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Pressure at altitude vs. pressure at lower elevations...?
#11
I did post a data chart somewhere here... I will try changing the ramp to auto. I find the start up when placing the pillows on to be of no discomfort. Where I do find discomfort is when I get up at night to take a leak and THEN put the pillows back on... it almost feels as if I did a sprint or some other strenuous exercise because when I put the pillows on it feels/ seems difficult to breathe or it take more exertion to get comfortable again.

Thank you and everyone for the comments.
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#12
(10-17-2017, 04:31 PM)S.L. Ping Beauty Wrote: I forget what DME stands for but I know it is my device provider and they are local and are aware of the limits in my area and account for it as there are several patients to whom they serve.

The 7 and 45 were what the doctor prescribed although I have learned how to set and adjust on my own- I manually turned off the "EXP" (<--- I am doing this from memory... I think it is called exp???)

My apnea occurrences per hour are quite low.  Perhaps that is why I am only at 7??  The DME mentioned that the ramp of 45 is for comfort level of getting used to the increasing pressure that would come on low and increase as I fall asleep.

All this feedback has me curious because I am more exhausted than ever since starting CPAP about a year ago.  I literally wake up tired-  I will usually sit on the side of the bed when I rise and will yawn several time while I sit and try to become aware of who and where I am at.  I have put on about 20 pounds since about a year ago too.  And I seem to be more forgetful than ever before.  Oh, and one other thing...

DME = durable medical equipment, short meaning for the device and accessories provider. I have been adding to my sleep deprived state due to apneas for years; I reasonable expect it will take at least a few months to pay back that sleep debt while being treated on my ASV. And.........what were we talking about?
Even a 1,000 mile trip requires a first step. My recommended first steps are getting good shoes and 2 of these  Coffee Coffee 
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#13
LOL... I see you got the joke.
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#14
(10-17-2017, 05:31 PM)S.L. Ping Beauty Wrote: I did post a data chart somewhere here...  I will try changing the ramp to auto.  I find the start up when placing the pillows on to be of no discomfort.  Where I do find discomfort is when I get up at night to take a leak and THEN put the pillows back on... it almost feels as if I did a sprint or some other strenuous exercise because when I put the pillows on it feels/ seems difficult to breathe or it take more exertion to get comfortable again.  

Thank you and everyone for the comments.

A couple of things:

1) "Ramp" is not the same as "Auto"

The ramp function starts the CPAP at one pressure (in your case 4 cm) and then ramps up to the setpoint (in your case 7) over some length of time (45 minutes).  That is helpful for people that have a high pressure setting, say something like 12 or more, where that pressure all at once is not comfortable.  In your case, 7 is not very high and you can probably jump right up to that pressure by turning off the ramp and be just fine.

Auto is a special function of Auto CPAPs.  In this case, your CPAP pressure prescription will be set to a range - low limit and high limit.  The Auto CPAP will vary the pressure within this range to find the "best fit" for you.  I don't know if your prescription is for a fixed pressure or a range of pressures.

2) The out-of-breath feeling you have might be related to the ramp.  Think about it - you've been sleeping for a while at 7cm pressure, get up to take a leak and turn off the machine.  You do your bidness, put the mask back on and turn on the CPAP.  It starts in ramp-mode with a low pressure of 4.  Your system got used to the 7, then you dropped back to 4 and you might feel starved for air.

I'll see if I can find the manual for your machine and paste in the ramp on/off instructions.


edit:

You said you played with the EPR setting.  That doesn't do anything with the ramp, that lowers the air pressure when you exhale.    For a high pressure setting, it can be more comfortable if the pressure drops when you breathe out, you can try it either on or off and see what you think.

Also, I now see what you meant when you said you set the ramp to "Auto".


>>>

Ramp time:

Ramp Time can be set to Off, 5 to 45 minutes or Auto. When Ramp Time is set to Auto, the device will detect sleep onset and then gradually increase from the start pressure to the minimum treatment pressure at a rate of 1 cm H2O per minute. However, if sleep onset is not detected, the device will reach the target pressure within 30 minutes. 


Expiratory Pressure Relief

Designed to make therapy more comfortable, Expiratory Pressure Relief (EPR) maintains optimal treatment for the patient during inhalation and reduces the delivered mask pressure during exhalation.

EPR On—EPR is enabled. Off—EPR is disabled.

The following settings are only available if EPR is On:
EPR Type Full Time—If set to Full Time, EPR is enabled for the whole therapy session.


Ramp Only—If set to Ramp Only, EPR is only enabled during ramp time. EPR Level 1, 2, 3 cm H2O

When EPR is enabled, the delivered pressure will not drop below a minimum pressure of 4 cm H2O, regardless of the settings. 

<<<
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#15
(10-17-2017, 05:31 PM)S.L. Ping Beauty Wrote: Where I do find discomfort is when I get up at night to take a leak and THEN put the pillows back on... it almost feels as if I did a sprint or some other strenuous exercise because when I put the pillows on it feels/ seems difficult to breathe or it take more exertion to get comfortable again.  

That's caused by the ramp. Turn it off. It's a feature that most people find useless after they get used to sleeping with their CPAP machine.
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.
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#16
(10-17-2017, 05:35 PM)S.L. Ping Beauty Wrote: LOL... I see you got the joke.

I try to keep up.
Even a 1,000 mile trip requires a first step. My recommended first steps are getting good shoes and 2 of these  Coffee Coffee 
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#17
(10-17-2017, 08:03 PM)Sleepster Wrote:
(10-17-2017, 05:31 PM)S.L. Ping Beauty Wrote: Where I do find discomfort is when I get up at night to take a leak and THEN put the pillows back on... it almost feels as if I did a sprint or some other strenuous exercise because when I put the pillows on it feels/ seems difficult to breathe or it take more exertion to get comfortable again.  

That's caused by the ramp. Turn it off. It's a feature that most people find useless after they get used to sleeping with their CPAP machine.

I will try resetting for this evening slumber and see how it goes.
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#18
(10-17-2017, 07:55 PM)KSMatthew Wrote: A couple of things:

~snip~

<<<

Thank you for the very clear description and definitions... I will read it again before I retire tonight and make some changes to see if it makes a difference.
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#19
About a differential between altitudes.  I can suggest that you download Sleepyhead then we can review typical daily charts at both altitudes.  While modern machines do compensate for altitude, it is possible that you are not optimized for one or the other or both altitudes.  The charts are extremely detailed and can tell us, om a breath by breath basis if necessary, exactly what is going on.

Fred
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#20
Sorry, in my post I thought I had said more. Glad others were there to fill in my blanks!

Even if you use the ramp, it is taking 45 minutes to go up 3 points in pressure. Unless it takes you that long to fall asleep whenever you turn the machine on, you don't need it for that long. If at all. You have gotten used to that 7 so when you put the mask on after going back to bed, that is why you have trouble inhaling.

By the way, here is a list of acronyms/abbreviations:
http://www.apneaboard.com/wiki/index.php?title=Acronyms
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.




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