new cpap usesr - cflex question

ben · Post by **ben** » Fri Jul 28, 2006 8:24 am

Hi!

I'm very, very new to CPAP - I have to say that without this forum I would know nothing about my treatment...my doctor (a very nice guy) had a DME bring me a CPAP machine and mask. I was not told by anyone that 1.different kinds of machines existed 2. that finding the right mask could be a huge challenge, etc. The rep neglected to tell me of the existence of the CFLEX feature - I had to find out about it here...I don't want to bore anyone, but without this forum (and CPAP.com) I'd be nowhere...

The CFLEX feature on my machine (a REMSTAR Plus M Series w/humidifier) seems to make no difference at all. My pressure is 19, so I was really hoping that CFLEX would make a difference - but it does not seem to do anything -- am I doing something wrong? Thanks again for a great forum.

idahogal · Post by **idahogal** » Fri Jul 28, 2006 8:32 am

ben, You are at the right place. I have the same machine you do and I know in the setup menu there is an option to turn the cflex off. Maybe the dme never set it for you. If it is on maybe you need to turn it up? I believe there are 3 settings available on this machine. I hope this helps.

ben · Post by **ben** » Fri Jul 28, 2006 8:36 am

thanks - the screen does show three settings - is it possible that the CFLEX is disabled but the three settings still show?

SleepyHibiscus · Post by **SleepyHibiscus** » Fri Jul 28, 2006 8:41 am

Ben, I am also very new to this too. I can tell you, you have found the right place to learn. Just keep reading and asking. I have been reading posts here all week and I have learned more here than asking anyone at my sleep clinic or Dr. office. Some of the "regulars" here have been here a long time and are considered guru's on CPAP equipment. Best wishes.

Handgunner45 · Post by **Handgunner45** » Fri Jul 28, 2006 8:47 am

If the C-flex setting are showing up on the users menu, that indicates that they did activate C-flex in the clinical menu. If you set the C-flex to 3 it will provide you with the most pressure relief on exhale.

ben · Post by **ben** » Fri Jul 28, 2006 8:52 am

thanks - I have it set on 3, with no evident effect...time to call the DME, I guess...

Linda3032 · Post by **Linda3032** » Fri Jul 28, 2006 9:12 am

Time to call the DME and the doctor.

With a pressure of 19, which is very high, they might want to try you on a Bi-pap. And if they let you test an Auto Bi-Pap (from Remstar), then you would be on the Cadillac of machines.

A Bi-pap will have more exhale relief than cflex does. And an Auto Bi-pap will have the exhale relief, plus allow you to use lower pressures for part of the night.

cpapjack · Post by **cpapjack** » Fri Jul 28, 2006 9:33 am

Linda3032 wrote:With a pressure of 19, which is very high, they might want to try you on a Bi-pap.

I agree. I'm surprised they put you on a CPAP to begin with. Well, considering we're talking about a DME, not really. But then again, your Dr. should've written your script for a Bi-PAP if you're pressure is that high.

_________________

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KansasRT · Post by **KansasRT** » Fri Jul 28, 2006 10:19 am

I don't want to make anyone mad, but DME companies do not have the freedom of choosing what pressure a patient's machine is set on. I think it is crazy that a patient is put on a CPAP of 19, but if that is what the Dr ordered, I cannot change that. I can and would recommend a second opinion or to have the patient question their Dr on that high of a setting, or I may call the Dr's office and ask if they are considering a BiPap. Also, some insurance companies won't cover BiPap until the patient fails on CPAP. Blaming any DME company for a Dr ordering substandard sleep apnea treatment is placing the blame with the wrong people. I am sure that most DME therapists know that 19 is a too high for comfortable treatment, I also know that there are some DME people that don't. I would hope that my sleep apnea Dr after going to school for years would know not to order someone on a substandard treatment.

Snoredog · Post by **Snoredog** » Fri Jul 28, 2006 12:33 pm

[quote="KansasRT"]I don't want to make anyone mad, but DME companies do not have the freedom of choosing what pressure a patient's machine is set on. I think it is crazy that a patient is put on a CPAP of 19, but if that is what the Dr ordered, I cannot change that. I can and would recommend a second opinion or to have the patient question their Dr on that high of a setting, or I may call the Dr's office and ask if they are considering a BiPap. Also, some insurance companies won't cover BiPap until the patient fails on CPAP. Blaming any DME company for a Dr ordering substandard sleep apnea treatment is placing the blame with the wrong people. I am sure that most DME therapists know that 19 is a too high for comfortable treatment, I also know that there are some DME people that don't. I would hope that my sleep apnea Dr after going to school for years would know not to order someone on a substandard treatment.

ben · Post by **ben** » Fri Jul 28, 2006 1:42 pm

Hi!

I want to thank everyone for their responses...my doctor is a reasonable guy - I'll ask him about the bi-pap - but again, thank for the warm welcome!

scbackpacker · Post by **scbackpacker** » Fri Jul 28, 2006 2:37 pm

I have the same cpap unit that you have. My old cpap was a Respironics solo lx that is an all the time blower. I had to get used to exhaling against the pressure after I was upped to 13cm h2o. Sometime I would wake up and my mouth would be so dry that you'd think that a brigade of soldiers with dusty desert boots had march through my mouth because my mouth was open during the night. Now back to your M series. Standing at the front of the machine with the tube coming out of the back there will be 3 buttons. Starting from the left 1st ramp..this lets your machine ramp the pressure up to your setting. 2. On no ramp. 3. cflex setting. Open the hood and push the cflex button. It will show 3 settings 1-2-3 there is a little arrow above a number . That is what it is set at. Push the cflex button and you should see the arrow move to another setting. What I did was try the cflex on 2 first and then I went to 3 and that's where I like it. 1 being the most resistance and 3 being the lowest. It takes it a few seconds for the cflex to come on but you should feel the difference. As far as mask go I've yet to find one that will stay on my head all night without me having to readjust the straps.

Moogy · Post by **Moogy** » Fri Jul 28, 2006 4:18 pm

Snoredog wrote: _________________

most insurance DOES state deeply hidden in their policy that you must first attempt a trial on cpap before they will cover bi-pap treatment. But your doctor could have circumvented that if he wanted to.

If you were not titrated for bi-pap therapy you will probably need another titration to obtain that.

BlueCross BlueShield did not require me to attempt a trial on cpap before getting an AutoBIPAP, and my titrated pressure was "only" 15. (However, the Auto kicks me up to 19-20 fairly often.)

The AutoBIPAP can be set for up to 8cm difference between your inhale and exhale, PLUS there is a BiFLEX feature that knocks the edges off the pressure switch, so you don't get hit so hard by the change in pressure. With pressure as high as yours, this is more of a necessity than a premium feature. (However, my own dear sister uses a straight 20 all the time, with only cflex for relief. She doesn't even use the ramp feature anymore.)

With a pressure of 19, I would lobby hard for the AutoBIPAP. And if you get the automatic unit, there will be no need for another expensive titration study.

Tell your doctor what you need, and do it soon, before the insurance buys the machine. My insurance rented only one month, then purchased. Yours may be different, of course.

Good luck,

Moogy

rested gal · Post by **rested gal** » Fri Jul 28, 2006 9:39 pm

I'm not surprised that you're not feeling much/any relief with C-flex when you're trying to exhale against that hurricane force 19.

The amount and duration of drop in pressure that C-Flex can give is almost entirely dependent on how forceful your exhalation is, against the amount of pressure coming in. 19 is a LOT coming at you.

I agree with the others that the doctor really should have prescribed a bi-level machine for you, given that kind of high pressure. Better yet, the Respironics BiPAP Auto with BiFlex... in case you don't really need a pressure that high all night long.

NightHawkeye · Post by **NightHawkeye** » Fri Jul 28, 2006 9:43 pm

Moogy wrote:BlueCross BlueShield did not require me to attempt a trial on cpap before getting an AutoBIPAP . . .

Me neither . . ., and I have BCBS, too. Insurance even paid 100% for BiPAP-auto.

Regards,
Bill

Mask

Additional Comments: cpap pressure: 12