New to cpap and forum

daniel · Post by **daniel** » Sat Jan 28, 2006 9:53 pm

Hello, I have been on cpap for 2 weeks now using s8 auto vantage. I didn't know anything when I had my sleep study and was totally clueless when I received my machine. After reading about the different technologies, I was thinking of asking my doctor for a Remstar with the C-flex. The S8 vantage is set to 'cpap' at a pressure of 10.

Is it unreasonable for me to ask for the remstar with C-flex?

Thanks for any help!

wading thru the muck! · Post by **wading thru the muck!** » Sat Jan 28, 2006 10:04 pm

Daniel,

Welcome to the forum and to cpap! IMO, there is no immediate reason for you to consider a switch to the REMstar Auto. You are lucky to have gotten the S8 auto, most are given a basic machine. The machine you have has a feature called EPR (expiratory pressure relief), do you know if yours is turned on? The one drawback of the S8 auto as compared to the REMstar auto is that EPR can not be used with the auto setting... the REMstar's C-flex (sim to EPR) can be used in both CPAP and APAP modes. I'd give your machine a shot and see how it goes. 10cm is a pretty average pressure and with the EPR turned on it should be fairly easy to tolerate.

Good Luck!

daniel · Post by **daniel** » Sun Jan 29, 2006 8:49 am

Thanks for your reply wading. I don't know if the EPR is on, is there a way to tell? I am renting the s8 monthly, and the place where I got it didn't explain the EPR feature or what the machine is capable of. If fact, most of what I have learned so far has been from this forum!

I was just doing alot of reading on this forum and it seems many have the remstar. I think it would be really cool to be able to use the software to track my own progress and mabey someday use the auto.

Barnaby · Post by **Barnaby** » Sun Jan 29, 2006 9:59 am

so what does epr mean ???

I have remed apap and set at 9/15

Barnaby

mikemoran · Post by **mikemoran** » Sun Jan 29, 2006 10:30 am

Barnaby,

It stands for Expiatory Pressure Relief. You have the choice of reducing the pressure upon exhalation up .3 for the pressure it is running at.

Daniel,

The C-Flex people are a little more prevalent on this board. there are plenty who use the ResMed equipment as well as the Puritan Bennett. We have al found various features that serve us individually. My Doctor felt the ResMed algorythm was the better one. Taht probably was marketing hype. But I have had my AutoSpirit for 9 months with no problems and it has been effective.

Like Wader said give it a try first. You can either leave it in CPAP mode and turn on the EPR. But since it is an auto I would suggest you set it in auto mode. thsi way you can start at lower pressures and it will only build up as necessary to counteract events. It is a very responsive machine.

I'm sure someone will help you on how to get to the Clinician Menu where you can change the settings. On the Spirit iyou hold down the right arrow and down arrow at the same time. Not sure if this is the same for the S8.

rested gal · Post by **rested gal** » Sun Jan 29, 2006 12:49 pm

mikemoran wrote:On the Spirit iyou hold down the right arrow and down arrow at the same time. Not sure if this is the same for the S8.

Yes, it's the same.

dsm · Post by **dsm** » Sun Jan 29, 2006 1:47 pm

Daniel,

You already have one of the best recent model AUTOS, you may be dissapointed if you try to swap it. Avoid the trap of 'the grass is greener' when reading a lot of our input. It is easy to get sucked into that cycle.

Cheers DSM

PS EPR as per cpap.com ...

Respironics C-Flex vs. Resmed EPR: There Is A Difference

Many similarities exist between Respironics C-Flex and Resmed EPR but they are NOT the same thing! Both are easy breathing, expiratory pressure reduction systems. Both decrease the pressure to the patient at the beginning of each exhalation and both have three comfort settings. However, major differences exist in the availability and effectiveness of these features.

Here are a list of the major differences:

* Auto Mode Pressure Adjustments. C-Flex works when the machine is in the "Automatic Pressure Adjust", or "Auto" mode. EPR only works in "Constant Pressure", or "CPAP" mode. EPR will not work when an S8 Vantage machine is in the "Auto" mode.

* Length Of Pressure Drop. C-Flex decreases pressure at the beginning of each breath. The decrease lasts for less than a second and then returns to the base pressure. EPR decreases the pressure at the beginning of each breath also but keeps the pressure low throughout the exhalation.

* Relative vs. Exact Pressure Drop. C-Flex settings reduce the pressure relative to the patient’s exhalation strength and the machine pressure setting. EPR reduces the pressure by one, two or three centimeters of water pressure.

* Sleep Disordered Breathing Event Handling. EPR has an Event Detection Circuit. When a sleep disordered breathing event is expected or has occurred, EPR stops until the event concludes and normal breathing resumes. C-Flex is of such short duration it is thought that is has no negative effect on sleep disordered breathing events and does not need to stop.

* Ramp Mode Pressure Relief. EPR can be limited to work in the ramp mode only. C-Flex can not be limited in this way.

So, if EPR reduces the expiratory pressure by a controlled 1, 2, or 3 centimeters, what is the difference between EPR and BiPAP (tm) or Bilevel?

Bilevel machines are categorized as "ventilatory devices". They use rapid pressure changes to expand and contract lung volume. EPR uses slower pressure changes, so there is little ventilatory effect. However, EPR does feel very much like a Bilevel to the patient.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, resmed, bipap, C-FLEX, Ramp, auto

daniel · Post by **daniel** » Sun Jan 29, 2006 9:27 pm

Thanks everyone for their input. Question - so with the s8, if it is in auto mode then EPR is not functional? And with C-Flex, you still get a pressure relief on exhalation when it is set in auto mode?

I pressed both side buttons and a different menu displayed! Thanks for that piece of info... It had efficacy data and displayed the following:

pressure 8.8
Leak 0.08L/s
AHI 3.2
AI 0.1
HI 2.6

This was for the previous week. I thought the doctor wrote the script for a pressure of 10. Dose this mean it is is auto mode?

rested gal · Post by **rested gal** » Sun Jan 29, 2006 9:56 pm

daniel wrote:Question - so with the s8, if it is in auto mode then EPR is not functional? And with C-Flex, you still get a pressure relief on exhalation when it is set in auto mode?

Correct.

The Respironics REMstar Auto with C-Flex can be operated in any of these four modes:

1. CPAP - cpap, one straight pressure

2. CFLE - cpap, one straight pressure, AND with C-Flex enabled to drop the pressure some when you exhale.

3. APAP - auto-titrating cpap (autopap), a range of pressure can be set from minimum of 4 to maximum of 20 (or any range between.) Pressure will vary as needed throughout the night. APAP mode does not use C-Flex.

4. AFLE - auto-titrating cpap (autopap) just like in APAP mode, AND with C-Flex enabled to drop the pressure some when you exhale.

The ResMed S8 Vantage autopap can use EPR only when operating in straight cpap mode. The Vantage cannot use EPR when operating as an autopap.

Sergeant Bob · Post by **Sergeant Bob** » Sun Jan 29, 2006 11:15 pm

pressure 8.8
Leak 0.08L/s
AHI 3.2
AI 0.1
HI 2.6

Hey, those are some excellent numbers!
I have an S7 and my numbers are a bit higher (although they have improved alot since I started reading this forum).

My numbers are usually about:
Pressure 13-15
AHI 11-14
AI .6- 1.2
HI 10-13
My machine doesn't have EPR and even at my high pressure, after a few days on it exhaling was effortless. I'd wake up and have to pull the mask away from my face to make sure it was working properly.

Anyway, you're doing great and I don't think you will significantly better with another machine.

daniel · Post by **daniel** » Mon Jan 30, 2006 8:16 pm

Well, you have made up my mind to stay with the s8 auto vantage. I also spoke with my DME, who was very nice and helpful. He told me the EPR is not on since the doctor didn't prescribe to have it on. He also said the Hospital I went to for the sleep study, OSF in Peoira IL, requires all patients that are prescribed a cpap have an auto so they can redo the pressure if needed at a later date and not have to come in for another $3,000 sleep study.

So, Sergeant Bob I guess I am the same as you. Not really having a problem with the pressure on exhalation

Thank you for your input, this is a really nice forum and you can realy learn alot!