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Lowest CM at start with ramp machine?
#11
RE: Lowest CM at start with ramp machine?
Quote:The doc was trying to tell me that the 4CM is basically normal atmospheric pressure, which is clearly wrong otherwise we wouldn't need to create a negative pressure in our lungs to inhale in the first place. 

I am not following your logic there.  The pressure in your lungs must be lower than atmospheric for them to inflate.  But CPAP machines (setting aside ASV and other qasi-ventilator types) do not inflate your lungs.  They simply lack the pressure to do so.  Put a party balloon over the outlet and crank it to 20 (the max).  The balloon will fill with air, but will not inflate.  The pressure is not high enough.  We are not talking about PSI levels of pressure here.  What it does produce is enough pressure to keep the sides of your airway from collapsing together.


Quote:... looking for a setting that is a strong enough pressure to offset the hose itself, and ultimately feel like breathing normal air at normal pressure.

That machine does not exist.  It is not going to feel like normal pressure.  It can be a bit of a strange sensation at first.  You can and will get used to it.  Then you won't notice it anymore.  I start each night at 15cm and don't notice it at all after the first breath or two.  I started at about 7 or 8 and did notice it for the first few weeks.  It can induce a panicky feeling.  Concentrate on something else.  Just let it happen.  The machine won't hurt you.  Once your brain figures that out, it will stop paying attention. 

Most people have the opposite sensation: that it is easy to breathe in, but more difficult to exhale as you need to do so against the additional pressure.  Your muscles will actually slightly strengthen to compensate.  
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#12
RE: Lowest CM at start with ramp machine?
Try 2 things for me. Sit up or ly down to read a book or watch tv and put the mask on but do not turn the machine on. That is 0 CM. Just to get the feel of it.

Now set the pressure to 7 or 8 (do you know how to set the pressure?) And watch tv or read for an hour with it on for an hour or so. This is an exercise to get you used to the machine and the pressure.

Your Dr is trying to accommodate with the 4CM. It is unlikely that pressure will provide adequate treatment.

You are uncomfortable. You need to get comfortable with your treatment to succeed. We can help with that.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#13
RE: Lowest CM at start with ramp machine?
Agreed, it can be a strange feeling.
I took to it like a duck to water, but I spent quite a few years Scuba diving, and was comfortable with some positive pressure on inhale, as well as some effort to exhale (to pop the exhaust valve open against water pressure)
It took my wife a bit to get used to it. After about a month she was able to dial the ramp back and finally eliminate it, and after another couple of months we brought the starting pressure up to 7 and brought the EPR down to 2. I'm running my EPR at 1.
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#14
RE: Lowest CM at start with ramp machine?
(06-26-2017, 08:34 PM)bonjour Wrote: ... put the mask on but do not turn the machine on.  That is 0 CM.  Just to get the feel of it.

That does not sound right.  There is no pressure from the machine, but there are obstructions (hose, filter, blower vanes etc) to the flow.  My personal experience is that it takes more effort to inhale when the machine is off than when not wearing a mask.  It is uncomfortable.  Wearing the mask without the hose attached would be closer to 0 CM.
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#15
RE: Lowest CM at start with ramp machine?
Sliight,

Back when I was a newbie, breathing out at 4cm seemed impossibly hard. So I understand what you are saying.

But 4cm is the lowest the starting ramp pressure goes because that's needed to insure that you don't rebreathe the CO2 that you exhale into the mask.

I do have one suggestion that will seem very counterintuitive, but bear with me.  Most machines have a form of "exhalation relief" available, but it is only available when the pressure is greater than 4 cm.  If you are using a Resmed machine, you may actually find it more comfortable to start with a pressure of 6 or 7 with EPR = 3.  If you are using a PR machine, you may find it more comfortable to start with a pressure of 6 and a Flex setting of 3.  In both these suggestions, the pressure will drop at the beginning of your exhalation, and that drop in pressure usually makes it much easier to exhale even though you are still "exhaling" at 4cm of pressure.
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#16
RE: Lowest CM at start with ramp machine?
Thanks everyone for posting. I'll see what the co-pay is on buying one, and if it's less than a few hundred I'll pick it up and just start watching TV with it at night before bed, then read (actual book, no blue light) with it on about an hour before I want to sleep in bed, then see if I can sleep. Thinking if I just get my mind used to realizing that it's safe, the subconscious should chill out some and lessen the feeling of not being able to breathe. Basically same thing I did when experiencing the PVC's, which thankfully seem to have left from my drugging myself into excess sleeping time... quantity to make up for quality in this case.

Thank you!
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