treated for 40% of the night! To learn why, do a search on "split night study".

As for the CFlex setting to use... personally, I started with a setting of 2, figuring that if it bothered me, I'd lower it to 1, and if still bothered, I'd turn it off. I personally enjoyed the exhalation relief so much that I upped it to 3, which I liked even more.

But remember, as in everything else, YMMV (your mileage may vary)! <grin>

Sleepless on LI · Post by **Sleepless on LI** » Thu Jul 28, 2005 5:58 pm

S&T,
THANK YOU!!! I went into the clinical settings and changed the CFlex setting like you said, but the DME, who I had a feeling wasn't familiar with this machine too well, had the ramp set for 4.00. I will presume that meant four hours. So I, like you, would have been missing some of the night with the setting at 4.00, if that's what it means. I set it for 0.00. I don't need the ramp since it's on auto anyway, according to him. I guess he just didn't set it correctly. Thanks for the tip.
When I put the machine in standby mode by turning off the power button, though, CFlex still says 1, but in the clinical mode it shows as a 2. Does your display do that, too? I kept doing it a few times and it kept telling me the CFlex was set at 2, but when the power is off (but not unplugged), it shows as a 1 in the display window. Guess that's normal???

dsm · Post by **dsm** » Thu Jul 28, 2005 6:00 pm

This is a great feature. I currently run my RemStar with a CFLEX setting of 2 (I am as of yesterday on a 13cms setting - I started at 15 then 14 now 13 - too much air entering body).

If u ar on high pressure (as I was) the setting of CFLEX 3 seemed too high. The machine noise bothered my wife & I was suspicious that a lot of my air ingestion was caused by the rapid run up when at a high cms and cflex of 3.

I switched to 2 and that seems fine. I may go to 1 tonight as I think that will be ok to.

Cheers & good luck

DSM
(PS incase the Q gets asked - I am participating in a research project & have agreed to run my APAP in CPAP mode for the duration).

Sleepless on LI · Post by **Sleepless on LI** » Thu Jul 28, 2005 6:14 pm

DSM,
But in your display window without the air turned on, does it show CFlex 1? Mine does, even though in the clinical menu is it listed as set for 2.

rested gal · Post by **rested gal** » Thu Jul 28, 2005 6:20 pm

C-Flex is for comfort. Users can access the settings for C-Flex without getting into the clinical menu. All they have to do is hold down the ramp button and the humidifier button at the same time (be sure to press ramp button first, then add the humidifier button.) They can then set C-Flex on 1, 2, or 3.

But to turn C-Flex completely OFF or ON, you do have to get into the clinical menu...unplugging the machine at the back, holding down the right/left arrow buttons while plugging it in, etc.

Sleepless on LI · Post by **Sleepless on LI** » Thu Jul 28, 2005 6:36 pm

RG:
Can you tell me why my display still shows CFlex 1 though??? I figure you'll know the answer...

rested gal · Post by **rested gal** » Thu Jul 28, 2005 7:27 pm

I don't know, Lori. I just now went in to look at the display on my REMstar Auto with C-Flex to see what it says:

The total hours the machine has been used is displayed. Mine says 1048.3

There are some words down under the number of hours:

Led Cflex Card

It may just be coincidence that the word "Cflex" is sitting directly underneath the .3 in the hours 1048.3. That juxtaposition makes it look like it's saying Cflex is set for "3". However, I've been using C-Flex on 2 for almost a week now.

If I do the ramp+humidifier button thingy, then use the right arrow button to get to the C-Flex setting, it shows "2" for C-flex, exactly as I set it several days ago.

I don't know where my user manual is. The "home health care provider setup instructions" are at hand, but I don't see anything about the user's display window stuff in the clinical instructions. Perhaps someone else can tell both of us if the "3" I'm seeing is .3 in the hours or really a "3" over the word Cflex.

Sleepless on LI · Post by **Sleepless on LI** » Thu Jul 28, 2005 7:58 pm

Thanks, RG, for the reply. You've got the home healthcare manual? They didn't give me that, just the end user's manual. But that's okay. I know already what to do now if I have to get into the clinical setup. I won't mess around with it, though. I just wanted to change the C-flex setting up from 1. I guess as long as it's comfortable tonight, I won't need to address this issue again. And so far, I think I am going to like the Swift. It is incredibly quiet and the only thing I see a problem with off the bat is the face strap that comes down, feels a bit rough where it ends before the place where it holds the barrel. But no leaks at all so far...I know, that's what I said about the Breeze before I slept with it. But this one doesn't have to push your nose out of whack to get it to be leak-less. I'll see tonight after trying it out. Two new things tonight, the machine AND the mask...oh, boy
I did have a question of someone of your experience, though, back to the machine for a moment. Did your ramp setting in the clinical menu say 0 or 3 or 4? I did set mine to zero on purpose now figuring that you don't use a ramp if you're using auto. No? Thought that made a lot of sense when Sick & Tired wrote that. What's your opinion?

rested gal · Post by **rested gal** » Thu Jul 28, 2005 8:28 pm

SickandTired told it exactly right. "Split Night" treatment when in auto mode means the machine will use a minimum pressure for those first hours. You get NO treatment -- actually it blows the minimum pressure of 4 during those hours -- not at all a therapeutic pressure for most people. The machine simply records what's happening to you, and doesn't begin using the pressures you need until the first hours of the "split night" are finished.

Set the ramp for zero when using the REMstar Autopap in autopap mode (APAP) or autopap with C-Flex mode (AFLE). Never, never, never set ramp for any time other than 0 in those two modes unless you just want to do a split night out of curiosity. Been there, done that, deliberately...heheh. The data for that night was not pretty.

Here's what it says about that, word for word, from the Home Health Care Provider's Set-up Instructions booklet:
_____________________________

Set the Ramp Time
f. The ramp time will appear

Range: 0 to 45 minutes (5 minute increments) for CPAP or C-Flex.

Settings of 2, 3, or 4 hours are also available, but they are only available if the device is in Auto-CPAP or Auto-CPAP with C-Flex therapy for the Split Night therapy.

Note:
For Auto-CPAP or Auto C-Flex therapy, set the time to "0".

For CPAP or C-Flex therapy, if prescribed, set a ramp time between 5 and 45 minutes. If you do not want ramp, set the time to "0".

For Split Night therapy, set a time of 2:00, 3:00, or 4:00 hours.

To change the ramp time, press the ramp or humidifier button until the correct time appears. If you do not want ramp, set the time to "0".

Press the right user button to go to the next setting.
____________________________________________

Sleepless on LI · Post by **Sleepless on LI** » Thu Jul 28, 2005 8:43 pm

Thanks again, RG. Now I have to go and make sure he set it for Auto with CFlex. I guess he did, though, if it shows Cflex in the display...oy!!!