REMstar C-Flex settings

Chris C · Post by **Chris C** » Mon Nov 06, 2006 12:00 pm

I use a REMstar/pro 2 with C-Flex. The C-Flex pressure is too high. It blows my mask off...............and when I changed to a Nasel Air canula, it blows the canula out of my nostrils. Presently it's set at 15, with a ramp of 7.5. Does anyone know how I can lower the C-Flex setting?

Wulfman · Post by **Wulfman** » Mon Nov 06, 2006 12:13 pm

They didn't give you the setup instructions? Tsk, tsk, tsk.....
See if this will help.
I would suggest copying them into a document on your computer for future reference.

Den

REMstar Pro 2 Setup

When in the Setup Menu, the humidifier ^ and ramp v buttons operate as up and down keys to change the settings, the left/right user buttons < > allow you to go to the previous/next question or setting, and the pressure start/stop button is used to exit the Setup Menu. Holding the humidifier or ramp buttons down will cause the values to change more quickly.

To enter the Therapy Setup Menu, hold the two top user buttons < > down while plugging in the power cord.
Continue holding the buttons down until the REMstar Pro 2 with C-Flex beeps twice.

Note: The word "setup" will appear on all of the screens indicating that you are in the Therapy Setup Menu.
If you press the Pressure start/stop button, you will exit the Setup Menu.

a. Compliance hours: (recommend leaving alone)
Select next setting with >

b. Therapy mode: (CPAP or CFLE) select with ^ or v
Select next setting with >

c. CPAP pressure setting: Select with ^ or v
Select next setting with >

d. C-Flex mode (if you chose CFLE mode): Select setting 1, 2 or 3 with ^
Select next setting with >

e: Ramp time setting: Select with ^ or v
(ramp time will be turned off with a setting of 0)
Select next setting with >

f. Ramp pressure setting: Select with ^ or v
Select next setting with >

g. Patient disconnect setting: 1 = on 0 = off Select with ^ or v
Select next setting with >

h. Buttons lights setting: 1 = on 0 = off Select with ^ or v
(Last setting. Use On/Off button to exit Setup)

Guest · Post by **Guest** » Mon Nov 06, 2006 12:25 pm

Thank you! Thank you!Thank you!!!!!!!

I got my machine through the Veteran's Administration and the C-Flex level supposedly can't be changed without a Doctor's prescription. I'm not stupid, and can certainly figure out how much pressure will keep me from snoring and "popping" and still be able to sleep. Your help just may solve my problem..................and I'll let you know.

Chris

SelfSeeker · Post by **SelfSeeker** » Mon Nov 06, 2006 12:25 pm

Chris,

C-Flex is something to help with exhaling.

The 15 you are talking about is the pressure that keeps your airway open.

That is what is determined by the titration study.

I do not know about pressure 15, but at 18 it is hard for the cannula to stay in place. I found that the strap had to hold the tubing tight for it to stay hard. Luckly, my pressures is much lower then that now.

http://cflex.respironics.com/

Which states:

C-Flex is a revolutionary new technology in Respironics REMstar® family of CPAP devices that provides a more comfortable treatment for sleep apnea. It's an ideal first-line treatment to ensure better Acceptance, Comfort and Results.

The difference is the C-Flex waveform: a better way to deliver sleep therapy that takes the work out of exhalation. To do this, C-Flex tracks – and reacts to – every breath throughout the night. This gives the device the ability to make breath-by-breath adjustments to ensure the optimal level of pressure relief during exhalation to deliver more comfortable therapy. (See how it works.)

Patients who use C-Flex simply feel better, and with good reason. A study published in the June 2005 issue of Chest * showed that patients using a REMstar Pro with C-Flex used their therapy an average of 1.7 hours longer per night than patients on CPAP after three months, and the difference in adherence widened over time.

To help you bring better results and more comfortable therapy to more of your patients, we’ve developed a family of REMstar devices with C-Flex so you can match each of your patients to a device that fits their needs. The REMstar family gives you a choice of therapy modes, reporting modes and humidification options to deliver a truly tailored therapy solution to your patients.

oldgearhead · Post by **oldgearhead** » Mon Nov 06, 2006 12:35 pm

Presently it's set at 15, with a ramp of 7.5. Does anyone know how I can lower the C-Flex setting?

Is 15 cm/H2O your titrated pressure? If so, I would try setting the C-Flex to level 3. If that doesn't help, try to obtain a Bi-PAP machine, or a ResMed machine with EPR. These offer a longer exhalation relief cycle than C-Flex.

Several doctors, when they see a titration above 13 cm/H2O, will order a Bi-Pap machine.

Wulfman · Post by **Wulfman** » Mon Nov 06, 2006 12:39 pm

Chris,

You've got a good machine (REMstar Pro 2). I have one and am using it this month. It's capable of giving you the nightly statistics through the Smartcard and Encore Pro software w/reader. If you can afford to get that and monitor your therapy, you might find out that you can get by with a lower pressure......I did.

https://www.cpap.com/productpage-bundle ... undle.html

Best wishes,

Den

Guest · Post by **Guest** » Mon Nov 06, 2006 12:47 pm

I'm not familiar with "titrated pressure", but I think that's what the 15 is. I've lowered it to 10 and will try that a few nights. If it doesn't work, I'll try adjusting it up from there.

Snoredog · Post by **Snoredog** » Mon Nov 06, 2006 1:04 pm

Anonymous wrote:I'm not familiar with "titrated pressure", but I think that's what the 15 is. I've lowered it to 10 and will try that a few nights. If it doesn't work, I'll try adjusting it up from there.

Note: You need to know the difference between the Cflex and the pressure. Cflex cannot blow anything off as it is the "relief" amount offered when you exhale. So the higher the setting, the more relief you would get. While it doesn't follow exact cm pressure drops, relief is based upon your particular pattern, you can use the following analogy:

Pressure=15 with

Cflex=1

Inhale=15cm
Exhale=14cm

Cflex=2

Inhale=15cm
Exhale=13cm

Cflex=3

Inhale=15cm
Exhale=12cm

You changed your pressure from 15cm to 10cm, that means if you had apnea happening at 13cm pressure the 10cm you now have won't clear those events.

Cflex settings are seperate from pressure settings.

snoregirl · Post by **snoregirl** » Mon Nov 06, 2006 1:21 pm

If you have a titrated pressure of 15 then unless you are using an auto machine to retitrate or collecting data, you do not want to arbitrarily lower your pressure. You may eliminate your snoring as you say, but it won't treat all your apneas.

This is a health concern.

If you are having issues with the pressure your machine is set at, go see your doctor and look for a solution. Lowering your pressure from 15 to 10 on your own with no data is not a solution.

You may be a good candidate for a Bipap or auto CPAP. Auto would allow you to only have high pressure when you really need it. The bi Pap is used by many people who have very high pressures. Don't just lower it. In the mean time your insurance company is probably buying a machine that may not be appropriate for you. Let them buy what you need by going and working with the doctor on your issues as you won't get the coverage probably again for 5 years.
_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): auto

TXKajun · Post by **TXKajun** » Mon Nov 06, 2006 1:33 pm

I'm with snoregirl's answer. It seems that Chris C is, at this time, totally unfamiliar with his CPAP unit (and CPAP in general) so if any changes are to be made, Chris, please bring it to the Dr. or the VA or your DME!

I'm not, by any means, saying you aren't capable of doing it yourself, Chris, but it sounds like you could use either a bunch of reading on the forum here to educate yourself or that you could use a good explanation by someone knowledgeable.....i.e. your Dr, the VA or your DME. Remember, this stuff is "prescription only" and setting it too high could have unintended consequenses, as well as setting it too low could have less than satisfactory treatment consequences.

Now, with that said (my disclaimer, so to speak), Chris, this is a great place to become extrememly well informed on CPAP, APAP, CFLEX, masks, DIY stuff and lots more. Welcome aboard and let us know how your treatment's going.

Kajun

This therapy WORKS!!!

Wulfman · Post by **Wulfman** » Mon Nov 06, 2006 2:10 pm

Anonymous wrote:I'm not familiar with "titrated pressure", but I think that's what the 15 is. I've lowered it to 10 and will try that a few nights. If it doesn't work, I'll try adjusting it up from there.

Chris,

Yes, that's what your "titrated" (prescribed) pressure means.....15. The C-Flex setting is the 0, 1, 2 or 3 (0 being off and 3 being the most relief)

Please remember what I said about the software..... If you don't know what you're changing, be careful.
You might have an issue with your mask/interface that's not right and that's what's causing it to "blow out your nostrils". Definitely work back up to your prescribed pressure as you get used to the pressure and figure out what the deal is with the mask. They came up with the pressure of "15" for a reason, so unless you can prove it wrong with the software, you need to use their numbers.

By the way, they prescribed me a pressure of 18 and I changed it to 10....but ONLY because I got the software and started using it from the very beginning. Right now I'm using a pressure of 12.....because it's what I need and the software confirms it..

Best wishes,

Den

Guest · Post by **Guest** » Mon Nov 06, 2006 3:36 pm

Okay everyone, I'll put it back up to 15 and call the VA. But you have no idea what that entails. It will be weeks before I can get anything accomplished. But you've convinced me I shouldn't change anything on my own without a proper understanding of the equipment. Thanks.

Sleepy-eyes · Post by **Sleepy-eyes** » Mon Nov 06, 2006 3:43 pm

Wulfman,

I also might add that I've tried the nose mask, full face mask, and am now down to the Nasal Aire. I wear a full beard and only the Nasal Aire isn't effected by leakage.............at least not because of the beard. And, as I mentioned earlier, I'm stuck with the machine. It's the only one the VA authorizes.

Wulfman · Post by **Wulfman** » Mon Nov 06, 2006 4:02 pm

Chris,

Could you please fill out your "profile" so we'll know exactly which mask (and other equipment) you have? I'm not familiar with the nasal masks and the one you're using may have a different size "pillows" or something that someone else could advise you about. (which may be what's causing the leaks)

When you were in the "setup" of the machine.....did you notice what the C-Flex setting was? THAT specific setting shouldn't make any difference in your prescription......it's purely exhale relief.....which may help a bit.

I can think of LOTS of other machines you'd be worse off being stuck with!

Best wishes,

Den

Sleepy-eyes · Post by **Sleepy-eyes** » Mon Nov 06, 2006 4:33 pm

Okay, Wulfman. I updated my profile. I have no idea what type software I have in the machine.

When I got into the setup program, the machine was set on C-Pap and not C-Flex. So there is no number selection possible. On C-Flex it is set at 1. I am using a Nasal-Aire II canula type mask and am using the 3rd from the smallest canula. It is the largest canula I can insert into my nostrils. I originally used a full-face mask, but with the pressure so high, it leaked everywhere. (I wear a full beard.) When I'd get it tight enough to "sort of" seal, it would cut so hard into the back of my neck that I'd end up with a headache within the hour.