Whoa Wait!? I do have a problem when i'm exhaling. feels like i'm trying to blow up a ballon. there is a little flapper on the mask that seems to shut off some air flow from the machine and opens up a hole in the mask for exhaling. One of the things that bother me is I don't seem to be able to exhale well. The machine also changes its sound (wheezes?)when I exhale
C-flex? I'm not sure what that is. when i click on the link I get an error message.
Please explain C-flex.
Thanks,
Bernie
Help with the Ramp Button, Please
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SleepySandy
- Posts: 330
- Joined: Sat Jan 13, 2007 5:25 pm
- Location: Seattle, WA
Bernie
C-Flex is the tradename of Respironics' exhalation relief. It reduces the pressure the machine is putting out as you're exhaling to make it easier to exhale. The settings are a low-medium-high amount of relief.
If the machine in your profile is right, you don't have C-Flex. Since you're having so much trouble exhaling, that's something you should definitely explore.
What pressure are you at these days?
Did you have your sleep doc appointment? I don't remember seeing a thread about that.
Sandy
C-Flex is the tradename of Respironics' exhalation relief. It reduces the pressure the machine is putting out as you're exhaling to make it easier to exhale. The settings are a low-medium-high amount of relief.
If the machine in your profile is right, you don't have C-Flex. Since you're having so much trouble exhaling, that's something you should definitely explore.
What pressure are you at these days?
Did you have your sleep doc appointment? I don't remember seeing a thread about that.
Sandy
Hello Sandy,
Yes I did see Dr. Sleep Last week. Since the sleep tests didn;t go that well. She ordered an Autopap machine for me to use for awhile to determine what pressurre is best for me. I currently am on 8. She is guessed that I probably should be a 10 or 12.
The more I think about the posts on this thread the more I am understanding one of my problems in exhaling. I don't think icnreasing the pressure is going to help that (is it?)
does that autopap machine help in exhaling? I
Bernie
Yes I did see Dr. Sleep Last week. Since the sleep tests didn;t go that well. She ordered an Autopap machine for me to use for awhile to determine what pressurre is best for me. I currently am on 8. She is guessed that I probably should be a 10 or 12.
The more I think about the posts on this thread the more I am understanding one of my problems in exhaling. I don't think icnreasing the pressure is going to help that (is it?)
does that autopap machine help in exhaling? I
Bernie
Better to CPAP then never to PAP at all
Hi Bernie! Sorry to hear you're having so much trouble. You and I were given bottom of the line Respironics machines. No C-flex, no data card, no leak rate, etc. If you are getting an Autopap to use, try your best to keep it!
First question I have for you is - why are you using a full face mask, and have you considered going to something smaller and forcing your mouth closed (tape, denture strips, chin strap)? If it were me, and I couldn't keep it on more than 3 hours, I'd go the complete opposite direction and try nasal pillows and see if that doesn't get you closer to "mask nirvana".
My final pressure is 10, and I don't use RAMP. In fact, I like starting at 10 because I feel like I'm getting lots of air and I can check for leaks. (What seals at 4 might leak at 10.)
Good luck, Bernie, I wish I had more wisdom to impart, but I'm muddling through this too. Take Care,
Cathy
First question I have for you is - why are you using a full face mask, and have you considered going to something smaller and forcing your mouth closed (tape, denture strips, chin strap)? If it were me, and I couldn't keep it on more than 3 hours, I'd go the complete opposite direction and try nasal pillows and see if that doesn't get you closer to "mask nirvana".
My final pressure is 10, and I don't use RAMP. In fact, I like starting at 10 because I feel like I'm getting lots of air and I can check for leaks. (What seals at 4 might leak at 10.)
Good luck, Bernie, I wish I had more wisdom to impart, but I'm muddling through this too. Take Care,
Cathy
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SleepySandy
- Posts: 330
- Joined: Sat Jan 13, 2007 5:25 pm
- Location: Seattle, WA
Hi Bernie,
Do you have the Auto now? I'm thinking you don't yet if you are at a constant pressure of 8.
If you have the Auto, what is the exact model of your Auto? Is it a REMStar Auto? Or, is it another brand? I know the REMStar Auto has C-Flex, but it has to be turned on. The Resmed Auto has EPR, which is the Resmed version of exhalation relief.
Let us know the model of Auto you have or will be getting.
Autos don't provide exhalation relief on their own. You need C-Flex or EPR. However, Autos will reduce your pressure depending on what you need. For example, if your Auto is set to a range of 8 to 14 the Auto will drop down to 8 as long as you're breathing okay. When necessary, the Auto will raise the pressure to whatever is needed to control your events. The pressure will max out at 14 in this example.
If you have a lot of trouble exhaling, you might ultimately need a bilevel. Bilevels have one pressure for inhale and one pressure for exhale. They're usually used for people on higher pressures because the higher the pressure the more difficult it is to exhale. I'm a little bothered you're having trouble exhaling on a pressure of 8 because 8 is still pretty low. Were you able to get used to exhaling at 6? Maybe you just need time.
Did you have trouble exhaling during the titration study? Maybe that's why the study went so badly...
Bottom line - you still have a lot of options. I'm glad your doctor prescribed an Auto. That's a really good start.
Sandy
Do you have the Auto now? I'm thinking you don't yet if you are at a constant pressure of 8.
If you have the Auto, what is the exact model of your Auto? Is it a REMStar Auto? Or, is it another brand? I know the REMStar Auto has C-Flex, but it has to be turned on. The Resmed Auto has EPR, which is the Resmed version of exhalation relief.
Let us know the model of Auto you have or will be getting.
Autos don't provide exhalation relief on their own. You need C-Flex or EPR. However, Autos will reduce your pressure depending on what you need. For example, if your Auto is set to a range of 8 to 14 the Auto will drop down to 8 as long as you're breathing okay. When necessary, the Auto will raise the pressure to whatever is needed to control your events. The pressure will max out at 14 in this example.
If you have a lot of trouble exhaling, you might ultimately need a bilevel. Bilevels have one pressure for inhale and one pressure for exhale. They're usually used for people on higher pressures because the higher the pressure the more difficult it is to exhale. I'm a little bothered you're having trouble exhaling on a pressure of 8 because 8 is still pretty low. Were you able to get used to exhaling at 6? Maybe you just need time.
Did you have trouble exhaling during the titration study? Maybe that's why the study went so badly...
Bottom line - you still have a lot of options. I'm glad your doctor prescribed an Auto. That's a really good start.
Sandy
Bernie, I think some of us are thoroughly confused by what machine you have. Your profile shows a basic M Series machine with no cflex.
You wrote that your doctor prescribed and Auto for testing. Do you have the Auto yet?
Please read the front/top of the machine you are currently using and tell us what it says. If it has cflex, it will say cflex on it.
And as others have asked, other than the ramp problem, just what problems are you having? That way, we'll know problems to try to help you fix.
You wrote that your doctor prescribed and Auto for testing. Do you have the Auto yet?
Please read the front/top of the machine you are currently using and tell us what it says. If it has cflex, it will say cflex on it.
And as others have asked, other than the ramp problem, just what problems are you having? That way, we'll know problems to try to help you fix.
_________________
| Machine: DreamStation Auto CPAP Machine |
| Humidifier: DreamStation Heated Humidifier |
| Additional Comments: Compliant since April 2003. (De-cap-itated Aura). |
Sorry for the confusion, my fault.
The Machine I have is at the bottom of this post. The Doctor is going to lend me an Auto, because she wasn't able to determine a good pressure number for me during the sleep test. I do not have the auto machine yet, but expect to have it in about a week. I don't know what brand of machine it will be. Hopefully this clears the confusion up a bit.
The Machine I have is at the bottom of this post. The Doctor is going to lend me an Auto, because she wasn't able to determine a good pressure number for me during the sleep test. I do not have the auto machine yet, but expect to have it in about a week. I don't know what brand of machine it will be. Hopefully this clears the confusion up a bit.
Better to CPAP then never to PAP at all
Yes, it does, thank you.
Well, since you got the ramp problem figured out, guess we will wait for the Auto and see how that goes.
Put lots of pressure and the DME to get you a better machine. Try to get an M Series Pro, or and M Series Auto. Both of those have cflex, and the Smart Card supports software which will give detailed reports.
A better machine won't cost you/your insurance any more money. It will simply be less profit for the DME.
Both those machines can still be used with your current humidifier (wrong picture in profile) -- so a new one need not be purchased.
You will be on cpap the rest of your life, get a good machine.
Good Luck.
Well, since you got the ramp problem figured out, guess we will wait for the Auto and see how that goes.
Put lots of pressure and the DME to get you a better machine. Try to get an M Series Pro, or and M Series Auto. Both of those have cflex, and the Smart Card supports software which will give detailed reports.
A better machine won't cost you/your insurance any more money. It will simply be less profit for the DME.
Both those machines can still be used with your current humidifier (wrong picture in profile) -- so a new one need not be purchased.
You will be on cpap the rest of your life, get a good machine.
Good Luck.
_________________
| Machine: DreamStation Auto CPAP Machine |
| Humidifier: DreamStation Heated Humidifier |
| Additional Comments: Compliant since April 2003. (De-cap-itated Aura). |
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Guest
Bernie,
What helps with exhaling is the C-Flex on the Respironic machines (Like the M series Pro and Auto). Resmed also has their version of exhalation relief on some of their machines.
Even if you are at a low pressure of 8 already, you still may feel better having that pressure reduced some when exhaling. I have a Respironics M Series Pro w/C-Flex and use a setting of "2" on C-flex even though my pressure is only 8, like yours. C-Flex can be set to 1, 2, or 3, with "3" giving you more of a relief when exhaling than "2," and so on. When I started on CPAP five weeks ago, I had my C-Flex setting at "3," and now I have it at "2." Some people don't need it at all. Everybody is different.
Oh, that little flap you were talking about? That has nothing to do with this. It's called an "asphixiation valve" or something like that. There has to be one on all full-face masks. When air from the machine is not going through the mask, the little flap is open and there's an open hole in the mask. When you're wearing the mask and air is coming through from the machine, the flap closes over the hole. If, for some reason (like the power going off) the air stopped coming through the mask while you were wearing it, the little flap would open back up to allow more room air inside your mask. Clear as mud?
Like others have posed, get them to let you KEEP an auto. The Respironic autos have C-Flex, which is what you want.
It may take you quite a while to find a mask that is "you"! Most people go with a nasal-only type, some full-face (like you have). I have a Hybrid and love it. It's a combination of covering your mouth and having nasal pillows. (It doesn't go up on your face and nose as far as a full-face mask.) Again, getting the mask right is probably the most important thing.
Keep us posted!
Pam
What helps with exhaling is the C-Flex on the Respironic machines (Like the M series Pro and Auto). Resmed also has their version of exhalation relief on some of their machines.
Even if you are at a low pressure of 8 already, you still may feel better having that pressure reduced some when exhaling. I have a Respironics M Series Pro w/C-Flex and use a setting of "2" on C-flex even though my pressure is only 8, like yours. C-Flex can be set to 1, 2, or 3, with "3" giving you more of a relief when exhaling than "2," and so on. When I started on CPAP five weeks ago, I had my C-Flex setting at "3," and now I have it at "2." Some people don't need it at all. Everybody is different.
Oh, that little flap you were talking about? That has nothing to do with this. It's called an "asphixiation valve" or something like that. There has to be one on all full-face masks. When air from the machine is not going through the mask, the little flap is open and there's an open hole in the mask. When you're wearing the mask and air is coming through from the machine, the flap closes over the hole. If, for some reason (like the power going off) the air stopped coming through the mask while you were wearing it, the little flap would open back up to allow more room air inside your mask. Clear as mud?
Like others have posed, get them to let you KEEP an auto. The Respironic autos have C-Flex, which is what you want.
It may take you quite a while to find a mask that is "you"! Most people go with a nasal-only type, some full-face (like you have). I have a Hybrid and love it. It's a combination of covering your mouth and having nasal pillows. (It doesn't go up on your face and nose as far as a full-face mask.) Again, getting the mask right is probably the most important thing.
Keep us posted!
Pam
I think it's unfortunate to use terminology that implies that people who do use the ramp feature are somehow weak or less of a person (crutch/walking upright) Give me a break! A large number of patients that I talk to that can't stand the pressure and don't use it, until I educate them on the ramp feature and their compliance goes through the roof.Goofproof wrote:the ramp is a crutch, we started our treatment walking upright. A pressure of 4 cm is generally to low to breath, it starves a lot of people for air.
If you are on the ramp and have a apnea event, you will not be treated. I want my pressure there, before my throat closes off. Jim
Granted 4 is a bit low for some people, that's why you can change it in the User Menu (not the clinician menu).
Also, I'm afraid your implying that as soon as your head hits the pillow, that you're going into full blown apneic episodes. This is clearly not the case. People shouldn't be afraid to use the ramp based on this erroneous information. Most of your apneic events happen muh later (usually in REM).
Do keep in mind people that your still getting pressure.
To know even one life has breathed easier because you lived. This is to have succeeded. -- Ralph Waldo Emerson
Hi all, Been away for awhile.
Thanks for the advise on the Ramp Button. After figuring out how to use it I discovered I can set it to start at a higher number. So I start it at 5 and let it ramp up to 8 in about a half hour.
When I mask up I hit the start button adjust Mr Mask to correct air leaks. then hit the ramp button.
If I am being wimpy for using the ramp button. Who cares? If I need to dip myself in Blueberry juice and roll around in Corn Flakes to get this therapy to work, you better believe I'll do it!
That being said I'm going onto my 3rd week (I think) Still not able to keep the mask on for more than 2 or 3 hours.
I'm still waiting for the AutoPap to arrive and I am going to request a hybrid mask. The full face mask I have really starts to become uncomfortable after a couple hours.
As always thanks for everything. this Site is Awesome!
Bernie
Thanks for the advise on the Ramp Button. After figuring out how to use it I discovered I can set it to start at a higher number. So I start it at 5 and let it ramp up to 8 in about a half hour.
When I mask up I hit the start button adjust Mr Mask to correct air leaks. then hit the ramp button.
If I am being wimpy for using the ramp button. Who cares? If I need to dip myself in Blueberry juice and roll around in Corn Flakes to get this therapy to work, you better believe I'll do it!
That being said I'm going onto my 3rd week (I think) Still not able to keep the mask on for more than 2 or 3 hours.
I'm still waiting for the AutoPap to arrive and I am going to request a hybrid mask. The full face mask I have really starts to become uncomfortable after a couple hours.
As always thanks for everything. this Site is Awesome!
Bernie
Better to CPAP then never to PAP at all
Now, I'll be the first to admit that I know very little about this stuff yet, but I think anyone who uses an "auto" xpap and says the ramp is a crutch is just a tad hypocritical.
With the auto, aren't you only getting the pressure that the xpap determines you need at a given moment? Aren't you somewhat ramping the night through since your machine is using minimal determined pressure?
IMO, using a bilevel and ramp, allows the algorythm to get in sync with my breathing and to adjust as the pressure increases. For me, it seems if I start out full force from the start, I do not breath normally for a while. This feature lets me normalize my breathing sooner, which if I'm understanding my machine, is important for proper application.
With the auto, aren't you only getting the pressure that the xpap determines you need at a given moment? Aren't you somewhat ramping the night through since your machine is using minimal determined pressure?
IMO, using a bilevel and ramp, allows the algorythm to get in sync with my breathing and to adjust as the pressure increases. For me, it seems if I start out full force from the start, I do not breath normally for a while. This feature lets me normalize my breathing sooner, which if I'm understanding my machine, is important for proper application.
Yes, That's called treatment.stages3n4 wrote: With the auto, aren't you only getting the pressure that the xpap determines you need at a given moment?
No, your pressure is preset below treatment pressure, and the times it is applied are preset, unlike Auto, which when correctly set applies the correct pressure you need, at the point in time that you need it.Aren't you somewhat ramping the night through since your machine is using minimal determined pressure?
Ramp is like driving your car with the speed control on, and setting in the back seat. You are going to go where it's set to takes you.
Auto, is like having a driver, telling him where you want to go, and he follows your directions, and does the work of getting you there safely. Jim
Use data to optimize your xPAP treatment!
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
So, to use your analogy, ramp isn't quite like setting cruise control, because that maintains one speed. Using ramp is simply smooth acceleration to the speed limit.
I just think it's a great feature, and I like using it for the reasons previously stated, and I don't see how it's crutch, which implies a negative image.
I'm more that happy to agree to disagree on this.
But, I do find it funny that you make he-man statements about "we started our treatment walking upright". With ramp we accelerate to full speed and stay there, and you with "auto" seem like you're the little ol' granny who keeps slowing down and speeding up.
I just think it's a great feature, and I like using it for the reasons previously stated, and I don't see how it's crutch, which implies a negative image.
I'm more that happy to agree to disagree on this.
But, I do find it funny that you make he-man statements about "we started our treatment walking upright". With ramp we accelerate to full speed and stay there, and you with "auto" seem like you're the little ol' granny who keeps slowing down and speeding up.