Sleeprider what exactly is the Aflex? I haven't heard that term before now. I'm not sure I've seen that setting on my machine. Some of the options are locked to me. Apparently the company I got it from is supposed to take care of settings etc. (I guess) She did say she would be downloading my data every night and be "behind the scenes"... but it's been several days and I haven't heard anything from her. I think I'll give her a call tomorrow to go over some things.
Sleepster, I do have 30 days to try the mask to see if it works. I tried on several others but I thought this one would be less cumbersome and awkward, but if it's not doing the job I may have to switch. I may try as someone suggested to put the chin strap over the mask and it may secure it better.
Respironics machines have two modes that reduce pressure when you start to exhale, A-Flex and C-Flex. Each has a setting from 1 (least) to 3 (most). Resmed machines have a somewhat similar mode called EPR.
Jen, A-Flex is Respironics version of exhale pressure relief. It makes it easier to exhale as it reduces pressure slightly as you exhale, then increases pressure as your inhale begins. Normally this feature is not locked out and is user-settable just like ramp. At the risk of being redundant, get the clinician manual and take control of your therapy. There is nearly no one here that does not do this.
Does using the aflex or cflex make the AHI ratings worse or better?
EPR, A-flex and C-flex are all considered comfort settings. For the most part, they don't make therapy better or worse, but more comfortable. That said, a lot of people seem to have increased clear apnea with changing inhale/exhale pressure. Usually not too serious, but it can happen. Also, it's possible, especially with Resmed EPR, to have more obstructive apnea when the exhale pressure (EPAP) becomes too low. For example, with a pressure of 7.0 and EPR at 3, the exhale pressure becomes 4.0 (5.0 with A-flex or C-flex). Sometimes that does not keep the airway open for the next inhale.
Lower EPAP than IPAP can feel great, but pressure has to stay high enough to prevent OA, and for some people, too much pressure support causes CA. So I guess the answer to your question is, it depends.
Unless A-Flex is raising your clear-airway (CA) apnea index, the only reason to lower it is comfort. Most people find it more comfortable to raise it. Indeed, that is it's purpose. It lowers the pressure on exhale. C-Flex and Bi-Flex do essentially the same thing, but they differ in the way they affect the shape of the expiratory portion of the flow rate graph. This is, I think, largely a marketing scheme.
Don't worry about the difference between A-Flex, Bi-Flex, C-Flex, and C-Flex+. They all essentially do the same thing -- increase comfort by lowering the pressure when you exhale. If you find them comfortable and they don't raise your CA index, use them.
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