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[Equipment] To Ramp or not to Ramp
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EwanRGR Offline

Members

Posts: 4
Joined: Jul 2016

Machine: Dreamstation Pro Auto-CPAP
Mask Type: Nasal mask
Mask Make & Model: True Blue
Humidifier: DreamStation Pro
CPAP Pressure: 20
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: United States

Post: #1
To Ramp or not to Ramp
Just moved from a six year old machine to a Dreamstation Pro Auto CPAP last night. Old machine had a constant pressure and a choice of a ramp over two minutes or none. I had always used none. On the DS, I decided to leave everything on auto, which starts at a 4.

I had a little trouble getting to sleep initially as I'm used to the pressure and air flow from the old machine. I am tempted to adjust the floor on the DS so that rather than going from 4-20 auto it goes from something like 10-20 auto (setting on the old machine was 12).

Any thoughts on this one way or the other? Any reason I "shouldn't" do this?
07-12-2016 12:21 PM
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Rcgop Offline

Advisory Members

Posts: 214
Joined: May 2016

Machine: Resmed AirSense 10 autoset
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: installed
CPAP Pressure: 6.0 - 10.0 / EPR 2
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Orlando Fl

Post: #2
RE: To Ramp or not to Ramp
I too turned my ramp off. Starting at 4 does me no good when 6 (for me) is where I am comfortable. Any thing below 6 is not comfortable and my night is always above 6. I will probably up my starting pressure in the next few days as I gather more data and still leave the ramp off.

HuhDont-knowI am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
07-12-2016 12:37 PM
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OpalRose Offline

Monitors

Posts: 3,178
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #3
RE: To Ramp or not to Ramp
Welcome to Apnea Board EwanRGR,
Order the Clinicians Manual for your machine.
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

Then download Sleepyhead Software.
http://sleepyhead.jedimark.net/

Yes, you should use a minimum setting bracketed around your pressure of 12 from your old machine as long as you felt that worked for you. Something like 10 to 16. It can always be adjusted as you monitor your progress. Keeping that machine at 4cm will make you feel air starved.
You didn't need ramp on your old machine, so no point in starting.

After a couple days, import your data from the SD card in your cpap. After about a week, check to see what your numbers are: AHI and what the breakdown is......Obstructives, Hypopneas, Clear Airways if any, leak rate, etc. Check your Medium and 90% pressure readings. These numbers will give you a better idea where your pressure range should be.

Check back with us and we can help you post a screenshot and look over your data if you like.

Good Luck with your new machine.

OpalRose
07-12-2016 12:39 PM
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PoolQ Offline

Advisory Members

Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #4
RE: To Ramp or not to Ramp
I will give the other side. I have always used ramp and I assume that your machine has ramp setting the same as mine. Mine has a ramp start pressure that I found best set to 6, 4 was just not enough air for me. The machine then takes the set time to ramp from this starting pressure up to you minimum pressure. I started out at max time of 40 minutes and then decreased it to 20 minutes, with the 40 I never noticed when I got to full pressure because I was always asleep, now I can tell that the pressure is ramping and it is manageable but barely with the time set to 20.

This to me is an individual preference and is a comfort feature that the manufacturers put in the systems on purpose to help people tolerate CPAP. If it does nothing for yo then of course don't use it, if it helps then do use it. The bracketing I have always heard about was for APAP settings on the min and max for therapy and this has nothing to do with the ramp starting pressure.
07-12-2016 12:57 PM
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trish6hundred Offline

Advisory Members

Posts: 6,446
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #5
RE: To Ramp or not to Ramp
Hi EwanRGR,
WELCOME! to the forum.!
Ramp is a comfort feature so it's up to you if you want to use it or not.
Much success to you as you continue your CPAP therapy, hang in there for more responses to your post.

trish6hundred
07-14-2016 06:03 AM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #6
RE: To Ramp or not to Ramp
From my reading of your post, you are talking about two different things.

RAMP is when the pressure goes from 4 to the minimum pressure of the APAP or the treatment pressure of a CPAP. It does this over a set period of time. Some people like it, many people don't. I've gotten so used to my higher pressure that anything lower than that and I feel smothered. If you didn't use it before, you won't need it now. And if you are using the machine "wide open" at 4-20, then the ramp is not doing anything anyway.

Treatment pressure is the 4-20, 10-16 you are talking about. If your previous pressure was a CPAP setting of 12, then I agree with the suggestion of 10-16. Leave it there for a few weeks to see how it goes. It's a good spread with enough room for adjusting but not so much the machine can't keep up with you.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
07-14-2016 01:28 PM
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JudgeMental Offline

Advisory Members

Posts: 324
Joined: Feb 2012

Machine: Respironics DreamStation Auto-CPAP
Mask Type: Full face mask
Mask Make & Model: Respironics Amara View
Humidifier: Respironics
CPAP Pressure: 11-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Florida USA

Post: #7
RE: To Ramp or not to Ramp
EwanRGR.. Something is missing in my mind. IF you were good and comfortable at the CPAP setting of 12 for 6 years, why, are you using the total gauntlet of 4-20 in the APAP mode? Did Doc write a new prescription? If your apneas were controlled at 12 then I would start your machine (as OpalRose) suggested somewhere around 9-10 and a top of 14. No need to start at a ramp of 4 and struggle with the lower pressures.

Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
07-14-2016 05:44 PM
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EwanRGR Offline

Members

Posts: 4
Joined: Jul 2016

Machine: Dreamstation Pro Auto-CPAP
Mask Type: Nasal mask
Mask Make & Model: True Blue
Humidifier: DreamStation Pro
CPAP Pressure: 20
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: United States

Post: #8
RE: To Ramp or not to Ramp
Thanks for all the advice on here. The reason I initially left the ramp at the default setting was that I wasn't sure if I could turn that off and still have the Auto functionality work. The last two nights I have had the ramp turned off, and the Auto range from 10-20, and seem to be doing much better. I have DL'd the Sleepyhead software, but have not yet pulled the SD card. The Philips phone app has shown my AHI came down from the first night (1.9) to .8 and then .6 after making the change.

Thanks again!
07-14-2016 06:03 PM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,994
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #9
RE: To Ramp or not to Ramp
(07-14-2016 06:03 PM)EwanRGR Wrote:  The last two nights I have had the ramp turned off, and the Auto range from 10-20, and seem to be doing much better.

Once you look at your data using SleepyHead you can make further adjustments. In your profile you have your pressure set at 20, so you might want to change that.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
07-14-2016 08:41 PM
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