Are C-Flex benefits superior to other CPAP machines?

[Sofi]

I've been using ResMed C-Flex Pro since April '05, and I notice that other CPAPs have other features (not C-Flex types). I'm pretty happy with what I have,but I really don't understand how others can use non C-Flex. Has anyone out there used C-Flex and non C-Flex and can you explain the difference in layman terms? Thanks a lot. Sofi

[dsm]

Yup,
Have tried several & was generally pretty happy with them no matter what features.

In my early days I used a RemStar AUTO set in CFLE mode - then later I stopped using cflex (my cms of 15 + cflex just did not work for me). Mouth puffs, aerophagia, ear pops + + + most stopped when I went to straight CPAP mode.

But in a recent trial with RemStar AUTO in AFLE mode (& thus cflex on) it did add comfort - but am now using a Spirit without cflex & it seems great (except the whine my particular machine seems to exhibit in the pressure band I set for it).

I can only conclude that xPAP is very personal & what works for me can be quite unrealted to what works for someone else. Just too many issues & factors. If you are happy, stay that way

One good example is how exactly the same model xPAP can sound so vastly different to different people.

Cheers

DSM
(familiar old saying - if it aint't broke don't try ta fix it )

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

[rested gal]

One good example is how exactly the same model xPAP can sound so vastly different to different people.

Also, several same models of machine can sound vastly different to same person - if the person tries more than one of that same model.

Case in point - I've used two 420E autopaps. First one made a very noticeable whining rev up/down sound - always. The other (the 420E I use now) is extremely quiet. Two different machines of same model being listened to by same person. Luck of the draw as to what exact sound each machine of same model will make as if comes off the assembly line, I suppose.

Have also used two Respironics REMstar Autos - almost same model, but not exactly. First one was before they added C-Flex. That one was very quiet. snork1 wrote of his REMstar Auto whining like a huge mosquito was loose in the room...his DME tried to convince him that was "normal sound." LOL!! Next REMstar I used was after they added C-Flex. For six months that one was extremely loud - worse than a mosquito, more like a sick cow groaning - even with C-Flex turned off. Then all of a sudden, with no changes whatsoever (not even dropping it on the floor! lol ) that second REMstar became very quiet. Became just as quiet, even with C-Flex on, as the first REMstar that had no C-Flex. Go figure.

Over the past two years I've seen people ask "which is the quietest machine" and others write about how noisy or quiet this brand or another is. For a long time, I thought it probably was just a matter of some people's hearing not being as acute as another person's. That might still be part of it, but I really think there are simply a LOT of individual variations in motor sound from same model machines....some "same models" being quieter than others just as a matter of luck of the draw.

[rested gal]

Sofi, C-Flex is the trademark name of the exhalation "comfort" feature in Respironics machines.

C-Flex gives a varying, vague but definite pressure drop depending on how forcefully a person exhales. I've read that a Respironics rep told someone that the maximum drop C-Flex might give (depending on how hard the person exhales) is 5 cm. Have also read of a rep saying the drop might be as much as 7 cm. Whatever. At any rate, with C-Flex the regular pressure ALWAYS kicks back in before you are entirely finished exhaling.

The pressure coming back in a tad prematurely (it's supposed to do that with C-Flex) can bother some people, and not be noticed at all by others. I noticed it, but got used to it easily and stopped noticing it once I found out it was supposed to work that way. At first I thought the machine was faulty for not letting me exhale completely!

Some people find breathing out much more comfortable if their prescribed pressure is reduced somewhat when they begin to exhale. Other people have no problem breathing out against their prescribed pressure and don't need C-Flex at all -- or any other machine's exhalation pressure drop.

Some people find the way C-Flex works annoying, others love it. I like it but don't need it. The nice thing is that with ANY machine that has ANY kind of pressure reduction feature for exhaling, the feature can be turned off.

C-Flex can be set for 1, 2, or 3; "3" being the most pressure reduction it can give. Those numbers do NOT mean C-Flex will drop the pressure by "that many cm's." Each C-Flex setting is for a vague drop in pressure...the actual amount of reduction depending on how forcefully you exhale and how long you maintain the steady force of your exhalation. Quite comfortable for most people since it's the start of breathing out against pressure that bothers most people, if they're going to have difficulty exhaling against their prescribed pressure at all.

Some ResMed machines have "EPR" (expiratory pressure reduction.) That pressure drop can be set for 1, 2 or 3 and DOES correspond to exactly that many cm's of pressure. ResMed's EPR will maintain that exact dropped pressure until you take your next breath. If you don't start to inhale within 15 seconds after finishing your exhalation, the regular pressure comes back in after 15 seconds. Unfortunately, ResMed's EPR feature cannot be used with their new S8 Vantage Auto in "auto" mode...just in cpap mode.

Polaris machines have "Soft-X." Similar to C-Flex. I haven't used a Polaris - not really interested in trying it, as I prefer using an autopap.

Then there are bi-level machines, commonly called "bipap" even though BiPAP is Respironics' trade name for its bi-level machine. Respironics' BiPAP, ResMed's VPAP, Puritan Bennett's bi-level can give any amount of exhalation pressure relief by setting the IPAP for a higher inhalation pressure and the EPAP for a lower pressure for exhaling. Unlike "C-Flex" and "EPR" which are going to eventually kick back in the pressure, true bi-level machines will hold the low pressure until the person actually starts to breathe in again. More advanced bi-levels that have a "timed back up" feature can be set to kick in the higher IPAP pressure from time to time if the person is not taking breaths often enough.

Respironics' BiPAP has an additional comfort feature called Bi-Flex which drops the already lower exhalation pressure down a bit more at the beginning of the exhalation. In somewhat the same way that C-Flex lets the regular pressure come back in before a person has finished exhaling, Bi-Flex lets the reduced EPAP pressure of the BiPAP machine come in soon after the exhalation gets underway.

Bi-levels can also be set to work as straight cpap with a single pressure. A Bi-level would be a rather expensive type of machine to use as a single pressure straight cpap, though!

An interesting "new kid on the block" is the Respironics BiPAP-Auto. A totally new combo machine that operates in both modes at the same time. An autopap with true bi-level exhalation relief. Now THAT one, I'd love to try...(even though I don't need it)....someday!

[RAMBLINMAN]

DSM,

In your thread you mention "mouth puffs"..

Can you explain what that means...?

[dsm]

DSM,

In your thread you mention "mouth puffs"..

Can you explain what that means...?

By this I am thinking to the following approximate conditions

1) Using a nasal mask (in my case an activa)
2) High cms setting (for me 14 or 15)
3) Running CFLEX at 2 or 3 in CPAP mode

I will suddenly become aware of a burst of air coming into my cheeks even if mouth is taped shut. Cheeks bulge or if no tape - mouth pops open.

The air then has to be swallowed, squeezed back into the throat, or puffed out.

Cheers

DSM

[IWannaSleep]

I found the CFLEX feature caused my AHI to run higher, so I turned it off.