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Ever wish there was a "reverse ramp" ?
#1
Ever wish there was a "reverse ramp" ?
I often find that I would like more pressure when I first settle into bed.  Maybe it's from showering, walking to the bedroom etc.. but when I first lay down I'm often inhaling with more force than I would like to.  If I bump my min pressure up, I dont notice this effect as much,  but I dont need the extra pressure once I settle down and sleep.. so it seems silly to set a higher min pressure.
 
A reverse-ramp would work great for this, I think.
Trickery seems to work for now, like holding my breath so the machine thinks Im in apnea and ramps up.
(I dont actually think I'd ever see a reverse-ramp feature, it would just add confusion for users Im sure.)

Alternatively.. maybe its just me, and Im broken ?  
My tidal is usually in the 1000-1200 range for the first 10min or so, then comes down to 600ish for most of the night.

(and yes, I have a fresh intake filter)
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#2
RE: Ever wish there was a "reverse ramp" ?
If you have ramp turned on, the default starting pressure is 4 cm H2O- will leave you working to pull more air. You can change that in the clinicians menu - look for 'Ramp Pressure'; also it usually makes sense to set the Ramp to Auto to minimise the time it is active, if you use it at all.
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#3
RE: Ever wish there was a "reverse ramp" ?
The only thing close to your reverse ramp idea is like what's on the ResMed ST-A. It's called Ramp Down and it's at the end of the night's therapy, to prepare the user to breathe without therapy.

Regardless of that, on to your issue, if you feel you're needing more pressure, is there a possibility that you need to increase your pressure settings? Or alternate, your ventilation rates may be elevated when you lay down and then strap on the mask. Maybe this signifies a need for some slowing down your breath rate by some form of relaxation.
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#4
RE: Ever wish there was a "reverse ramp" ?
I think you only need to set minimum at a good level and the machine will take care of the rest. Based on your profile info, your minimum pressure is 11.0. Even assuming EPR 3, you are starting at 11/8 pressure. On the Vauto I start at 13/9.0. Instead of wishing for something that does not exist, either wait to mask-up until respiration has settled down, increase pressure to a more comfortable starting pressure, or get a bilevel. Show me the data, but this appears to be about jumping in bed with a high respiration rate and expecting the machine is going to keep up until you settle into sleep. Either increase your pressure to meet the initial need, or settle a bit before masking.
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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#5
RE: Ever wish there was a "reverse ramp" ?
" Maybe this signifies a need for some slowing down your breath rate by some form of relaxation. "

So no more karate kicking the light switch off ?

I could bump up the min pressure, but I dont usually need much higher to keep the OSA numbers at bay. That being said, I dont get CAs at all, so there's no harm (knock on wood).

@pholynyk: Ramp off entirely (never did like it..)
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#6
RE: Ever wish there was a "reverse ramp" ?
Smile Whatever physical activity you are enjoying before bedtime, let the adrenaline settle a bit before masking up. This sounds like a healthy problem, and someone that wants to get on to the next task (sleep) in a hurry.
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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#7
RE: Ever wish there was a "reverse ramp" ?
I have to say virtually every "comfort" feature of cpap makes therapy less comfortable for me. I've wanted "reverse ramp" since the beginning, too. EPR was really annoying at first. Hot, humid air drove me crazy.

And calling them "comfort features" sabotaged my therapy -- It took me 6-1/2 years to find out that EPR was vitally important to lowering my flow limits (and the annoyance factor had long since gone away.)
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#8
RE: Ever wish there was a "reverse ramp" ?
I don’t use ramp, but I experimented with it briefly. I think I could set the auto ramp to just .2 below my full CPAP pressure. I don’t remember if it could be that close to the top pressure in Auto mode though.

Yes, the comfort features are backwards to what I want. Indeed why not let us set ramp to whatever pressures! Why not let EPR start after I’m asleep (not as much of a problem now that I’m on ResMed, but I hated Cflex on my PRS1 450/460 while awake, but was told it made a difference in my sleep by the tech)?
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