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SleepingUgly wrote:

Wulfman wrote:With an EPR setting of "2", you're getting two less centimeters of pressure on exhale. So, if you're at the minimum pressure of 7.4, after you exhale, you're "effective" pressure is down to 5.4 when you start your inhale cycle. Snores occur when inhaling.

What does this mean with Cflex + ? For example, I have CPAP set to 8.0 and I have Cflex + set to 3. Does this mean the pressure is 5 when I start to inhale, or is that how it is with Cflex, but not Cflex +?

"Nothing" and "No". C-Flex and EPR do not work exactly the same. The "Flex" technologies from Respironics sense the exhale process and give a slight drop in pressure at the beginning of the exhale......relative to the person's exhale effort. It also keeps a little back pressure to help prevent apneas from occurring and increases pressure as the inhale process begins again. The C-Flex setting does not correlate to a fixed pressure number like EPR does in the ResMed machines.
With EPR, the pressure drop in centimeters corresponds to the EPR setting and drops that amount of pressure for the full exhale effort.
I haven't actually studied or read up on the "C-Flex +" technology, yet. But, I have been using C-Flex for nearly 5 years in my own machines.


Den

Back to a 4.2 on the 2nd night, and I woke myself up a couple times this morning, don't know if they were central apnea or obstructive, not sure if there is even a way to tell.....I know it's still to early to tell, so far my wife hasn't noticed any snoring though.

JC

Well, so far, so good. One night I had a TON of measured events, but the overall AHI for that night was still less than 4, and every day so far, other than one, has been less than 4...and my wife has not reported any snoring, so I guess that answers the question.

JC

Not sure if anyone cares or not, and I don't care if they do or not, LOL, but I wanted to follow up with my results. AHI has gone down and snoring has stopped almost completely with just a .2 increase in pressure. I'll probably try another .2 or .4 to see if my #'s continue to go down.

I did wake myself up gasping the other night, not sure if that was a central, or if it was just good ole' plain OSA...

JC

So what settings are you running on now? (For how long?)
What's your AHI, and how are you feeling?

7.4 min, no EPR, 16max, no humidity (but humidifier is installed and full). AHI is ~3.5, I feel as I pretty much always have, although I do seem to be a little peppier in the AM. Still after 2 years of xpap therapy I've not seen any of the supposed gains I was sold on, shy of I don't snore and my wife doesn't hate me as much.

JC

jrcmlc wrote:7.4 min, no EPR, 16max, no humidity (but humidifier is installed and full). AHI is ~3.5, I feel as I pretty much always have, although I do seem to be a little peppier in the AM. Still after 2 years of xpap therapy I've not seen any of the supposed gains I was sold on, shy of I don't snore and my wife doesn't hate me as much.

JC

And, you're still alive.
You gotta look at the bright side.

Are you getting ENOUGH sleep?
Have you considered trying CPAP mode? (maybe with your 95% pressure) It could be the pressure changes during the night are keeping you from feeling well-rested.


Den

SleepingUgly wrote:

Wulfman wrote:With an EPR setting of "2", you're getting two less centimeters of pressure on exhale. So, if you're at the minimum pressure of 7.4, after you exhale, you're "effective" pressure is down to 5.4 when you start your inhale cycle. Snores occur when inhaling.

What does this mean with Cflex + ? For example, I have CPAP set to 8.0 and I have Cflex + set to 3. Does this mean the pressure is 5 when I start to inhale, or is that how it is with Cflex, but not Cflex +?

SleepingUgly, that's not how it is with either C-Flex or C-Flex+ (used in Respironics machines.) What Den (Wulfman) described is how it works only with EPR (used in ResMed machines.)

EPR works completely differently from the way C-Flex and C-Flex+ work.

EPR and C-flex:
Aug 2008
viewtopic.php?p=289251#p289251

Feb 26, 2009
viewtopic.php?p=342731#p342731

C-flex is Respironics' way of handling our exhalations. I just got an M series where i could dial it in. This makes a bit of sense to me that it's a measure of % basically, where #1 setting allows less decrease in pressure and the #3 makes me wonder if I came unplugged from the machine or got a hole in the hose! I need to watch my numbers and personal reaction to figuring out how to use the papcap chin strap for a couple more nights, then start in with this variable!! I just love a good experiment!!

Kelvin

I think I'm snoring or maybe breathing from my mouth the last two nights? Wake up with dry mouth and never had mouth breathing issues before?

I'm on apap, started 4-20 range in early Jan and been trying to slowly find the sweet spot. My average pressure has held to 9.6 area and as usual each weekend, make adjustments, this time to an 8.4-11.4 range (don't ask about the decimals!). I thought another week or so and I'd settle in for the long haul

My AHI still fluctuate in 10 range (although last week did drop below 10 at an apap range of 7.4 - 11.4) but my Ai the last two nights have dropped to personal bests: <2. My leakage, which has historical trend of 0.16 jumped to 0.44 and 0.66 last two nights - which confirms something is going on.

Any ideas what's causing this 'change'? My card reader is enroute so can only rely on daily lcd readings. On the one hand my Ai are improved, but more leakage and dry mouth?

dtsm wrote:I think I'm snoring or maybe breathing from my mouth the last two nights? Wake up with dry mouth and never had mouth breathing issues before?

I'm on apap, started 4-20 range in early Jan and been trying to slowly find the sweet spot. My average pressure has held to 9.6 area and as usual each weekend, make adjustments, this time to an 8.4-11.4 range (don't ask about the decimals!). I thought another week or so and I'd settle in for the long haul

My AHI still fluctuate in 10 range (although last week did drop below 10 at an apap range of 7.4 - 11.4) but my Ai the last two nights have dropped to personal bests: <2. My leakage, which has historical trend of 0.16 jumped to 0.44 and 0.66 last two nights - which confirms something is going on.

Any ideas what's causing this 'change'? My card reader is enroute so can only rely on daily lcd readings. On the one hand my Ai are improved, but more leakage and dry mouth?

If your leak rate rate is that bad, your therapy "numbers" can be out of whack (not accurate).
Too much humidity can increase nasal congestion and cause you to mouth-breathe.
Do you do nasal rinsing/cleansing before bedtime? (it helps)
Do you tape your mouth shut? (obviously not if you're waking with a dry mouth)


Den

Wulfman wrote:If your leak rate rate is that bad, your therapy "numbers" can be out of whack (not accurate).

Is that possible - artifacts?

Wulfman wrote:Too much humidity can increase nasal congestion and cause you to mouth-breathe.
Do you do nasal rinsing/cleansing before bedtime? (it helps)
Do you tape your mouth shut? (obviously not if you're waking with a dry mouth)
Den

What i described happened only in the last two nights. I don't use humidifier, don't have nasal congestion - when I started therapy, was very conscious of mouth opening and never had this occur before.

I put a call into the sleep center and spoke with my favorite nurse/RT - she suspects in deep rem sleep I am super relaxed, causing my mouth to relax and open. That makes sense because during early part of evening my leakage is 0.0, Ai are 0 and the numbers jump from about 3 am onwards (I read the lcd when I do my regular bathroom wakeups).

I've ordered a chinstrap from my DME (they need a Rx from sleep center, guess insurance will cover it?) and hopefully this will solve it. And hopefully it means I'm getting to that sweet spot.

I'm the OP, and I'll answer the one question I found in there for me.

YES, I think I'm getting enough sleep, almost always 7.5-8hrs per night.

JC