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[CPAP] C-FLEX
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thefotochef Offline

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Posts: 4
Joined: Sep 2012

Machine: ResMed S9
Mask Type: Nasal mask
Mask Make & Model: ResMed Ultra Mirage II
Humidifier: Enhanced H5i Humidifier
CPAP Pressure: 19/15
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: Newton, NJ

Post: #1
C-FLEX
I was just given a REMstar Mseries CPAP with C-Flex as a temporary fix to a problem with my current machine. I was just wondering what the pressure relief is between the 1 2 3 sections of the C-FLEX. I'm normally on 20/15 on my Bi-Pap.

I have an appointment next week to set up a new sleep study and should be able to get a new machine then.

Thx
06-04-2014 10:34 PM
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SuperSleeper Offline

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Posts: 9,973
Joined: Feb 2012

Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #2
RE: C-FLEX
C-flex levels:

1 = 1 cmH2O reduction in pressure on exhale

2 = 2 cmH2O reduction in pressure on exhale

3 = 3 cmH2O reduction in pressure on exhale

So the maximum pressure relief you can get is 3 cmH20 of pressure. So effectively you can set it for 20 on the pressure and 3 on the C-flex, giving you a rough equivalent of BiPAP set at 20/17. Not exactly the same but close.

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

06-04-2014 10:41 PM
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robysue Online
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Posts: 1,240
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #3
RE: C-FLEX
(06-04-2014 10:41 PM)SuperSleeper Wrote:  C-flex levels:

1 = 1 cmH2O reduction in pressure on exhale

2 = 2 cmH2O reduction in pressure on exhale

3 = 3 cmH2O reduction in pressure on exhale

Nope. C-Flex does NOT work this way. What you are describing is Resmed's EPR pressure relief rather than PR's Flex.

C-Flex provides a variable amount of pressure relief at the beginning of the exhalation. The stronger the exhale, the greater the pressure drop is. But regardless of what C-Flex setting you are using, the maximum amount of pressure relief on even a very, very strong exhale is probably going to be no more than about 1.5-2 cm even when C-Flex is set to 3. And it will be less than 2cm when you're not exhaling really forcefully.

To the OP:

Your BiPAP is set to 20/15. You are used to a 5cm drop in pressure at the beginning of every exhalation AND you are used to having the pressure stay at 15cm all the way through your full exhalation. There is no way to even come close to duplicating this BiPAP setting on a REMstar Mseries CPAP with C-Flex.

If you set the pressure to 20cm, at the beginning of your exhalation, you might get a reduction in pressure to maybe 17.5-18.5 cm on a regular basis at the beginning of the exhalation with C-Flex set to 3, but the pressure will be increased back up to 20cm during the second half of your exhalation. And that's going to feel very, very different from your BiPAP.

If it's important to have the EPAP pressure approximate 15 cm due to aerophagia or a tendency to have centrals when your EPAP is higher than 15cm, then setting up that REMstar Mseries CPAP with C-Flex is going to be trickier. To have an EPAP in the 15cm range with C-Flex, you'll only be able to set the CPAP pressure at around 16.5-17.5, which is quite a bit lower than your current IPAP is.

Is this really the only loaner machine the DME could set you up with while your machine is in for repairs? They really have NOT given you an appropriate loaner machine and it's not clear that you'll be able to set this loaner up with an appropriate setting to treat your OSA both comfortably and effectively.
06-04-2014 11:04 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #4
RE: C-FLEX
(06-04-2014 10:41 PM)SuperSleeper Wrote:  Not exactly the same but close.
Poor man pressure relief Coffee
Setting of 1 provide the smallest pressure relief
06-05-2014 12:16 AM
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SuperSleeper Offline

Administrators

Posts: 9,973
Joined: Feb 2012

Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #5
RE: C-FLEX
Yep, you're right... that's EPR for ResMed machines, not C-Flex for Respironics machines. But the basic concepts are the same - the higher the C-Flex (or EPR) level, the greater the pressure relief. That's why I said it's a "a rough equivalent" to what Bi-level does and "Not exactly the same but close". I agree that Bi-level is going to provide better overall therapy and they should give the OP a loaner bi-level instead of this older single-pressure machine with C-Flex. But in the meantime, until a better machine is provided, the OP should use that machine rather than none at all, and set it up as 20 cmH2O with C-Flex set to 3 to approximate as closely as possible what their old Bi-level was set at. Yeah, I know it's not exactly the same, but that's what this particular older machine should be set at to help the OP get the best treatment with the machine they were given.

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

06-05-2014 01:18 AM
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jaycee Offline

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Posts: 115
Joined: May 2014

Machine: S-9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quattro Air Large
Humidifier: 5i
CPAP Pressure: 9-13
CPAP Software: ResScan

Other Comments: RT at a DME

Sex: Male
Location:

Post: #6
RE: C-FLEX
I guess I'm confused. In your post it says BIPAP but below your name it says M - Plus (which is a CPAP). Maybe that is what you just put in there because that is your loaner.

If you are on BIPAP, I would call your DME and say you aren't tolerating CPAP and want to go on a BIPAP at the same settings you are currently on. If they don't want to help, ask them if they have the ordering doctor's phone number so you can call and explain to your doctor that the DME put you on settings that aren't ordered by the doctor.

If you are on BIPAP, how long ago did you get your machine? Most insurances will pay for a new machine every 5 years.
06-05-2014 08:50 AM
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trish6hundred Offline

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Posts: 6,450
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #7
RE: C-FLEX
Hi thefotochef,
WELCOME! to the forum.!
Good luck to you with getting your machine situation straightened out and hang in there for more responses to your post.

trish6hundred
06-05-2014 09:14 AM
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thefotochef Offline

Members

Posts: 4
Joined: Sep 2012

Machine: ResMed S9
Mask Type: Nasal mask
Mask Make & Model: ResMed Ultra Mirage II
Humidifier: Enhanced H5i Humidifier
CPAP Pressure: 19/15
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: Newton, NJ

Post: #8
RE: C-FLEX
(06-04-2014 10:34 PM)thefotochef Wrote:  I was just given a REMstar Mseries CPAP with C-Flex as a temporary fix to a problem with my current machine. I was just wondering what the pressure relief is between the 1 2 3 sections of the C-FLEX. I'm normally on 20/15 on my Bi-Pap.

I have an appointment next week to set up a new sleep study and should be able to get a new machine then.

Thx

Here is an update on what I wrote last week. While doing some research on the M series I found out how to shut off the auto off feature on my Philips System One BiPap plus with Biflex. I shut the auto off off and replaced my harness which was stretched out, this seems to have fixed the leak problem on my old mask, as I can't stand the full face mask. I will update my profile with the current machine and mask ASAP.

I also saw the pulmunologist on Monday and am waiting now on the insurance approvals to get a new sleep study done.
06-11-2014 12:24 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #9
RE: C-FLEX
(06-11-2014 12:24 PM)thefotochef Wrote:  Here is an update on what I wrote last week. While doing some research on the M series I found out how to shut off the auto off feature on my Philips System One BiPap plus with Biflex. I shut the auto off off and replaced my harness which was stretched out, this seems to have fixed the leak problem on my old mask, as I can't stand the full face mask.
Replacing the headgear or/and cushion might helps with leaks but 'Auto off' is something different , here the definition from Phillips:
Auto off - You can enable or disable this feature if you want the device to automatically turn the airflow off whenever the patient removes the interface (mask) from their airway.

Auto on - You can enable or disable this feature if you want the device to automatically turn the airflow on whenever the patient applies the interface (mask) to their airway.

Some clinical manuals available by direct downloads from section two and some via Email from section three
http://www.apneaboard.com/adjust-cpap-pr...tup-manual
06-11-2014 04:22 PM
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thefotochef Offline

Members

Posts: 4
Joined: Sep 2012

Machine: ResMed S9
Mask Type: Nasal mask
Mask Make & Model: ResMed Ultra Mirage II
Humidifier: Enhanced H5i Humidifier
CPAP Pressure: 19/15
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: Newton, NJ

Post: #10
RE: C-FLEX
The machine was shutting off because when I moved at night the machine thot the mask came off. Has not happened since shutting off auto off.
06-11-2014 11:11 PM
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