Post Reply 
Increased AHI with C-Flex +
Author Message
Rritch Offline

Preferred Members-2

Posts: 107
Joined: Feb 2012

Machine: Respironics System One Pro (450)
Mask Type: Nasal mask
Mask Make & Model:
Humidifier: Respironics System One
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: NoVA USA

Post: #1
Increased AHI with C-Flex +
As I have been posting about, we are trying to get my girlfriends new PRS1 dialed in and at a good pressure. After increasing her pressure from 9 to 10 with no C-Flex her AHI was averaging around 1.8. 4 days ago we turned on C-Flex + at a setting of 1 to see if it would increase her comfort and help with the minor headaches that she is still having in the morning. Since turning on the C-Flex+ her AHI is running around 4.

Is there a correlation between the exhale relief and higher AHI? I am trying to decide whether to turn the C-Flex back off or increase the pressure to 10.5 as the next step. Any thoughts?
04-09-2012 10:22 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #2
RE: Increased AHI with C-Flex +
Or could be something else is going on to raise the AHI. And an AHI is still good. Great, even.

Try your experiment longer than 4 nights. Go for 2 weeks or so. Give her body time to get used to it.
04-09-2012 10:27 AM
Find all posts by this user Post Reply Quote this message in a reply
Rritch Offline

Preferred Members-2

Posts: 107
Joined: Feb 2012

Machine: Respironics System One Pro (450)
Mask Type: Nasal mask
Mask Make & Model:
Humidifier: Respironics System One
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: NoVA USA

Post: #3
RE: Increased AHI with C-Flex +
(04-09-2012 10:27 AM)PaulaO2 Wrote:  Or could be something else is going on to raise the AHI. And an AHI is still good. Great, even.

Try your experiment longer than 4 nights. Go for 2 weeks or so. Give her body time to get used to it.

The only thing that has changed was the C-Flex. Prior to that her AHI had been steady for almost 2 weeks.
04-09-2012 10:35 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
SuperSleeper Offline

Administrators

Posts: 9,967
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: #4
RE: Increased AHI with C-Flex +
Although C-Flex (a brand-specific term for Exhalation Pressure Relief) is said to be basically a "comfort feature".. it in fact does slightly affect your treatment... there's simply no way for it not to.

Even though C-Flex is supposed to primarily affect exhalation pressures, it simply can't "turn off" fast enough to not have an effect upon inhalation pressures as well. In fact, it's the process of the beginning of the exhalation breathing cycle that triggers the C-Flex into action (reducing pressure for exhalation). So there's always going to be a small delay in reducing the exhalation pressure, and also a small delay when bringing back up the inhalation pressure when the patient starts the inhalation breathing cycle. So, the net effect upon inhalation pressure due to this "overlap" effect is a general reduction in the overall average delivered inhalation pressures, no matter what the pressure is currently set at.

So, yes, it will have some effect upon inhalation pressure: it will reduce (although to a small degree) the overall average inhalation pressures administered over time, thus, it may indeed raise the AHI by the amount you state if the machine isn't delivering the prescribed inhalation pressures consistently (which is what happens when you use C-Flex).

The only way to insure that you're getting the prescribed inhalation pressures exactly as the machine reports it is to completely turn off all Exhalation Pressure Relief (C-Flex, A-Flex, Bi-Flex, EPR, etc.).

Granted, the general effects of using C-Flex upon AHI are usually not substantial. But on some patients where small increases of pressure provide a greater reduction in AHI, using C-Flex can indeed have a negative effect upon overall AHI levels, because they aren't getting the full effects of the correct pressure at all times due to the C-Flex delaying the pressure changes upon inhalation (as opposed to turning off C-Flex and allowing the machine to deliver the same inhalation and exhalation pressure with no variations).

Just my opinion, of course.

Smile

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.

04-09-2012 11:57 AM
Find all posts by this user Post Reply Quote this message in a reply
Chuck Offline

Preferred Members

Posts: 21
Joined: Mar 2012

Machine: ResMed VPAP Auto 25 (S8)
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro
Humidifier: ResMed (not used)
CPAP Pressure: I = 12; E = 8
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Arizona

Post: #5
RE: Increased AHI with C-Flex +
I too have been noticing that my therapy is better without C-Flex. I noticed last night that C-Flex wasn't following my breathing rhythm well, and at times got it exactly backwards, increasing pressure during exhalation and lowering during inhalation, then getting all random for a few breaths before it got back on track. This would no doubt cause an increase in events.
04-09-2012 02:00 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
Dreamcatcher Offline

Members-b

Posts: 899
Joined: Mar 2012

Machine: Resmed Autoset Spirit II with Quattro F/F & FX Masks
Mask Type: Full face mask
Mask Make & Model:
Humidifier: H4i
CPAP Pressure: 10 - 18 cmH20 (auto range)
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location:

Post: #6
RE: Increased AHI with C-Flex +
YES, YES and YES.........My AHI went up to 14 Too-funny when I put my EPR on its due to it triggering apneas. You will always see a rise using c-flex as apneas can accur wile the pressure has dropped.
04-09-2012 02:55 PM
Find all posts by this user Post Reply Quote this message in a reply
Rritch Offline

Preferred Members-2

Posts: 107
Joined: Feb 2012

Machine: Respironics System One Pro (450)
Mask Type: Nasal mask
Mask Make & Model:
Humidifier: Respironics System One
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: NoVA USA

Post: #7
RE: Increased AHI with C-Flex +
Good to hear that I am not the only one noticing this. I will probably wait a couple more days to see if the trend continues. Now just to figure out whether to turn off C-Flex or increase pressure to 10.5. I have read arguments for both approaches. I know what the results will be (or at least should be) if I turn it back off.
04-09-2012 02:59 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #8
RE: Increased AHI with C-Flex +
Hmmm. Makes me wonder if I should turn off the EPR. At first I thought it was just coincidence. The old machine was not working completely so I felt better for a while with the new machine. Then I started feeling bad again. Hmmm.

Got the O2 thingybob today. I'll do an experiment! Cool.
04-09-2012 03:41 PM
Find all posts by this user Post Reply Quote this message in a reply
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: Increased AHI with C-Flex +
I haven,t noticed any AHI changes whether EPR is off or on but have turned off bc it suited my breathing pattern better this way.
I think one should do what is more comfortable and also would like add seeing improvement by how you feel is a good sign that the therapy having some positive effect.
04-09-2012 03:50 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
SuperSleeper Offline

Administrators

Posts: 9,967
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: #10
RE: Increased AHI with C-Flex +
(04-09-2012 03:41 PM)PaulaO2 Wrote:  Got the O2 thingybob today. I'll do an experiment! Cool.

Sure would appreciate a review of that thingybob when you get a chance... I want to see if it's going to be worth getting... thanks!

Big Grin

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.

04-09-2012 07:46 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  philips remstar auto a-flex skylersdad 2 161 11-29-2016 05:47 PM
Last Post: trish6hundred
Question BiPAP vs EPR/Flex etc? SleepyBee 7 264 11-13-2016 08:52 PM
Last Post: Galactus
  [CPAP] Setting up this auto a-flex is really intimidating. SierraMadreMe 6 381 10-27-2016 04:25 AM
Last Post: SierraMadreMe
  Flex settings and hypopneas KSMatthew 4 523 10-21-2016 09:47 PM
Last Post: Sleeprider
  Respironics Flex setting VTSleeper 12 5,628 10-17-2016 02:49 AM
Last Post: Dreams of Green
  Increased AHI somnia16 2 219 10-11-2016 12:04 PM
Last Post: Sleeprider
  [Equipment] Respironics REMstar Auto A-Flex 550P Issue PreciousRoy1981 27 24,101 09-30-2016 06:51 PM
Last Post: Sleeprider

Forum Jump:

Who's Online (Complete List)