What exactly is c-flex?

ldemmery · Post by **ldemmery** » Sat Aug 12, 2006 1:46 pm

Now, as you can see from my list below, the machine I use doesn't use c-flex, but I've been listening and writing here for quite a while now and I'm wondering just what exactly is c-flex? I know it's for another type of machine than the one I use, but I'm just wanting to learn some more. Can anyone give me an report?

Lynne (in Ottawa)

puffing billy · Post by **puffing billy** » Sat Aug 12, 2006 2:02 pm

Hi Lynne
Cflex is a Respironics product name for a system that reduces the pressure when you breath out. It has 3 settings 1 is a small pressure 2 & 3 are progressively larger. It is especially helpfull for those needing higher pressures.
Hope this helps

Billy

ldemmery · Post by **ldemmery** » Sat Aug 12, 2006 3:12 pm

Thanks. Clears it up for me. Just sounds like alot of equipment. Personally I like my little Fischer Paykell machine... humidifer and machine in one.. simple and works for me.

Lynne (in Ottawa)

dsm · Post by **dsm** » Sat Aug 12, 2006 3:59 pm

Hi,

The dip in pressure is momentary (very short portion of the exhale cycle. It varies in both duration & size a bit according to your cms setting and the strength of your breaths. Of course the 1, 2 & 3 also adjust the duration & size to various presets. Some people find 3 to be a bit too big a variation (can allow aerophagia (wind getting into stomach) for some of us).

DSM

Arizona Willie · Post by **Arizona Willie** » Sat Aug 12, 2006 5:10 pm

My machine < S8 Elite > does EPR similar / equivalent to C-FLEX.

I have always wondered how C-FLEX or EPR was different than BI-PAP.

dsm · Post by **dsm** » Sun Aug 13, 2006 3:27 am

Willie,

Having just been through a significant realignment of my use of Bilevels I have to say that the Resmed S8 with EPR suddenly looks very attractive.

I had been running my Bilevels (PB330, VPAP III, Bipap S/T) with a gap between Ipap & Epap (Inhale & Exhale CMS settings) of 7 CMS. When I finally got a Bilevel that recorded detailed nightly data (the VPAP III) I discovered my AHI index was higher than when I did my sleep study. I was recording regular AHI of 45-63 !!!.

On the advice of some esteemed regulars I dropped Ipap to 13 & upped Epap to 10 & my AHI has dropped to below 3 on average & of that the AI (Apnea Index tends to be 0.something) which is very good to know. My SpO2 (oxygen sat) is also quite ok (av 95).

So here I am with a Bilevel that was using a 7 CMS gap now down to a 3 CMS gap & my AHI at its best in a while.

So here we have the Resmed S8 that can do similar (either 1 CMS, or 2 CMS or 3 CMS) to my Bilevel by just using the S8 EPR.

Seems to me the S8 may be a winner !.

DSM

mister_hose · Post by **mister_hose** » Mon Aug 14, 2006 7:59 am

dsm wrote:I had been running my Bilevels [...] with a gap between Ipap & Epap [...] of 7 CMS. When I finally got a Bilevel that recorded detailed nightly data [...] I discovered my AHI index was higher than when I did my sleep study. I was recording regular AHI of 45-63 !!!.

On the advice of some esteemed regulars I dropped Ipap to 13 & upped Epap to 10 & my AHI has dropped to below 3 on average & of that the AI (Apnea Index tends to be 0.something) which is very good to know. My SpO2 (oxygen sat) is also quite ok (av 95).

So here I am with a Bilevel that was using a 7 CMS gap now down to a 3 CMS gap & my AHI at its best in a while.

This is interesting. I have a detailed-data-recording CPAP machine (REMstar Pro M-Series) and when using C-Flex = 3 my AHI's are noticeably higher than with C-Flex = 2, even though I can't notice much difference in breathing effort between them. But when I switched from 3 to 2, my AHI's went from around 2.4-3.2 down to about 1.8-1.9. This is a significant improvement.

The difference between C-Flex's 2 and 3 settings is the amount of pressure difference between inhaling and (the initial part of) exhaling. This very similar indeed to your experience, where you lessened the inhale/exhale pressure difference and saw improved AHI.

I may try C-Flex = 1 next, but it's noticeably more annoying to breathe out against, so I may not... especially since 1.8-1.9 is a very good AHI.

Anybody else experience this?

krousseau · Post by **krousseau** » Mon Aug 14, 2006 9:25 am

Arizona Willie asked

I have always wondered how C-FLEX or EPR was different than BI-PAP.

C-Flex is just a little pressure relief at the end of inhalation that allows you to exhale more easily. There is no specific amount of pressure. That means the numbers are not equal to cms of H2O-just amount of relief. On a BiPAP the numbers do mean something and relief can be set at higher levels. This is helpful to people on higher pressures where a drop of even 3 on the APAP or CPAP C-Flex really isn't much pressure relief.

Lynne-it is just a built in feature not a separate piece of equipment. Especially at low treatment pressures it may or may not be useful to everyone.

DME_Guy · Post by **DME_Guy** » Mon Aug 14, 2006 10:26 am

Here's a link to Respironics explanation with videos.

http://cflex.respironics.com/How.asp#

Patrick A · Post by **Patrick A** » Mon Aug 14, 2006 6:20 pm

DME_Guy
Thanks for the post now I'm more confused than I was today when I got out of bed

Just kiddin' the link really helps.

GoofyUT · Post by **GoofyUT** » Mon Aug 14, 2006 6:40 pm

Both provide expiratory pressure relief.

In Respironic's C-flex, there is a momentary decrease in the pressure that the machine is blowing at the very start of your exhalation.The amount of that momentary decrease in pressure can be varied between settings of 1-3, which are tied somehow to your efforts at exhaling, and are relative values (1 is the least; 3 is the most).

ResMed's EPR provides, as DSM elegantly indicated, a fixed amount of pressure reduction during the entirety of the exhalation. The degree of pressure reduction can be set at 1cmH2O, 2cmH2O and 3 cmH2O. EPR lasts for the entirety of the exhalation (rather than just momentarily at the start of the exhalation as does C-Flex), and in this regard closely approximates the actions of a Bi-level PAP (or BiPAP as Respironics trademarked). However, ResMed's EPR is, sadly, NOT available in ResMed's auto-titrating machines (S8 AutoSet Vantage) while that machine is operating in AutoSet (auto-titrating) mode. Respironics' C-flex operates in either standard CPAP (fixed) or auto-titrating modes.

Having tried both, i DEFINITELY like C-flex better, but that's just one man's opinion.

Hope this helps.

Chuck

dsm · Post by **dsm** » Tue Aug 15, 2006 6:27 am

mister_hose wrote:
dsm wrote:I had been running my Bilevels [...] with a gap between Ipap & Epap [...] of 7 CMS. When I finally got a Bilevel that recorded detailed nightly data [...] I discovered my AHI index was higher than when I did my sleep study. I was recording regular AHI of 45-63 !!!.

On the advice of some esteemed regulars I dropped Ipap to 13 & upped Epap to 10 & my AHI has dropped to below 3 on average & of that the AI (Apnea Index tends to be 0.something) which is very good to know. My SpO2 (oxygen sat) is also quite ok (av 95).

So here I am with a Bilevel that was using a 7 CMS gap now down to a 3 CMS gap & my AHI at its best in a while.
This is interesting. I have a detailed-data-recording CPAP machine (REMstar Pro M-Series) and when using C-Flex = 3 my AHI's are noticeably higher than with C-Flex = 2, even though I can't notice much difference in breathing effort between them. But when I switched from 3 to 2, my AHI's went from around 2.4-3.2 down to about 1.8-1.9. This is a significant improvement.

The difference between C-Flex's 2 and 3 settings is the amount of pressure difference between inhaling and (the initial part of) exhaling. This very similar indeed to your experience, where you lessened the inhale/exhale pressure difference and saw improved AHI.

I may try C-Flex = 1 next, but it's noticeably more annoying to breathe out against, so I may not... especially since 1.8-1.9 is a very good AHI.

Anybody else experience this?

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