New to CPAP- Difficulty exhaling

Saltydog · Post by **Saltydog** » Fri Jan 20, 2006 6:50 pm

Hi-
My third night on CPAP is tonight. The DME left me with a very basic remstar with a humidifier. My setting is 9cm. I have a swift mask which is working very well thus far. I feel like I am really struggling to exhale when it fully ramps up.

I have a Dr. appt next week and am thinking of requesting a script for a c-flex. Am I on the right track? How does it work? or should I give my current set-up more time? I need to be informed when I talk to him.

I have used many tips from here already. This site is very helpful! Thanks

wading thru the muck! · Post by **wading thru the muck!** » Fri Jan 20, 2006 6:55 pm

Saltydog,

How "BASIC" is this REMstar machine... they've ALL had C-flex for nearly a year and a half now, so your machine must be older than that. Did they tell you they were giving you a used machine??? C-flex will make it much easier to exhale.

Saltydog · Post by **Saltydog** » Fri Jan 20, 2006 6:59 pm

No they did not tell me it was used. My insurance got nicked for $1000 for this. It does not appear to be used. All it says on the machine is remstar.

Guest · Post by **Guest** » Fri Jan 20, 2006 8:23 pm

9cms is not very high, so I think you could get used to it. But if you can get your DME to take back your machine and give you a Remstar with the c-flex feature, you will instantly have pressure relief upon exhalation. The way it works is there are 3 possible c-flex settings. Setting it at 3 gives you the most pressure relief on exhale, and 1 the least. The actual amount of relief at each setting is dependent upon the force of your exhale. You can adjust the c-flex settings right on the machine to experiment and find which one works best for you.

If you're interested in having the software to check your data so you can see how many apnea events you're having, ask for the Remstar Pro II with c-flex. If you're interested in having an auto-adjusting machine, ask for the Remstar Auto with c-flex.

Snoozie · Post by **Snoozie** » Sun Jan 22, 2006 12:48 am

My pressure is at 9 and I definitely have nights when I have trouble exhaling with the Aura/Headrest (don't know why), and then there are other nights that are just fine. I don't seem to have this problem with my Swift. I also for some reason, have more trouble exhaling with the humidifier on, than when it is off. Even on the lowest setting. Again, don't know why. Also, sometimes C-Flex works for me and sometimes it doesn't. I can't explain any of it, because nothing seems to be consistent. I have been on this since September and still trying to figure things out.

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CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, C-FLEX, swift, Aura

NightHawkeye · Post by **NightHawkeye** » Sun Jan 22, 2006 10:30 am

Saltydog wrote:The DME left me with a very basic remstar with a humidifier. My setting is 9cm.

You might consider your sinuses. I started three weeks ago . . ., found out right away that sinuses limit my ability to exhale. My Auto also senses this and keeps jacking the pressure up to clear them out! No way I can stop it unless I breathe through my mouth, then no problem.

I haven't figured out a solution for it yet other than to see an ENT.

Good luck.

elliejose · Post by **elliejose** » Sun Jan 22, 2006 2:33 pm

Definitely get the c-flex if possible. I started out on a pressure of 14 and could not exhale against the pressure. Finally got an auto with c-flex and it made all the difference in the world. I don't even use the c-flex feature now but it kept me on the machine for some months. I used it for about 6 months and I think I would probably have given up without it. It really hurt my chest to exhale and I didn't get any sleep for trying to breathe. With the auto I was lot less restless in the night and made it easier for my hubby to adjust to the treatment. Also most nights I spend most of the night on a lower pressure. I have my auto lower pressure set at 12. That seems to work best for me. It was almost 3 months before I slept a complete night with the mask on so don't give up. It just takes longer for some of us to adjust than other. And it was also about that timethat I got the auto.

Good luck to you. Keep us posted.

Saltydog · Post by **Saltydog** » Sun Jan 22, 2006 6:17 pm

Thanks for all the information, it does help me. I do have sinus issues and will need to discuss this with my Dr. Not sure if an autopap would help, but may be a consideration. I may have insurance problems with the autopap. I have had four nights now and can only seem to tolerate it about 4 hours.

I do know that my ramp pressure of 4cm to start is too low as I can't seem to get enough air at that point. Thanks!

john5757 · Post by **john5757** » Sun Jan 22, 2006 10:42 pm

Saltydog,

I is quite common for people to feel that 4cm is to low and the starting ram pressure can be raised in the user menu which the instructions are in the user manual.

GrumpyInKC · Post by **GrumpyInKC** » Mon Jan 23, 2006 1:31 pm

I would start by checking the model number of your CPAP and checking to see if it has the C-Flex option. As was mentioned above all the new ones do and I would assume yours does as well. I just got my CPAP last week and specifically asked for one with C-Flex, my DME provided me with a REMStar with C-Flex but wouldn't (couldn't according to him) enable the C-Flex function because it was not on the Doctors script.

If your machine has C-Flex I would call my doctor today and get him/her to approve C-Flex and have your DME enable it ASAP, or do it yourself. My only experience with a CPAPs is the one used in my sleep study without C-Flex and my new RemStar with C-Flex and the C-Flex makes it much easier to adjust. By getting it enabled now you should know if it will make enough of a difference by the time you have your appoitment next week, if not you might try to push for a APAP or BiPAP.

I don't understand why this option can't/won't be activated by default, it seems to me that it has no negative medical effects and it makes it much easier to get used to using a CPAP.

Saltydog · Post by **Saltydog** » Mon Jan 23, 2006 3:42 pm

Thanks for the advice. There are not any adjustments noted anywhere in the manual. That info is probably in the home care provider setup instructions which have been conveniently removed. I can't find any reference to c-flex anywhere in the manual or on the machine. Someone else from this site gave me instructions for changing the ramp, however, the buttons suggested for me to use do not exist on this machine. I suspect this machine is a bottom line, obsolete model.

Wulfman · Post by **Wulfman** » Mon Jan 23, 2006 5:18 pm

Saltydog wrote:No they did not tell me it was used. My insurance got nicked for $1000 for this. It does not appear to be used. All it says on the machine is remstar.

For $1000 you could get a top-of-the-line "Auto" (AND mask). SOMEBODY got ripped off.

Are you still on a "trial" basis with the machine (or rent to purchase)?......or is this a "done deal". If it isn't completely paid for, I'd be screaming at that DME and asking for a better machine (like a REMstar Pro 2 or Remstar Auto) if I were you.

Good luck,

Den

sthnreb · Post by **sthnreb** » Mon Jan 23, 2006 9:32 pm

You may want to discuss a bipap machine with them too. It gives some relief for Epap (exhale). You can set it higher for Ipap. 9cm is not very high like they said, my Epap is set at 8 cm and titrates from there usually being around 9 cm with a 12 cm Ipap. Usually the Remstar require you to turn them off and upon restarting, hold down two of the buttons to get into the provider mode to change settings. Or, with software and card, you can also change that way too.

stanta · Post by **stanta** » Wed Jan 25, 2006 11:22 am

I had the same problem when starting out and discovered a way that worked for me and has helped two other people since.

Obviously breathing under even 9 cm of pressure is not natural for our body. What I did and recommended to my brother and friend is to use large breaths when you have the air coming actually over inflating your chest compared to normal. This way the muscles have to push out the air, using a kind of spring action as they go back to the resting position. It feels awkward at first and takes some practice but after a little practice your body does it automatically.

I can slap on the mask and be instantly comfortable and asleep in minutes. There are also times when I wake during the night where I have to check the exhaust to make sure it is running.

I did fail at the CPAP the first time I was diagnosed because I fought it all the way, I felt I "couldn't" adapt and went through some very painful throat surgery that eventually failed me.

Stick with it. Your body and brain is very adaptable and will take over on it's own if you give it a little help and time.

Saltydog · Post by **Saltydog** » Wed Jan 25, 2006 11:35 am

Thanks for the advice, I will give it a try....

Machine

Additional Comments: Resmed AirCurve 10 VAuto BiLevel with HumidAir

Machine	Mask

New to CPAP- Difficulty exhaling

New to CPAP- Difficulty exhaling

Re: New to CPAP- Difficulty exhaling