Questions for Pr S1 Auto A-Flex users

[Raz]

Hi guys,
On in the clinical menu setup there is a setup A-Flex 1, 2 or 3 i'm using on number 2, I checked all three couldn't feel the difference, which should I use, any one knows ?

One more thing, usually you guys use on auto A-flex or C-flex plus, which is better?
Thanks
Raz

[mayondair]

It's a very individual thing, your mach has a flex demo, or you can try different setting for a few nights, see which if any, you find comfortable.

[trike-mike]

I tend to use A-Flex at setting 3. Basically the three settings, as I understand them, are different degrees of pressure relief at various stages of the breathing cycle and are NOT necessarily a fixed pressure reduction as with the Resmed machines. What are your pressure settings on the APAP? If the bottom and top are fairly low, the difference in pressure relief may NOT be all that much. Even if the range is fairly wide, when awake, unless the lower pressure setting is fairly high, you may well not experience any significant difference but will in your sleep.

One other thing... according to the Respironics site, you need to have your minimum pressure setting at 6 or higher to enable A-Flex otherwise will run in C-Flex+

[jbn3boys]

I also understand it as mike does, that the three numbers are three levels of exhalation relief. I didn't notice any difference when I was awake when I changed mine. The DME had set it up as AFlex of 2. A few weeks ago, I changed it to 3 in an ongoing effort to get my numbers (AHI, CA, OA, H) to look better. I don't know that it made any noticeable difference, but I've decided to leave it at 3 for now. I really think it's mostly a personal preference, and you can try different levels to see if/how they effect you.

[sleepnationtv]

Really it is just a matter of comfort the difference in the flex will only be 1 cm of pressure different, so really it is not a huge noticeable difference. I like to use level 3 to get the most relief but you may not notice the difference.

Good Luck

Dane

[trike-mike]

Consider also that my travel machine is a really, really, really basic CPAP - fixed pressure, no exhalation pressure relief. I have it set at my 90% pressure as determined by empirical data captured by the APAP. Once I got to a reasonably solid number, I set my APAP to run in its most basic mode - fixed pressure, no exhalation relief.

I found that in several nights of using the APAP in that mode with a couple of different mask types (to be sure I'd have one I liked in conjunction with this mode while traveling) that my numbers were just dandy... AHI < 2 always and typically < 1.

When I'm home, I definitely take all the comfort night-over-night the machine will give me with the pressure range and the highest A-Flex setting. Even at that, when traveling or even at home once in a while my preference is some serious kick-butt air and use the machine almost exclusively for napping or even some nights when the softer approach isn't working for me.

From this experience it seems it is definitely more of a comfort thing so experiment away with this. Also, don't be too sure or stress about what worked last night won't work tonight. We are maddeningly variable

[Raz]

I tend to use A-Flex at setting 3. Basically the three settings, as I understand them, are different degrees of pressure relief at various stages of the breathing cycle and are NOT necessarily a fixed pressure reduction as with the Resmed machines. What are your pressure settings on the APAP? If the bottom and top are fairly low, the difference in pressure relief may NOT be all that much. Even if the range is fairly wide, when awake, unless the lower pressure setting is fairly high, you may well not experience any significant difference but will in your sleep.

One other thing... according to the Respironics site, you need to have your minimum pressure setting at 6 or higher to enable A-Flex otherwise will run in C-Flex+

Hem...... I didn't know that to enable AFlex the setting should be minimum 6 and max 20, the machine should have normally grayed out the minimum and maximum settings when you select AFlex setting. Like when you select AFlex the ramp for CFlex disappears.

[Raz]

Thank you all for the replies. A great forum.

Raz

[jbn3boys]

Hem...... I didn't know that to enable AFlex the setting should be minimum 6 and max 20, the machine should have normally grayed out the minimum and maximum settings when you select AFlex setting. Like when you select AFlex the ramp for CFlex disappears.

There's nothing about the min being 6 AND the max being 20. I believe the min may have to be 6 in order to use flex, since if the min is set at 4, and the machine min is 4, there really can't be a lowered pressure.

the difference in the flex will only be 1 cm of pressure different.

From what I understand, it is the ResMed machines that use the 1cm per number. I believe the Respironics just use a "decrease" in pressure, not a specified amount. My guess, and it's only a guess, is that may be based on pressure, with a greater reduction on higher pressures.

Regardless, it really IS a matter of comfort, and the best way to figure out what you like is just trial and error.

[Amigo]

...

Regardless, it really IS a matter of comfort, and the best way to figure out what you like is just trial and error.

I agree, you'll need to experiment to find YOUR specific comfort level. A bit of a nuisance, but well worth it.

For me A-Flex just didn't feel comfortable. My sweet spot, at least for now, is C-Flex on a setting of '2.'

[trike-mike]

Interestingly enough, I had been very happy with A-Flex on 3. That being said, I finally figured I'd take the plunge and set the "mask resistance" setting last night for the masks I have.

That sucked.

The exhalation relief ended up being so massive vs. the pressure I spent the night with the mask rising and falling against my face. Took a while to get to sleep. Clearly there is enough interaction between the two that it changes how it functions.

I did not like it.

[snoozysue]

Trike-Mike, I have the same machine as you and I know the felx is set at 3. You mentioned a "resistance setting" - could you please explain what that is all about?
Thanks

[trike-mike]

Trike-Mike, I have the same machine as you and I know the felx is set at 3. You mentioned a "resistance setting" - could you please explain what that is all about?
Thanks

snoozysue, I saw some discussions here about resistance setting. It ostensibly adjusts the machine for the resistance of the mask you are using and seems to be similar to the mask setting on the Resmed machines. I'm not sure what it is supposed to do but I found it changed a rather smooth therapy delivery to one that changed so much that I could feel the mask rising and falling on my face. I really did not like it.

If you search for "resistance" you'll run across the bigger discussion on it. It is accessed through the clinician menu on the machine.

This is likely a YMMV kinda thing but I haven't seen many that actually use or like it.

mike

[jbn3boys]

It is accessed through the clinician menu on the machine.

This is likely a YMMV kinda thing but I haven't seen many that actually use or like it.

mike

I actually started using it recently, after one of the discussions here. At that point, it actually helped my therapy, helping my numbers improve.

Last night, I used a new mask, and since it was not made by Respironics, I had to guess at what setting to use. I found what I thought was the most similar type mask, and went with that resistance, but it was very uncomfortable. I split the difference between the resistance I had used, and what I thought I should use, and it seemed to work just fine.

And actually, you can access the System One Resistance in the Setup menu (not the clinician menu), at least on my machine. I suppose it might be possible in the clinician menu to disable the ability to set it from the main Set Up menu.