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A-Flex Respironics - need more info on how auto adjusting CPAP works

I just read your profile and am curious about something.  When I finally decided to have a sleep study done, my husband had already been using a CPAP for a year.  He has an uncle that also has sleep apnea that refused to use his CPAP.  It was new and the last of several he tried.  This is an a-flex respironics CPAP machine.  His insurance paid over $2500 for it and it was in the storage bag since a month after he got it.  He cant handle the smothering feeling.  and after trying several other machines, masks, and pressures he gave up.  He sold it to us for $250.  I had it checked out by my DME and it had maybe 9 hours of total usage on it.   I used it at the settings he had.. which was 5 or 6 for 2 weeks before I had my study done.   I found it kept my nose from stuffing up and I just generally felt better in the morning.  

 

I continued to use the A-Flex until I finally got my prescription which was about 4 weeks after my sleep study, it was adusted by the DME to 8 with a ramp up of 5 which I deactivated because I felt like I cant take in enough breath when it is set that low.   I have used it like this since then until a week ago.  I have gained alot of weight in the last 6 months and even though I shouldnt have.. I found instructions online to change my pressure and bumped it to 9 which has helped me not feel like I am straining to pull in air.   I will tell the doctor what I have done on the 25th and face the music but I guess I need some more info on the auto adjusting option.  I think my machine can pe programmed this way based on information online.  

 

Before I had the unit programmed by the DME with my prescription, I liked the way it seemed to breath "with" me before they adjusted it.  The doctor wanted me on a constant pressure I suppose?   I go to the doctor again on the 25th for my 6 month checkup.  I would like to talk to him about this but I am not sure I know enough to be asking him about it.  

 

I use my CPAP every night .. my biggest motivator to use it all the time is being able to wake up without my nose completely stuffed up each morning.  

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What would you like to know Becca?
pretty much how it actually works. Does it base pressure on how deep you breath or exhale for the next breath? how does it know to increase pressure?
The machine has an algorithm that reacts to your breathing events (apneas, hypopneas). After you have so many events the pressure will go up.

Becca said:
pretty much how it actually works. Does it base pressure on how deep you breath or exhale for the next breath? how does it know to increase pressure?
I guess what I am trying to find out is can anyone use this or is it only for a specific type of sleep apnea?
Sounds to me like you have a Cadillac when you could be driving a Chevy...you will still get where you are going...it will just be a lot more comfortable with more features!
Anyone can use the auto feature. This is something that you should discuss with your physician.
The expiratory pressure or what you exhale out against is the most important number to get right. Everybody needs a slightly different number . The Auto machine can be used to find your best pressure, depending on your doctor they may want you on the exact fixed or constant pressure that the machine determined or they may say that auto settings are fine. You could argue that fixed can be more consistant because depending on the brand of machine there can be a slight delay when the auto machines increase the pressure when they sense you are having an apnea. Some people find auto's more comfortable to wear but usually only if they are on high pressures. Aflex is a feature that gives you a bit more air when you breath in, sort of like a puff of air. It also helps the transition from inhaling to exhaling. Its not a must for most people but if you have it as a feature you can try between aflex (insp and expiratory help and then plain cflex which is just help on the exhalation. The starting pressure is important , like you said if it is to low you may not feel like enough air, like when you have a low ramp setting of 4 or 5. Talk to your dr. but comfort is important too,sounds like you are heading in the right direction.. also make sure your humidifier is set warm enough. If you are having any nasal congestion turn it to a higher number (ie runny nose , sneezing or plugged up.) Its one of the most common side effects of CPAP .... good luck.. Steve(from Canada)
I beg to differ from Steve. Many of us find we have MORE congestion with a higher humidity setting.

My suggestion is to try the various settings, both higher and even on pass-over mode where there is no heat. This will allow you to find the setting most comfortable to you.

With a higher humidity setting, I struggle to breathe -- that way when it is rainy or the air is really full of moisture.
In general Carol, steve is right. Your case and many others prove the need to treat the pt rather than the rule.

sleepycarol said:
I beg to differ from Steve. Many of us find we have MORE congestion with a higher humidity setting.

My suggestion is to try the various settings, both higher and even on pass-over mode where there is no heat. This will allow you to find the setting most comfortable to you.

With a higher humidity setting, I struggle to breathe -- that way when it is rainy or the air is really full of moisture.
Humidification is still a bit of a mystery. Most of my patients need a certain level of moisture, but then some dont need any and are still fine. I think it is just how your nasal mucosa or the lining in your nasal cavity respond . Carol is right you do have to play around with the moisture settings to whatever fits you.. most of the new machine that are coming out like the s9 from resmed and new fisher paykel have heated wire's in the circuit which can help with any condensation or rain out that may occur if you are a person who need higher temps but sleep in cold rooms . Cheers... steve

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