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[Equipment] BiPAP ramp settings
#1
BiPAP ramp settings
Hi all. Thanks in advance for your help. My first time posting.

I have recently purchased a new Dreamstation BiPAP Auto for my rekindled treatment. 5 years ago I set aside my System 1 fixed pressure CPAP being unable to relax/let go of my breathing and fall asleep. Trying a DreamWear mask has changed things significantly.

Most of the night my EPAP is 4cm, sometimes rising to 5. I’ve found through small adjustments that I get a better API score and shorter events with an IPAP starting at 8cm (PS of 4). I initially had a PS min of 2cm, Their was no need for a ramp as this setting as it was easily tolerable, but I has a lot of OI and HI. Hence the 8/4 baseline. I’m balancing my mild OSA and Central SA.  

My problem is that getting to sleep with 8/4 pressure is difficult. The ramp button doesn’t do anything. I’d really like for the the ramp button to put the pressure down to 6/4 for the length of time. This may be wishful thinking but I’m hoping someone can help.

My settings are:
Auto BiPAP
IPAP max = 10
EPAP min = 4
PS min = 4
PS max = 6

Smart ramp - tried both on and off
Ramp = 4
have tried multiple flex settings. I believe this is to with the timing of the pressure changes.

Having done some further research into complex apnea, I'm wondering if an autoSV might have been the best option. But this is hindsight and would have been of far greater expense. My pressures are fairly minimal, which might be part of the problem. Sorry for the rambling.

To recap: is there a way to make the ramp setting temporarily bring down the PS from 4 to 2? 
Thanks
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#2
RE: BiPAP ramp settings
You are limited by the low pressure capability of your machine which I believe is 4.

Post your daily charts from SleepyHead and we can much better help with your settings, especially since you ARE talking about Central and complex apneas.


Fred
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#3
RE: BiPAP ramp settings
The lowest setting for Ramp is 4cm.
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#4
RE: BiPAP ramp settings
Hi. Thanks.
I'll post the details as soon as i can.
I understand that the lowest pressure is 4cm, thats ok.
What I would like is to be able to go to sleep on 6/4 and from then the minimum be 8/4, auto adjusting higher from that baseline.
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#5
RE: BiPAP ramp settings
There's no adjustment you can make to do that. The best you can do is Start with EPAP 6 With PS min 2. That will give you 6/4. You can adjust the Max PS to a higher level but there's no guarantee the IPAP will raise up unless needed.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#6
RE: BiPAP ramp settings
Hi theebrad,
WELCOME! to the forum.!
Good luck as you continue CPAP therapy.
trish6hundred
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#7
RE: BiPAP ramp settings
I have never used such low pressures, but you might try setting ramp to a minimum pressure of 6, and with the PS at 4, it may provide 6/4 to start, and increase to 8/4. Try it, and let us know.
Sleeprider
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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.
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#8
RE: BiPAP ramp settings
I hope i've done the screen captures in the right format.

https://imgur.com/a/ZTbRz


The 11th image is last night, I put the PS on 3. Easier to get to sleep on.
I believe that the higher PS is reducing the length of the various episodes, this may well be incorrect. Last 3 are the event breakdowns (seconds).

Thank you
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#9
RE: BiPAP ramp settings
Set EPAP min to 6.0, no further changes. Your hypopnea and obstructive events are all because your EPAP pressure is too low. Your starting pressure will be a very low 8/6. If you need ramp, keep the time minimal and set it for a minimum pressure of 6.0. It should provide 6/4 and ramp up to 8/6 which should greatly improve your results.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#10
RE: BiPAP ramp settings
Thanks very much.
I'll see how the results go after a couple of days.
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