Remstar Auto questions

larryp1941 · Post by **larryp1941** » Fri Jan 25, 2008 1:56 pm

I just bought a RemStar Auto (p/n 1017453) and have tried to set it up through the provider menu. It doesn't seem to be varying the pressure like I expected. The options in the setup menu includes one that calls for Afle, CPAP, Cfle and APAP. I'm think I know what they mean but I'm unsure how the machine is supposed to work. Can I assume that APAP and CPAP do not use CFlex and therefore do not reduce pressure during exhaling? Can I also asume that Aflex finds the correct pressure required and Cfle will use a pre-set pressure yet both should reduce air flow on exhaling? Another option calls for a Cflex setting between 1 to 3 but I'm not sure which gives maximum reduction in flow during exhalation. No matter how I set the machine, I don't seem to get any "auto" air flow adjustment or any reduction in air flow when I exhale.

Anyone have a provider manual that may clarify some of these things?

Regards,
Larry P.

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CPAPopedia Keywords Contained In This Post (Click For Definition): cflex, CPAP, auto, APAP

Goofproof · Post by **Goofproof** » Fri Jan 25, 2008 2:14 pm

If the machine's not set correctly, it won't work correctly. Aflex and Cflex are for exhale relief. ! to 3 are the levels of exhale relief, with 3 being the most relief.

Auto (APAP) is the range of pressures. CPAP is a set preasure. APAP's work best with a limited range, I set mine to a high of 1 cm over my CPAP pressure and my low 2 or 3 under the my CPAP Pressure.

Aflex usually provides the most normal breathing, 1 to 3 are the range of relief, 3 being easiest.

I do not believe a RAMP setting is in the best interest unless you can't do without it.

These machines are to keep your airways open when you sleep, they are not made to guess about if they are working while you are awake.

Getting the software and reader, are a big plus in getting the treatment you need. Welcome to the forum. Jim

Goofproof · Post by **Goofproof** » Fri Jan 25, 2008 2:19 pm

Your machine can be set in a mulitude of modes with or without Aflex or Cflex, and as APAP and CPAP. You also need to fill out your profile with your equiptment and how you use it (pressure) mask ECT.

And if you use a nasal mask, read up on mouthbreathing. Jim

larryp1941 · Post by **larryp1941** » Fri Jan 25, 2008 2:36 pm

Thanks - this is an active board. I have 5700 hours on a Remstar Pro without Cflex so I just not sure if I should be able to sense a difference in the exhale pressure with the new machine. This "new" machine is used and I am trying to determine if it actually works correctly. So far, I can't tell much difference in any of the modes. I have set the max pressure to 14 (I need 12) and the minimum to 8 and have it set to Aflex but I can't see any differences.

Goofproof · Post by **Goofproof** » Fri Jan 25, 2008 9:55 pm

Since you are use to CPAP, it might make it harder to see a difference. Anyway you have all the options,and that's a good thing. Now you need the software and reader. Jim

GumbyCT · Post by **GumbyCT** » Fri Jan 25, 2008 10:15 pm

Goofproof wrote:If the machine's not set correctly, it won't work correctly.

How right he is...
I hope you have already written down the "original" settings - right?
If you've been doing your reading, then you have, right?

I too, thought Afle stood for Aflex - I forgot what RG said it does stand for -- hopefully she will be around shortly to refresh my memory.

I know you have to go in pretty deep into the menu and choose the right things or it very well could behave just like cpap- then again is that how it was set-up for you?

wabmorgan · Post by **wabmorgan** » Sat Jan 26, 2008 12:47 am

GumbyCT wrote:I too, thought Afle stood for Aflex - I forgot what RG said it does stand for -- hopefully she will be around shortly to refresh my memory.

Only the M-series have Aflex. Afle stands for AutoCPAP with cflex relief.

rested gal · Post by **rested gal** » Sat Jan 26, 2008 6:56 am

GumbyCT wrote:I too, thought Afle stood for Aflex - I forgot what RG said it does stand for -- hopefully she will be around shortly to refresh my memory.

wabmorgan is right.

In the older pre-M Respironics REMstar Auto with C-Flex, "A" means Auto and "FLE" means "C-flex."

AFLE means that older non-M series machine is set to operate in auto-titrating mode with C-Flex turned on.

"AFLE" does not mean that machine has "A-Flex." It does not. It has only C-Flex.

The older REMstar Auto with C-Flex (not an M series machine) can be operated in these modes:

CPAP - as a cpap using one pressure with C-Flex turned OFF
CFLE - as a cpap using one pressure with C-Flex turned ON
APAP - as an autopap using a range of pressures with C-Flex turned OFF
AFLE - as an autopap using a range of pressures with C-Flex turned ON

A-Flex is available only in an M series autopap, and only if the name on top of the M series machine includes the word "A-Flex", like this:

Respironics REMstar Auto|Aflex
M series

The first M series Auto had only C-flex.

Then Respironics added "A-flex" to their M series Auto. A machine that says "A-Flex" on top has both A-flex and C-flex built into it.

If you want A-flex, be sure the M series Auto has "A-flex" as part of the name on top of the machine. An older M series Auto that does not say "A-flex" in the name will have only C-Flex.

rested gal · Post by **rested gal** » Sat Jan 26, 2008 7:09 am

Larry, if you'll PM me your email address, I'll be glad to send you a PDF of the Provider Setup manual for your REMstar Auto with C-flex.

xyz · Post by **xyz** » Sat Jan 26, 2008 11:19 pm

Goofproof wrote:
> 1 to 3 are the range of relief, 3 being easiest.

What does that correspond to in cpap units?

rested gal · Post by **rested gal** » Sat Jan 26, 2008 11:31 pm

xyz wrote:Goofproof wrote:
> 1 to 3 are the range of relief, 3 being easiest.

What does that correspond to in cpap units?

C-flex and A-flex settings do not correspond to exact "cm H20". Neither C-flex nor A-flex reduce pressure an exact number of cm's.

C-Flex, for example, is very dependent on the person's own breathing as to how much "drop" in pressure it will give. If the start of a person's exhalation is very forceful, C-flex will give more drop than for an exhalation that begins lightly. The amount of drop will be different even at the same C-flex setting, depending on how forcefully or lightly the person begins each exhalation.

GumbyCT · Post by **GumbyCT** » Sat Jan 26, 2008 11:32 pm

xyz wrote:Goofproof wrote:
> 1 to 3 are the range of relief, 3 being easiest.
What does that correspond to in cpap units?

1=less relief
2=relief
3=most relief

xyz · Post by **xyz** » Sat Jan 26, 2008 11:59 pm

I understand that 1-3 is not an exact cm H20 and that 3 is most relief.

But since that means nothing to someone who has never used the machine, can someone _approximate_ how many cm H20 of relief a 3 is? Or a range. Or an average.

Goofproof · Post by **Goofproof** » Sun Jan 27, 2008 12:14 am

xyz wrote:I understand that 1-3 is not an exact cm H20 and that 3 is most relief.

But since that means nothing to someone who has never used the machine, can someone _approximate_ how many cm H20 of relief a 3 is? Or a range. Or an average.

It is what it is, you would have to be asleep, and measure it breath by breath without waking up with a manometer, and the results would be different every time for every person. It's NOT 1 CM, 2 CM and 3 CM, for that you need a Resmed and it will only do that in the CPAP mode, it has no relief in the auto mode.

Or you could buy a BPAP or Auto Bipap. Jim