CPAP product reviews and other helpful tips for CPAP users!

If you’re researching or shopping for a new CPAP machine, chances are you are either new to CPAP therapy or you’re replacing the one you already have. We’ve said this many times before, CPAP machines these days are packed with incredible technology. But what exactly is this technology? 

CPAP machines have integrated wireless and battery-powered options, Bluetooth capabilities, remote monitoring and reports at your fingertips through apps on your phone. Another technology which we will be focusing on is a technology called Expiratory Pressure Relief (EPR) or FLEX which are both features to increase comfort and compliance for all users. 

What exactly is EPR or FLEX? Continue reading as we break down some fancy acronyms and abbreviations. Learn what EPR means and the difference between the types of Flex available as we simplify the terms much as we can. Here we go!

What Is Expiratory Pressure Relief (EPR)?

CPAP machines have “comfortable” settings that allow CPAP therapy to mimic your natural breathing pattern as much as possible. ResMed calls this feature EPR while Philips Respironics calls this comfort feature, Flex.

ResMed defines their comfort setting as EPR - Expiratory Pressure Relief. In other words, making it easier for you to exhale or providing a deeper exhale with each breath while on CPAP therapy. For example, your CPAP pressure setting is 10cmH20 with function EPR 3 on...you would be inhaling at 10chH20 and exhaling at a dropped pressure of 7cmH20 and will return to 10cmH20 on the inhale.

There are 4 settings for Expiratory Pressure Relief on a ResMed machine: OFF, Setting 1 = mild comfort (1 cm H20), Setting 2 = medium comfort (2 cm H20), Setting 3 = maximum comfort (3 cm H20).

What Is Flex Technology? 

Philip Respironics calls their comfort setting Flex. Flex comfort feature provides users with pressure relief on various (CPAP, APAP or BiPAP) modes of therapy. There are various types of Flex available. C-Flex, A-Flex, Bi-Flex and C-Flex+.

C-Flex Pressure: Breakdown

C-Flex, identical to EPR on ResMed, lowers pressure during exhalation for users to adjust to CPAP therapy and works on a breath-by-breath basis.  Using the same example from earlier, if your CPAP pressure setting is 10cmH20 with function EPR 3 on...then, you would be inhaling at 10cmH20 and exhaling at a dropped pressure of 7cmH20 and will return to 10cmH20 on the inhale.

C-Flex also has 4 settings for on their machines: OFF, Setting 1 = mild comfort (1 cm H20), Setting 2 = medium comfort (2 cm H20), Setting 3 = maximum comfort (3 cm H20)

Following along so far? Good, let’s keep going.

Bi-Flex Pressure: Breakdown

Bi-Flex works on BiPAP mode and offers pressure relief at both inhalation and exhalation. The Bi-flex setting offers pressure relief at 3 important areas - the transition from exhalation to inhalation, the transition from inhalation to exhalation and during the exhalation.

A-Flex Pressure: Breakdown 

A-Flex works within Auto-CPAP mode. Like C-Flex, A-Flex provides pressure relief at the beginning of exhalation and like Bi-Flex softens transition avoiding spike ups from inhalation to exhalation. It's a smoother and more comfortable feeling. A-Flex mimics your natural breath the most.

C-Flex+ (Plus) Pressure: Breakdown

C-Flex+ (Plus) is a newer setting within the more advanced CPAP machines when in fixed-CPAP mode.  Like C-Flex, C-Flex+ provides pressure relief at the beginning of exhalation. Like A-Flex, C-Flex+ offers a smoother and softer transitioning from inhalation to exhalation providing additional comfort when in fixed-CPAP mode.

If you got a blank stare and feeling a bit confused, we don’t blame you - it can be confusing. The take-home message is Expiratory Pressure Relief (EPR) and Flex are both comfort settings available on ResMed and Respironics machines. They come in different modes to ultimately make your adjustment to Sleep Apnea therapy more comfortable by mirroring your most natural breathing patterns possible regardless of your CPAP pressure.

Which Comfort Function Is Best For You And Your CPAP Machine?

Which function is best for you? Ultimately, it comes down to personal comfort and preference. You’ll need to give the functions at various settings a test drive. Some people like EPR and Flex, some don’t use them and others even dislike these comfort settings. These settings may bring on other problems - possibly make your apnea better or worse or the pressure changes may increase your chances of experiencing CPAP mask leaks.

After all, that’s said, many do find the comfort functions helpful. This is the part where we say try it, see what setting works best for you!

Dear CPAPmachines.ca fans, many of you have discovered the latest addition to the DreamStation line, The DreamStation Expert. This newly released Auto-CPAP machine is made especially for patients who complain about pressure resistance when they exhale while using their CPAP.  

If this is you, then the DreamStation Expert is the CPAP Machine you are looking for. This model was built to enhance comfort for new patients acclimatizing to therapy. 

The DreamStation Expert Provides a More Natural Breathing Experience

The major advantage of the DreamStation Expert over the DreamStation Auto is the inclusion of a pressure relief mode during exhalation called the P-Flex.

Other CPAP brands also have this pressure relief mode - ResMed calls it the EPR™ (Expiratory Pressure Relief) and Philips Respironics calls it the FLEX technology. P-Flex intelligently mimics a patient’s individual breathing pattern and lowers the pressure when the patient exhales. With the function enabled, breathing while on therapy feels more natural compared to having to breathe against a constant PAP pressure. (More to come on EPR & FLEX on a future blog).

So why is the P-Flex better than all the other pressure relief functions on the market? Normal pressure relief functions only lower its PAP pressure down to a certain level when expiration is detected. P-Flex, on the other hand, is so intelligent that it detects the onset of inhalation as well as expiration so it delivers the right amount of pressure relief when the patient needs it. This ensures that the P-Flex creates a more smoothing breathing pattern than a traditional pressure relief function, and is unique in being able to adjust its pressure below 3cmH2O. 

With that being said; the DreamStation Expert also provides the same intelligent auto-adjusting functionality as the Auto model. The machine automatically adjusts to your optimal pressure based on your breath throughout the night. 

Our Verdict

This newly-released DreamStation Expert is a more suited choice to those whose exhalation pressure needs vary more often throughout the night. If you’re a brand new CPAP user or If you’ve been complaining to others that you find CPAP hard to adapt to because of the pressurized air, we highly recommend you give this DreamStation Expert a try! This machine is truly an expert in helping new patients who are acclimatizing to therapy.