Newbie what does my RX mean

[Poprouge]

Hi newbie disabled veteran, getting my CPAP from the Veteran's administration. My prescription is CPAP @10 CM H2O W/C-FLEX OF 3CM OF H2O, and I'm curiuous as to what it means. From what I found online I get the 10cm is the actual setting or air pressure. But I'm confused as to what C-Flex of 3 cm means, and how it works?

Thanks for the input, my appointment is next week and want to make sure I'm getting what my doctor is prescribing.

[Julie]

The C flex is an option on your machine ( called EPR for exhalation pressure relief on others) that you can set if you feel the need to whatever setting you choose - many of us don't need it so turn it off altogether... it's just what EPR says, if you have trouble exhaling against your pressure setting. But as I said possibly the majority don't. And the higher setting of 3 may give you a higher AHI (Apnea Hypopnea index) reading, which is not terrible, as the difference is usually very small, but it worries people on occasion. Curious why you were put on straight Cpap vs Apap, when Apap machines [i]can[/i] do plain Cpap, but give you more options as well for your therapy... you might want to ask about that.

[Pugsy]

CFlex is the Respironics brand name for exhale relief...the pressure drops during exhale.
On the ResMed machines it is called EPR..which is Exhale Pressure Relief.

The 3 is the highest setting for exhale relief on regular cpap/apap machines...so the greatest available drop during exhale.
Suppose to make it easier for you to exhale against the pressure.
Some people like it and some don't. It's considered a comfort feature that you can alter or turn off ...whatever feels the best for you.

Respironics machines don't do a straight across the board per cm drop...the actually amount of drop will depend on how forcefully you breathe...If you tend to breathe rather shallowly you won't get as much of a drop as if you breathed more forcefully. The setting of 3 on a Respironics machine won't equal 3 cm...it can't...Respironics machines have a max of 2 cm drop at that setting of 3 and even that will depend on how you breathe.

So...CFlex or AFlex ...are just terms for exhale relief so that breathing is easier and more natural for you.
If you use ramp and the pressure starts at 4 cm...there is no exhale relief because the machine can't go below 4 cm.
It's considered a comfort feature and something you can adjust if you need to or want to.

[robysue]

Hi newbie disabled veteran, getting my CPAP from the Veteran's administration. My prescription is CPAP @10 CM H2O W/C-FLEX OF 3CM OF H2O, and I'm curiuous as to what it means. From what I found online I get the 10cm is the actual setting or air pressure. But I'm confused as to what C-Flex of 3 cm means, and how it works?

Thanks for the input, my appointment is next week and want to make sure I'm getting what my doctor is prescribing.

Adding to the basic information that Julie already told you.

Your machine is running in straight CPAP mode, meaning that it does not automatically increase or decrease the pressure during the night in response to events. Most sleep docs start patients out with straight CPAP. Double blind studies seem to indicate that patients do as well on straight CPAP as APAP, but there's a lot of anecdotal evidence (particularly around here) that many patients do prefer APAP mode to CPAP mode.

10cm is the pressure setting. If you had a titration study done, 10cm is what the tech who ran the test determined as the appropriate pressure setting to control your apnea. It should be regarded as a starting point: Many people need pressure adjustments or a switch to APAP or both before they get everything optimized.

"C-Flex of 3cm of H2O" is a garbling of two different exhalation relief systems.

C-Flex is available on Philips Respironics machines. It can be set to 1, 2, or 3, but the setting is not equal to the amount of pressure relief. Instead the setting number controls how fast the pressure returns to 10cm and where in the exhalation the pressure starts to return to 10cm. The amount of pressure relief is determined by both the forcefulness of the exhale and the C-Flex setting. But at any setting, the maximum pressure relief is about 2.5cm.

EPR is available on Resmed machines. It can be set to 1, 2, or 3 and the setting equals the amount of pressure relief on each and every exhalation. If EPR = 3, then the pressure is reduced by 3cm at the beginning of every exhalation.

So to make sense of your exhalation relief system, you need to determine whether you have a Philips Respironics machine or a Resmed machine.

Finally: Many people do find exhalation relief a very important comfort feature. If the current setting feels natural and does not bother you, I'd suggest leaving it alone. If, however, you feel like the machine is somehow rushing you to inhale or not allowing you to inhale fully before the pressure drops, then turning the exhalation relief system down or off is a reasonable experiment.

[Poprouge]

Curious why you were put on straight Cpap vs Apap, when Apap machines can do plain Cpap, but give you more options as well for your therapy... you might want to ask about that.

I have no idea. I'll see the VA CPAP clinic next week and wanted to understand what was being prescribed so I could ask these types of questions. I'll besure to ask.

[chunkyfrog]

Thank you for your service.
I hope the VA does not stick you with a "brick".
That would be a shameful way to treat a veteran.

[Poprouge]

Thank ya'll very much. Gives me a much better idea of what's being recommended. I don't have an idea what machine I'll be given, I'm sure it will be based on what the VA has a contract for. I was sent outside the VA for the sleep study (Choice Program for Vets when VA does not provide the service) and the VA is acting as DME for that study. So glad I found this forum.

[Poprouge]

Thank you for your service.
I hope the VA does not stick you with a "brick".
That would be a shameful way to treat a veteran.

LOL from what I understand it's usually a decent piece of equipment. My mom and dad both needed CPAP, my mom's was from traditional insurance and daddy used the VA, mom told me they were given the same exact unit. Mom's is pretty small and quiet, so I'm not overly worried. It's been my experience that I get pretty decent medical gear when it's needed. Sorta like a fair, good, better, best scale, we typically get better.

[Pugsy]

Thank you for your service.

From what we see with other veterans getting machines through the VA they normally will at least get a full data cpap machine (fixed mode only) but from what I have seen most of them end up getting an apap machine but maybe set in fixed cpap mode.

Once you get your machine come back and tell us the model name you see or the model number (usually on the bottom of the blower) and we can tell you which machine you have.
The RX as written points to a Respironics brand machine...it's the only brand that uses the term CFlex but whoever supplies the equipment could maybe supply a ResMed machine with EPR and still technically fulfill the RX requirements.

CPAP mode...fixed single pressure
APAP mode...auto adjusting single pressure

As written your RX is for fixed pressure but often the VA supplies a machine that will also do apap mode (so it's like 2 machines in one)...apap machines have the 2 modes but cpap only machines only have the one fixed mode.

[Guest]

from what I understand it's usually a decent piece of equipment.

Get your equipment and supplies from the VA. If you can afford it consult an outside sleep doc if they won't refer you under the Choice program and depending on your location they may not. The reason for the doc will be only if you need a different model for some reason. If you get an auto you are in.

You can get all the info you will need on how to use or adjust your cpap and how to read your data right here in this forum. It will take some time for reading and learning how to use your cpap to fine tune your treatment.

You may not get someone at the VA to help you understand the use of the cpap and the data but do not worry all that is here. You landed in a good spot.

Welcome aboard. Thank You for your service.

I don't think it's proper to say Happy Veterans Day but do what you can to enjoy the day.

[chunkyfrog]

Every veteran who makes it home whole is a blessing--all those who are lost, we remember.
Those who are broken, we must do everything possible to restore.

[Poprouge]

Every veteran who makes it home whole is a blessing--all those who are lost, we remember.
Those who are broken, we must do everything possible to restore.

Completely agree. While I was in the military I had to cross train from my original AFSC due to migraines, it was an automatical medial disqualification from ATC. But they crossed trained me into Personnel. I worked as the Castuality assistance clerk for a few years before leaving service. As depressing as that may seem, it was my job to assist the widows/widowers after the death of an Active duty or retiree member. Many of the widows that I served became like my grandmother. While both jobs were high profile and high stress, and my mission with ATC was more directly a part of the wing mission, I got more gratification and warm fuzzies knowing the help I was providing my widows. The Military has a long tradition of taking care of our own. And the VA is a vital part of that, it's a promise that we all made to our Veterans. I hate seeing when something goes wrong, but I'm grateful to see the improvements moving forward in VA health care. I want to thank everyone who has wished me a pleasant or Happy Veteran's day, as I'd like to also echo my warm wishes to all other current, & future Veterans -- Happy Veteran's day!

[Sir NoddinOff]

It's best not to get a straight CPAP machine (brick) because an autoPAP can be easily turned into a plain CPAP if necessary. Here's the best way to sort it all out machine by machine:

Here's a reasonably up-to-date database that tells you if a machine has data capability. Yes, even a few of the newest models are NOT data capable, sad to say. Some other features are covered also. This links to one database but there are two views into it – use whichever one is expedient for you:

https://sleep.tnet.com/equipment/cpapmachines

https://sleep.tnet.com/cmd

[Poprouge]

Okay had my appointment with the CPAP clinic at the Alexandria, LA VA Hospital. I was issued a ResMed AirSense 10 Autoset with Humidifier, with a nasal mask. They are in the process of getting approval for wireless data retrevial which will save me the 2 1/2 hour drive, so I'm a happy camper.

[Okie bipap]

Did they explain the process for setting up your MyAir account? That web site will give you a little information, but you will get much more with the free software sleepyhead. If you don't want to constantly be moving the SD card from your machine to the computer, you can put a Flash Air card in the machine and use your in-home router to transfer data to your computer. I use that set up and leave the flash air card in my machine all the time. When I go in for my periodic checks, I take my machine in and the download the information for the doctor.