New A-flex technology from Respironics - Anyone used it yet?

[SuperSleeper]

[parts of this thread were copied from our old forum]

Earlier this year I heard that Remstar was about to introduce a significant improvement in CPAP technology called A flex. I noted our moderator made a post about this new machineseveral days ago and I was wondering if anyone with OSA has used this new machine and could give us a brief review of this machine.

[SuperSleeper]

Hi Idreos, welcome to Apnea Board!

The A-Flex technology is relatively new - I did a search to see if I could find any reviews of it and didn't find much at all. If anyone else can find a comprehensive review of these machines, please post it.

For reference, here is a link to Respironic's description of what A-flex is all about:

http://aflex.respironics.com/

[SuperSleeper]

I have a REMSTAR M AUTO A-FLEX w/ humidifier, Comfort Gel small and Premium chin strap for about 5 weeks now.
In my titration study I was like a duck into water, I loved it! For 3 days I felt better. But it took almost a month to get my own machine. I told my doctor to proscribe the A-FLEX as I studied the forums and the CPAP suppliers. I didn't wait passively to get my machine and pushed everybody to move faster! (1 week for the titration study report, 0 for my doctor, 4 weeks messing with 3 different approved providers) I used an "In System Provider" just because I didn't have the cash to purchase on line and save later on my reimbursement. I would have saved almost $1000 for the insurance company.
I actually set the auto (min) starting up from 4 cm/H2O to 10 because I needed more pressure. At 4cm I felt out of breath, at 10 it felt like it was doing something. Sealing has not been a problem as long as I don't move my head so the straps slide off the back of my head. It is remarkable how loose the straps are to hold the mask in place (in a way too lose because it is easy to move the straps off).
Also I set the Max from 16 to 18 which made me have noticeably better quality sleep too. I guess it allows the A-FLEX to crank up to the necessary pressure.
It makes it easier to breathe and I fall asleep faster and don't wake up every hour to pee (maybe once a night now).

Right now it is too humid to really use the humidifier over 2 but I'm sure I'll need it when it get dry.

[SuperSleeper]

I've had my Respironics Auto M Series with A-flex for about 3 weeks after using a C-flex CPAP machine for about 3 years. I got the auto A-flex machine because it's so versatile and it's just enough smaller that it fits in my carry-on -- one less thing to carry on the plane.

After 2 nights on A-flex, I found it to be very distracting. I could sharply feel sudden and annoying "relief" at some part of the cycle -- I think at the end of the exhale. As I was leaving on a trip, I wanted quick success so I set it to the C-flex mode I was used to and it's much better for me. I haven't tried going back to A-flex. (BTW, on the trip the security guys never even looked at the machine beyond X-ray. There is little consistency in airport security.)

The DME said the ComfortClassic mask I had been using was old technology and switched me to the ComfortGel. As rhayashi noted, it's amazing how loose the straps can be on the ComfortGel to hold the mask in place without leaking. In fact, the new mask is more of a bonus than the new machine! It may also be that reduced leakage is the result of using autoPAP rather than the fixed CPAP pressure. In my case the 90 percent autoPAP pressure is significantly lower than my old CPAP prescription. The ComfortGel mask is heavier, but it's a good tradeoff for superior performance.

In short, I like the auto "A-flex" machine even though I use it in C-flex mode now. I was worried about small humidifier capacity here in the dry desert air, but it works fine and can pump out more humidity than the humidifier on my old Remstar Pro with C-flex. Others have noted the blue button lights are ridiculously bright and even knowing that, the brightness about blew me away. It's almost like Respironics never used one of these at night... I lay several thicknesses of folded handkerchief over the buttons. Others use a sock. The auto-on feature is nice as is the humidifier that powers itself on. At night I just put on the mask and that's it. While others have said the humidifier is easy to clean, I find it somewhat harder to clean than the old one. I also wish Respironics would sell their software to end-users, although the regular machine display shows more than the old machine. Be sure to set it to "Show AHI/Leak".

I managed to get the Provider Quick Setup Guide for the REMstar Auto M Series with A-flex and sent a copy to supersleeper, the board owner, but haven't seen it posted with the others setup guides yet.

John

[SuperSleeper]

I managed to get the Provider Quick Setup Guide for the REMstar Auto M Series with A-flex and sent a copy to supersleeper, the board owner, but haven't seen it posted with the others setup guides yet.

John

John - I uploaded the guide for the Remstar Auto M with A-Flex... it's available for download at:

http://www.apneaboard.com/CPAP%20Adjustment.htm

I think also there's a full version of the complete Clinician's Manual available via email request on the above page.

[A C Hunter]

I own the machine in question.
I've copied my stats page from Sleepyhead - columns don't line up, but you get the picture....

Diagnosed late 2011 with AHI 75... fast tracked to cpap for Christmas week, but with a mis-communication of appointment dates did not get on therapy until following week.

My first 6 weeks or so are a blur of full face masks (thrown down in disgust), nose only and finally nasal pillows (after steroid spray cleared passages); AAahh.

When I got my own machine I requested the aflex be activated, and have found no problems with it using auto pressure.
My prescription was for a start of 6.0, but found that I used the ramp feature quite a bit before falling asleep.
Being techie I got under the hood and reset to 4.0 for start pressure.

The numbers are quite good (greatly improved over my first few weeks) and I have had no noticeable negative results.

All I can say for other newbies is DON'T GIVE UP ON PAP, it gets better.
... and don't get too hung up on the numbers....

AC



CPAP Statistics as of May-03-12
88 days of CPAP Data, between 05/01/2012 and 03/05/2012
Details Most Recent Last 7 Days Last 30 Days Last 6 months Last Year
AHI 0.52 1.73 1.91 3.38 3.38
RERA Index 0.78 0.74 0.95 1.94 1.94
Flow Limit Index 2.07 1.91 1.19 1.26 1.26
Hours per Night 03:51 05:39 05:48 04:57 04:57
Average Pressure 6.27 7.01 3.88 6.59 6.59
95% Pressure 7.50 10.00 9.70 12.50 12.50
Average Total Leaks 23.37 22.64 24.64 29.42 29.42
95% Total Leaks 29.00 29.00 35.00 46.00 46.00

Changes to Prescription Settings
First Last Days AHI Machine Mode Pr. Rel. Min Pres. Max Pres.
20/04/2012 03/05/2012 10 1.96 PRS1 Auto A-Flex x3 4.00 18.00
17/04/2012 19/04/2012 1 1.18 PRS1 Auto A-Flex x3 6.00 18.00
21/03/2012 16/04/2012 17 1.89 PRS1 CPAP None 9.00
05/01/2012 20/03/2012 60 4.18 PRS1 Auto None 6.00 18.00
The above has a threshold which excludes day counts less than 5 from the best/worst highlighting

Machine Information
Brand Model Serial First Use Last Use
Philips Respironics System One RemStar Auto with A-Flex (551P)