C-Flex - exactly what is it? Clarification needed.

[lola]

I am finally getting to see the Sleep Doctor (no not the bedroom furniture franchise, ) on Monday, and I want to make sure I've got my information correct and understand what's going on (especially if there's a case of Stubborn or Ignorant Doctor).

I ought to be receiving my CPAP machine in the next week, because it's done through the public health department, I'm pretty sure you just get a fairly basic CPAP machine + humidifier. Hey, it's free and better than nothing! I would like to discuss AutoPAP options with the doctor though, and just need some clarification about exactly what C-Flex does. From what I can tell it's kind of like a cross between an APAP and a BiPAP - reduces the pressure on breathing out, but with the breathing detection algorithms as well, so you could have something like IN - 10cm, OUT - 6cm; IN - 8cm, OUT - 5cm; as the night goes on, instead of just IN 10cm - OUT 6cm constant all night. Is this correct or have I missed some vital point?

[littlebaddow]

That's pretty much it, Lola.
C-flex is available only on remstar machines (though I think a similar feature is available from other manufacturers).
I don't know by how much it reduces the pressure as you breathe out, as the settings represent a bit, a little bit more, and most rather than a specific number of cms.

[WillSucceed]

Lola:

C-FLEX is an option that is available on the RemStar line of machines. It gives some exhalation relief -the amount of relief is not clearly quantified by Respironics. Their literature talks about C-FLEX 3 as being 'most' relief whereas C-FLEX 1 is 'least' relief. This does not mean that C-FLEX 3 is a relief of 3 increments of pressure.

So, on a RemStar machine that is NOT an auto (RemStar, RemStar Plus & RemStar Pro) if your CPAP pressure is set at 10, C-FLEX 3 does NOT mean an exhalation pressure of 7. It just means 'most' relief.

If you have a RemStar AUTO, the machine will be automatically adjusting your inhalation pressure as many times as necessary during the night and, the C-FLEX setting that you select will give you a corresponding amount of exhalation relief which, again, is not an exactly quantified amount. It will be 'least', 'some' or 'most' relief relative to which C-FLEX setting you select.

An auto machine (no matter which manufacturer) is a good selection as it will work in auto mode or, if you don't like auto, can be set to regular CPAP mode. Further, with the RemStar machines (all of them) the C-FLEX option can be turned off if you don't like it. Contrary to popular opinion on this forum, not everyone likes C-FLEX. I would not, however, suggest that opinion, other than your own, guide you. If at all possible, trial as many auto machines, using the same mask, as you can. In this way you will find the machine that gives you best treatment.

If you are only going to buy a regular, single-pressure CPAP machine, it does not matter much which machine you select other than whether or not C-FLEX is helpful to you and, other features (size, portability, etc.,) of the machine. Vanilla CPAP machines are all vanilla.

If you are going to buy an auto machine, be aware that each of the manufacturers use proprietary algorithms in their machines. While you might want a RemStar because you like C-FLEX, if the RemStar algorithm does not suit your breathing patterns, C-FLEX will be of no use to you as the basic auto function of the machine is not a good match for you.

You might, after some trials, find that the ResMed Spirit is best for you, or the PB 420E.

All of the machines have valuable features:
ResMed Spirit allows you to add a pulse oximetry module -some find this very valuable.

PB 420E is wonderfully small and easy to travel with. It is also the ONLY auto machine (out of the RemStar, ResMed and PB line-up) that allows the user to adjust some of it's triggers so that you can tailor the machine to fit your breathing pattern if the algorithm is not quite right for you. If you buy RemStar or ResMed, you get what they give you and that is it... no adjustment, no tailoring.

So, after having said all of this, try out the different machines if you can. If you can't, and your titrated pressure is high (>11) give strong consideration to the RemStar with C-FLEX as it may be a benefit for you. If your pressure is low (<11) or, if you did not find it at all uncomfortable breathing out against the pressure during your sleep studies, don't lust too heavily after C-FLEX, look at the features of the different machines and make a decision based on features/options/portability/ etc.

[Guest]

The following are excerpts from the Respironics C-Flex Brochure:

...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.

A typical complaint of sleep apnea patients using CPAP is that it’s uncomfortable or even difficult to exhale against the continuous positive pressure. This discomfort can be a major barrier to long-term therapy compliance. C-Flex is designed to remove that barrier.

How C-Flex works: C-Flex tracks the patient’s breathing to lower the amount of pressure delivered at exhalation. With three C-Flex settings, patients have the ability to select the level of pressure relief that’s right for them. The amount of pressure relief delivered by a unit equipped with C-Flex is based on the patient’s expiratory flow and the C-Flex setting. As you move through the settings, the amount of variable relief increases. This allows the patient to choose what they feel is the right level of pressure relief at exhalation – which makes therapy more comfortable. And that makes long-term compliance easier to come by.

For entire brochure: Respironics C-Flex Brochure

[rested gal]

Willsucceed, your explanation is a keeper! Bravo!
(You walked that fine line soooo well.)

Thanks for the brochure info, Guest. That's useful, too.