A-Flex-- advantages?

[Sleepster]

A-Flex is a feature that's available and helpful to a lot of people. I say set it at the maximum value of 3 so you can take advantage of this feature. If you don't like it you can always turn it down to 2 or 1, or even turn it off altogether.

[FLcracker]

Follow up:

With A-Flex turned on, set at 3, she got up this morning saying her night was way less than restful... Her AHI jumped up to 11+.... first double digits in a while.

Resetting it back to 'no flex'.... And see what happens tonight.

FLc

[vsheline]

With A-Flex turned on, set at 3, she got up this morning saying her night was way less than restful... Her AHI jumped up to 11+.... first double digits in a while.

Resetting it back to 'no flex'.... And see what happens tonight.

Hi FLc, welcome to the forum

Actually, our pressure needs are highly variable, usually depending on position (flat on our back, supine, is usually worse for obstructive apneas), sleep stage (dreaming, REM stage sleep is usually worse for obstructive apneas), medications (can make worse both central and/or obstructive apneas), diet, stress, exhaustion, etc.

It is usually best to make small adjustments and to keep settings unchanged for a week or two or longer between adjustments, so we can average the results of multiple nights with the same settings.

Take care,
--- Vaughn

[Ghost1958]

Try the cflex option FlCracker. With a 15.5 max she will probably need some exhalation relief.

Cflex doesnt tail off at the top of her inhale cycle and puts pressure back on quicker at the end of exhale. So she will have full pressure thru the entire inhale cycle. Some folks, including me for a while that tailing off the pressure at the top of my inhale that Aflex does wasnt getting it done for me even set to one so I switched to Cflex which doesnt do that.

Go into clinical switch to Cflex and try it. She will get exhalation relief without losing inhale pressure at any point during her inhale cycle.

That being said I usually run 2 AHI down to less than 1 after getting my machine tweaked out. But occasionally Ill have a night that gets up near 5. Once it went as high as 8.

We all have a night here and there where we ate to close to going to bed. Did some other innocent but not so good for sleeping thing and have a night where the numbers go high.

[vsheline]

Below are links to a Philips Respironics website, illustrating Bi-Flex, A-Flex, C-Flex+ and C-Flex:

http://biflex.respironics.com

http://aflex.respironics.com

http://cflexplus.respironics.com

http://cflex.respironics.com


Below is a post which illustrates ResMed EPR, copied from another forum. (In the figure, the "Pressure" setting on the machine sets the pressure level at the peaks, and the pressure level at bottom of the troughs are 3 cm H2O lower if EPR is set to 3.)


Re: CPAP vs APAP vs BiPAP (poll)
Postby -SWS on Mon Jan 10, 2011 1:30 pm



Above we can see Resmed's graphical representation of EPR set at 3cm pressure relief. It transitions as Resmed BiLevel transitions. I drew some colorful lines in that diagram that we can use for reference.

C-Flex and A-Flex are back up to full inspiratory pressure BEFORE that vertical blue line occurs. We can see that Resmed's EPR/VPAP barely BEGINS inhale pressure's rise where I drew that vertical red line.

[Ghost1958]

Below are links to a Philips Respironics website, illustrating Bi-Flex, A-Flex, C-Flex+ and C-Flex:

http://biflex.respironics.com

http://aflex.respironics.com

http://cflexplus.respironics.com

http://cflex.respironics.com


Below is a post which illustrates EPR, copied from another forum. (In the figure, the "Pressure" setting on the machine sets the pressure level at the peaks, and the pressure level at bottom of the troughs are 3 cm H2O lower if EPR is set to 3.)


Re: CPAP vs APAP vs BiPAP (poll)
Postby -SWS on Mon Jan 10, 2011 1:30 pm



Above we can see Resmed's graphical representation of EPR set at 3cm pressure relief. It transitions as Resmed BiLevel transitions. I drew some colorful lines in that diagram that we can use for reference.

C-Flex and A-Flex are back up to full inspiratory pressure BEFORE that vertical blue line occurs. We can see that Resmed's EPR/VPAP barely BEGINS inhale pressure's rise where I drew that vertical red line.

Yep. However Aflex tails the pressure off at the top of the inhale but before the inhale cycle is complete. By quite a bit even on setting one. Cflex doesnt.

Cflex at least on his machine and mine will keep full pressure on until the machine sense the beginning of actual exhaleation.

Aflex if your not used to it can leave you feeling like your working to get the last part of your inhalation complete, because the pressure drops before your done breathing in entirely. Once your used to it its really smooth but even me who is used to it only uses the min 1 setting. 3 theres to much pressure fall off before Im done inhaling.


Cflex is a bit rougher but you dont get that starved for air at the end of each inhale feeling that you can with Aflex until you get used to aflex.

[FLcracker]

Follow-up on the follow-up:

After turning the A-Flex back off, she dropped from an AHI of 11+, right back to 3+... Guess that's telling me something...

Ghost'58: We'll absolutely try the C-Flex as you advised...However she wants to wait until the coming weekend to try it. She had such a bad time with the flex on, that she's reluctant to try again during her 'work week'.

It sure would seem to me that the higher final pressure (15.5) that she seems to need to keep her pipes open, that it would be hard to exhale against it (she says: no), but even set the way it is, the best AHI numbers have yet to drop below 3.

Although not even close to as bad as she was before starting PAP, her snoring is still there, even with pressure set where it's at.

My own personal opinion, is that she has/had as bad a case of OSA as can be, and still be alive.

I will NEVER submit without a fight to MY last breath!

Blessings to all here who are so willing to help.

FLc

[Ghost1958]

Follow-up on the follow-up:

After turning the A-Flex back off, she dropped from an AHI of 11+, right back to 3+... Guess that's telling me something...

Ghost'58: We'll absolutely try the C-Flex as you advised...However she wants to wait until the coming weekend to try it. She had such a bad time with the flex on, that she's reluctant to try again during her 'work week'.

It sure would seem to me that the higher final pressure (15.5) that she seems to need to keep her pipes open, that it would be hard to exhale against it (she says: no), but even set the way it is, the best AHI numbers have yet to drop below 3.

Although not even close to as bad as she was before starting PAP, her snoring is still there, even with pressure set where it's at.

My own personal opinion, is that she has/had as bad a case of OSA as can be, and still be alive.

I will NEVER submit without a fight to MY last breath!

Blessings to all here who are so willing to help.

FLc

Well bro heres where you kind of have to listen to her lol. If she has no trouble exhaling against pressure and it does not bother her there is no reason to run Cflex or Aflex.

Quite a few including myself have a problem exhaling against pressure more than around 10 some less some more.. Which is where the Aflex Cflex thing helps.

But if she doesnt need flex to sleep comfortably there is no reason to enable either one.

Also give at least a week for a change to show what its really going to do as far as numbers go. It takes the body a bit to get used to even subtle changes in pressures humidity flex etc and numbers to settle down into a readable pattern.

keep at it. 3 is good. Anything under 5 is good as long as shes resting well and feeling good.

[Sleepster]

After turning the A-Flex back off, she dropped from an AHI of 11+, right back to 3+... Guess that's telling me something...

All it tells you is that more data is needed to draw any conclusions. AHI can change that much on a whim. The A-Flex setting could be just a coincidence or the cause of a temporary condition.

[PaulaO2]

What Sleepster said. Give her some time where it is now to gather data. Don't make changes quickly.

Also, make sure you are making notes as to when you made the changes!