C-Flex Confusion

I have been on CPAP for about 6 weeks, and have been following cpaptalk posts since I was diagnosed with OSA. The information I have received has been invaluable. This is my first post.

Since beginning CPAP, there has been improvement in that I am not as tired, but my asthma has become more difficult to control. I requested changing from a Remstar Plus to a Remstar Pro2 C-Flex CPAP with heated humidifier. This was authorized by insurance, but then they called me to say that this was the wrong machine - it is a Bipap not a CPAP. So they sent a new authorization for a "C-Flex CPAP machine with heated humidifier." Now I see on this site that the CPAP Pro2 is taking the place of the C-Flex CPAP, which is being discontinued.

Help! Isn't a Remstar Pro2 a CPAP? Isn't it the one I should get? I expect to hear from my DME within the next few days, and want to sound like I know what I'm talking about. Any input would be appreciated!

Thanks!

Nancy,

I don't know a lot about all the different machines, but I do know that if you have asthma you should not be using a BiPAP machine. That was one of the tests I had specifically because I had requested a BiPAP. They said that they had to be sure that there was no trace of Asthma or I would not be allowed to use a BiPAP.

Don't ask me why, that's just what I was told by the Pulmonologist.

- JB

Nancy
Have a quick look at the cpap.com pages for full details of each machine, but there is both a CPAP and a Bipap called Pro2.

Here are the pages:

Bipap https://www.cpap.com/productpage/1219

CPAP https://www.cpap.com/productpage/1620

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, cpap.com, CPAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, cpap.com, CPAP

Nancy,

Respironics has a model that is a CPAP called the Pro 2 and a BILEVEL called the BiPAP Pro 2.

C-Flex is a relatively new feature from Respironics that provides pressure relief during the expiratory phase of breathing. This feature is available on all newer models of their CPAPs and APAP. The BiPAP models have a similar feature called Bi-flex.

Does your current plus model have C-flex? You can tell by the blue C-flex sticker on the top of the machine. If not and you have trouble exhaling agaist the pressure, a machine with C-flex may help. A BiPAP would also help, but is a much more expensive machine. I would contact your Doc and clarify which machine you are suppose to get.

Thanks for the quick responses. I will check the links suggested and print out the info. Checking with the doc won't help, because he requested authorization based on what I specifically asked for as a result of reading info on cpap.com and posts on cpaptalk. I mentioned to my pulmonologist that I had been authorized to change to a C-flex machine, and he didn't know what C-Flex was. I know C-flex is fairly new, but he is supposed to be a sleep specialist, so I thought he would be more up-to-date!

My current machine is not a C-flex. I am eager to be contacted by the DME to see what they come up with!

Regards to all,
Nancy

As a fellow asthma sufferer, I do know that if you have UNCONTROLLED Asthma; you should not be on an Auto machine of any kind. It becomes too easy for the pressure levels to change and actually exascerbate your asthma. CFLEX provides some level of relief on exhalation. I will guarantee to you, that if you are in the throes of a serious asthma attack, the CFLEX CANNOT provide enough relief on exhalation. The normal course of treatment SHOULD be a BIPAP or a VPAP depending on the severity of your symptoms. The BIPAP provides one stable setting for inhalation and another stable setting for exhalation. I made a mistake with a straight Auto machine and thought I was going to die because I could not breathe against the pressure. I am presently using a Remstar Auto with CFLEX - it has worked for me most of the time but the settings are pretty tight and the CFLEX is set at 3. One thing I can suggest to you - find out if your sleep tech was a Respiratory Therapist. The average Sleep Tech cannot differentiate between a hypopnea and an episode of asthmatic breathing. You also need to find out if your sleep study was AUTO read or read by a real live human being. If it was AUTO read, as mine was, it is not worth the paper it is printed on. Your Pulmonologist probably received a 1 page printout of results with no acknowledgement of how asthma affected the results. I have just seen my Pulmonologist and was referred to a new Sleep Doctor so the results will be reviewed - which means the printouts and tapes. One thing my sleep study did indicate was that I had no episodes of apnea until they elevated the pressure to 8. My Pulmonologist told me that it was suspect and that they could have actually caused an asthmatic episode. So I suggest to you - do your homework. There is a lot of info out there about Sleep Apnea and Asthma. Ask questions, questions and more questions. If your asthma is getting worse, you are on the wrong machine or the settings are way off base. Good Luck! You are your best advocate! Also, beware of the DME and the insurance. They will try to stick you with whatever they want to clear out or whatever is the cheapest!! I made that mistake before I found this forum! Do not accept anything but the BEST!

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, cflex, Hypopnea, auto

2listless . . .

Thanks for the input. There is so much to learn, and very little information provided by the doctors, insurance, or the DME! I have found that I get the best information from this forum, a few internet sites, and staff from the company who performed the sleep study. They call periodically to monitor my progress, and report the info to the insurance company. The rep I spoke with most recently also has apnea and is on CPAP so at least she knows what I am talking about! That's more than I can say about the insurance or DME reps! I will continue to study and work toward getting the best treatment possible. I know I don't have to settle for inferior treatment, and have very good cooperation and support from my primary physician and pulmonologist. That, along with my persistence and follow-through will eventually result in my getting the treatment that is right for me. This forum is a wealth of information! I would know almost nothing if it weren't for all of you "users" posting such good info!

Thank you!!!!
Nancy

if you have asthma you should not be using a BiPAP machine. That was one of the tests I had specifically because I had requested a BiPAP. They said that they had to be sure that there was no trace of Asthma or I would not be allowed to use a BiPAP.

Don't ask me why, that's just what I was told by the Pulmonologist.

That's very interesting that the pulmonologist would say that, Judy, because it's been my understanding from what people with asthma post to the message boards that bi-level machines (BiPAP and VPAP) are the machines of choice prescribed by sleep doctors (including pulmonologists) for many asthmatics.

Quite a few with controlled asthma, as 2listless mentioned, have also posted that they did fine on straight cpap, on cpap with C-Flex and on Autopaps with or without C-Flex. I guess it depends on the individual, and the ability of either the patient or the RT to get the settings right. (Excellent post, 2listless!)

Judy, perhaps your pulmonologist's statement is tailored to your specific medical conditions, rather than a blanket statement against BiPAP for asthmatics in general? Seems hard for me to believe that BiPAP should be ruled out for asthmatics at large. The easier "breathing out" surely would be helpful, I'd think. But I'm no doctor. Don't have asthma either, so don't really know what a person with asthma goes through on any of these machines.

Good luck, Nancy, with your treatment.

Dear Rested Gal,

Thanks for the good wishes! I always enjoy your posts because your information appears to be well thought out and researched. I am still waiting to hear from the DME, but have back-up information from CPAP.com and Respironics support staff regarding their c-flex machines. It will be interesting to see what the DME comes up with considering the fact that insurance said a Pro2 is not a CPAP. Whatever they come up with, if it does not help, I'll keep on until I get something that works for me. It's a shame that we patients have to fight so hard and so often, but if we aren't our own advocates, who will be? The doctors have their hands full just keeping the insurance companies happy!!!

Well, I have rambled on enough and will get off my soap box now. Thanks again for your good wishes.

Nancy