Why no EPR/C-Flex as norm?

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englandsf
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Why no EPR/C-Flex as norm?

Post by englandsf » Mon Jul 28, 2014 8:21 pm

It appears that DMEs do not normally turn on exhalation relief on machines at set up - so many folks asking how to use it (and it's "behind the clinician menu).

Why don't they turn it on to patient control automatically so the user can easily control it? Does it need to be on the prescription?

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Nick Danger
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Re: Why no EPR/C-Flex as norm?

Post by Nick Danger » Mon Jul 28, 2014 8:37 pm

My ENT said he didn't like EPR because he wasn't sure the software would react soon enough if the airway was collapsing. The studies I read suggested this isn't a problem.

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Re: Why no EPR/C-Flex as norm?

Post by JustTia » Mon Jul 28, 2014 8:45 pm

I don't know. I wasn't even sure what it was for until today. Set it and planning to give it a try tonight to help with aerophagia.

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Re: Why no EPR/C-Flex as norm?

Post by palerider » Mon Jul 28, 2014 9:21 pm

JustTia wrote:I don't know. I wasn't even sure what it was for until today. Set it and planning to give it a try tonight to help with aerophagia.
I hope it works, and your eyes won't be bugged out quite so much tomorrow

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JustTia
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Re: Why no EPR/C-Flex as norm?

Post by JustTia » Mon Jul 28, 2014 10:01 pm

palerider wrote:
JustTia wrote:I don't know. I wasn't even sure what it was for until today. Set it and planning to give it a try tonight to help with aerophagia.
I hope it works, and your eyes won't be bugged out quite so much tomorrow
You and me both!

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archangle
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Re: Why no EPR/C-Flex as norm?

Post by archangle » Mon Jul 28, 2014 10:08 pm

Sometimes the reduced pressure on exhale can increase your apneas.

Some people find it uncomfortable.

The changing pressure can sometimes "pump" the mask up and down on your face and cause leaks or other problems.

The machines and masks are sometimes noisier with exhale relief.

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Pesser
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Re: Why no EPR/C-Flex as norm?

Post by Pesser » Mon Jul 28, 2014 10:19 pm

englandsf wrote:It appears that DMEs do not normally turn on exhalation relief on machines at set up - so many folks asking how to use it (and it's "behind the clinician menu).

Why don't they turn it on to patient control automatically so the user can easily control it? Does it need to be on the prescription?
you're question is clear!!!! I think DMEs don't want you to control your life. They think we are stupid?

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Justin Case
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Re: Why no EPR/C-Flex as norm?

Post by Justin Case » Mon Jul 28, 2014 10:37 pm

My previous Sleep doc recommended straight CPAP when I asked him what he thought about APAP. He bluntly said, save your money and just buy a regular CPAP. In hospitals when I had a PSG done, if not mistaken, there was no EPR or C-Flex.
JC

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palerider
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Re: Why no EPR/C-Flex as norm?

Post by palerider » Mon Jul 28, 2014 10:57 pm

Justin Case wrote:My previous Sleep doc recommended straight CPAP when I asked him what he thought about APAP. He bluntly said, save your money and just buy a regular CPAP. In hospitals when I had a PSG done, if not mistaken, there was no EPR or C-Flex.
I like the 'save your money' line, given how close in price the cpaps and apaps are in cpap.com (50-75$ diff)

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Justin Case
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Re: Why no EPR/C-Flex as norm?

Post by Justin Case » Mon Jul 28, 2014 11:01 pm

I guess in his defence, it was 10 years ago and the price difference was much wider. However, I think that mindset is still maintained today hence DMEs not enabling EPR/CFLEX.
JC

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palerider
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Re: Why no EPR/C-Flex as norm?

Post by palerider » Mon Jul 28, 2014 11:03 pm

Justin Case wrote:I guess in his defence, it was 10 years ago and the price difference was much wider. However, I think that mindset is still maintained today hence DMEs not enabling EPR/CFLEX.
well, typically, the whole point of epr/xflex is just patient comfort, and that's typically not something the medical profession spends much time thinking about.

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Re: Why no EPR/C-Flex as norm?

Post by sc0ttt » Mon Jul 28, 2014 11:49 pm

englandsf wrote:It appears that DMEs do not normally turn on exhalation relief on machines at set up - so many folks asking how to use it (and it's "behind the clinician menu).

C-flex is on the standard user's screen menu.

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Re: Why no EPR/C-Flex as norm?

Post by zoocrewphoto » Tue Jul 29, 2014 2:21 am

palerider wrote:
Justin Case wrote:I guess in his defence, it was 10 years ago and the price difference was much wider. However, I think that mindset is still maintained today hence DMEs not enabling EPR/CFLEX.
well, typically, the whole point of epr/xflex is just patient comfort, and that's typically not something the medical profession spends much time thinking about.
Except they almost always turn on the ramp, starting at 4, which they think will help people get started with cpap, yet it ends up bothering a lot of people so much that they quit if they don't find a forum like this one and make some adjustments.

I think my doctor included epr at 2 as part of my prescription. I would have to check, but I think that is what my copy says. My copy, though, was written at my request, after I got my machine. The original went straight to the DME, and I am fortunate that my doctor has sleep apnea himself and specifically prescribes Resmed autosets to everybody. He likes the auto feature and the full data.

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Re: Why no EPR/C-Flex as norm?

Post by robysue » Tue Jul 29, 2014 8:34 am

My DME does set up PAP machines with EPR/Flex turned ON (and usually at the max setting). They also make sure that patient access to the EPR/Flex setting is also turned ON. And they tell the patient how to access that setting and tell them to experiment with it if desired.

On the PR machines there's a really neat feature that's available whenever the clinician allows patient access to Flex: There's a real-time demo of Flex available where you mask up, press the demo button and you can change Flex while the mask is on and breathe with the new Flex for several minutes before changing to yet a different Flex if you want. It allows you to directly compare Flex = 1, 2, or 3 (but alas, not OFF) at your pressure and without restarting the machine. You can flip back and forth between settings as much as you like by simply turing the knob. When you figure out which you like best, you simply turn the machine off while the Flex is at that setting and the new setting is now the default setting in the set up menu(s).

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englandsf
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Re: Why no EPR/C-Flex as norm?

Post by englandsf » Tue Jul 29, 2014 8:45 am

You have a great DME. The ResMed I have does not do that but I think both widely used machines require a setting to allow user access to EPR/Flex - which seems crazy...

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