Relationship between C-Flex setting & sleep disturb. det

strobotach · Post by **strobotach** » Mon Feb 20, 2006 11:25 am

Is there any correlation or relationship between C-Flex setting & sleep disturb. details, reports from Encore Pro/MyEncore?

--- OR ---

Is the C-Flex setting only a personal setting that really doesn't affect other
values?

Thanks for everyones input..

Wulfman · Post by **Wulfman** » Mon Feb 20, 2006 12:00 pm

I can't imagine that Respironics would create a setting on their machines (C-Flex) that would show up in/as "sleep disturbances".....if that's what you're asking. So, I would choose the second option you listed. It's a "comfort" setting for breathing while sleeping.

Den

yardbird · Post by **yardbird** » Mon Feb 20, 2006 1:42 pm

Think of C-Flex as another option on the REMstar. Some folks will do better with it, some may do worse, and still others may not really see a difference. Just as some people do better with an auto machine and some do better with straight CPAP (constant pressure). The ADVANTAGE that you have with the REMstar is that if you have the software you can make these little changes and see how they affect your sleep.

Just be sure to make changes slowly.... one at a time ... and give ample time to determine whether or not that change has had an affect.

snorzalot · Post by **snorzalot** » Mon Feb 20, 2006 1:59 pm

The C-Flex setting is designed to lower your pressure 1, 2, or 3 cm H2O during exhale (ePAP). A lot of the newer equipment provides easy access, menu settings to control your C-Flex range--it is a feature designed to help patients with that "smothered" feeling so common with constant pressure (CPAP) equipment that leads to non-compliance.

As an example, if you had a setting of 10 cm H2O with a C-Flex of 3, your exhale pressure would drop to just 7 cm H2O and then return to 10 cm H2O as you inhale to hold your passage way open.

My original equipment (in the non compliant days) did NOT include C-Flex which I believe would have helped with my initial compliance as I would wake in a panic attack; feeling like my mask was a pillow over my face. For those that really can't tolerate the exhale pressures, BiPAP technology might be a good solution to discuss with your physician as it allows for two separate settings, one during inhale and the other during exhale. Likewise, it can bridge large gaps that C-Flex technology can not overcome. I'm currently 16 iPAP (inhale) and 12 ePAP (exhale) on my new BiPAP equipment that is working VERY well--finally!

Thanks!

WillSucceed · Post by **WillSucceed** » Mon Feb 20, 2006 2:35 pm

The C-Flex setting is designed to lower your pressure 1, 2, or 3 cm H2O during exhale (ePAP)

You might want to check the accuracy of this statement... C-FLEX is NOT an exact amount of pressure drop. C-FLEX of 3 does not mean a pressure drop of 3 cm. All C-FLEX of 3 means is that you are getting the most pressure relief at the beginning of exhalation, that the RemStar unit can offer. Similarly, C-FLEX of 1 is the minimum amount of presure relief upon exhalation that the RemStar can offer.

...and then return to 10 cm H2O as you inhale to hold your passage way open.

You might want to check on this statement as well. You statement seems to imply that C-FLEX will maintain pressure relief until the user starts to inhale. This is not correct. C-FLEX does NOT maintain the pressure reduction during the entire exhalation, with an increase to the pre- C-FLEX pressure (in your example, 10) "as you inhale." C-FLEX does provide a pressure drop as the user starts to exhale but, and this is an important 'but,' the C-FLEX pressure-reduction cuts out and the full pressure returns before the user has finished exhaling.

This is where the breath-stacking that some users experience can come from. The increase in pressure BEFORE the user has finished exhaling can, for some users, contribute to the user starting to inhale prematurely. The breaths "stack," becoming shorter and quicker -in essence, the user starts panting.

C-FLEX is a great feature for many, but it is not great for everyone. It is not an exacting pressure drop and, it is not pressure relief (like a bi-level) during the entire exhalation.

Goofproof · Post by **Goofproof** » Mon Feb 20, 2006 2:42 pm

Everything we do affects our treatment, that said, C-Flex allows you to use the XPAP treatment with less discomfort while exhaling. This allow more people success in becoming compliant, whitch is the goal. As the Army says, "Be all you can be!"

It's just another tool avaiiable for us to use to help us in our quest of better sleep and over all health care.

The Ramp feature is another tool for the same reason, but I feel it is for the most part useless. While using the Ramp you are not getting the full benefit from the treatment due to lower pressure. Most of the problems using XPAP are in our own minds. We have better success it we make ourselves determined to succeed. The faster we get on with the program the sooner we will have relief and sound sleep.

snorzalot · Post by **snorzalot** » Mon Feb 20, 2006 2:59 pm

WillSucceed,

I spoke with a specialist from my sleep lab (called just after I read your message to check on my next equipment )and he confirmed your remarks and my mistakes regarding C-Flex.

Settings of 1, 2, 3 and are NOT 1, 2, and 3 drops in cm H2O settings. Apparently, the conversation with my original RT was inaccurate. Thanks for pointing this out as it helps me even better understand why I'm having so much more success with my BiPAP equipment now when I felt "smothered" on CPAP during exhale. I'm truly dropping 4 cm H2O on the BiPAP between iPAP and ePAP.

Thanks!

rested gal · Post by **rested gal** » Mon Feb 20, 2006 5:50 pm

Perfect description, WillSucceed, of what C-Flex does -- and does not do.

snorzalot, you are spot on with this observation:

For those that really can't tolerate the exhale pressures, BiPAP technology might be a good solution to discuss with your physician as it allows for two separate settings, one during inhale and the other during exhale.

Interestingly, several of ResMed's new S8 machines (the S8 Elite and S8 Vantage) can operate almost like a true bi-level (BiPAP, VPAP) machine. ResMed developed a technology they call "EPR" (expiratory pressure relief) that has settings of "1, 2, or 3" and does drop exactly 1, 2, or 3 cm's for exhaling.

Unlike Respironic's C-Flex, ResMed's EPR does maintain the pressure reduction throughout the entire exhalation. Unfortunately ResMed's EPR can't be enabled when their new S8 Vantage autopap is operating in auto mode...can be used only in the Vantage's cpap mode and in the S8 Elite (a straight cpap machine.)

However, as you said, snorzalot, a true bi-level machine can be set for an even wider difference between inhale pressure and exhale pressure. That can bring very welcome exhaling relief -- moreso than either C-Flex or EPR -- especially when someone has been prescribed a very high inhale pressure or has difficulty breathing out in general against any incoming pressure.