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[Pressure] ramp and pressure range
#1
Hello dear members. I don't understand two things that are also related to each other and I would appreciate it if anyone can explain them to me.
1- I don't understand why some people use the ramp feature in an auto cpap when the machine is supposed to regulate how high or low the pressure should be from start to end of night. And from my experience unless one falls asleep the pressure is not going to be high at the beginning and then if it gets high when you fall asleep it won't be an issue even if it is high.
2- this one also falls in the same principle and it is regarding the pressure range. So since also the machine is supposed to change the pressure automatically why do some people set a specific range (i.e. 8 to 12) and not leave it at default which is 4 to 20 and then the machine does its part?
Thank you in advance.

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#2
willyboy, the ramp feature is a comfort setting and can be used if wanted, personally I have had mine set up at 4 for 30 mins and never bothered to change it.
On the second point, if someone set the high pressure at 20 and was not needed and got mask leaks the pressure could raise 20 and stay there till the leak is fixed plus some more. It could possible wake the person up more than if they hit their high pressure from getting one or more apnea's. Mine is set at 5-15 and the only time I hit 15 is if I get a servere mask leak, most other times my max is around 12 so in theory I could come down to 12. Some people also worry about having too high a pressure which may cause centrals, that really should never happen if they are using an auto machine.
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#3
Hey Tez, I thought the machine only increases flow in order to compensate for leaks. I think the point of doing that is to keep the mask pressure where it needs to be to treat the apnea but no higher.
Thinking-about
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#4
My pressure is all over my range of 12-16 but it has nothing to do with compensating for leaks, which have been running about 6 L/min. In my case I think it has to do with sinus issues, which have always been a problem for me. I use a neti pot to help control my sinus problems, but it is not 100% effective.

If the congestion is bad, I'll use a Mirage Quattro for part of the night, maybe about once a month. Then, my pressure sits at 12 (if I keep my machine in auto mode) and my leaks are sky high. Except, if the headgear is adjusted wrong, the leaks turn noisy, and then the pressure shoots up to 16. I think the machine interprets the noisy leaks as snores. I can't stand the Quattro, but sometimes it's a necessary evil.

There are other reasons for needing auto mode, such as positional apnea.
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#5
Here's a post I did a while back on "wide open" vs narrowed down range:
http://www.apneaboard.com/forums/Thread-...1#pid39951

As for the ramp, it depends on what the starting pressure is. Some people just cannot handle the full blast right off the bat. This is especially true of new users. The ramp helps them to adjust.

Many of us "old timers" no longer use the ramp. I've gotten so used to my higher pressures that if I were to lower it, I'd feel suffocated.
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#6
Machine increase pressure in respond to snoring and flow limitation which are precursor to full blown apnea event so if one have a problem with flow limitation, machine can increase pressure until maximum is reached or the person wake up

What i find as things calmed down and no further events detected, the pressure head towards the minimum and if the minimum set too low, it would take that much longer for the machine to do its job effectively

In my experience, the minimum pressure has to be right for the person, not too low otherwise would feel suffocating and not getting enough air to breathe and that in turn cause drop in oxygen levels and more apenic events as pressure too low to maintain open airways
As for Ramp, I use it but just 1 cm below the minimum pressure for 15 minutes, for me it feel just right, each one should make own choices and see whats feel comfortable and works best for them regardless what works for others ... everyone is different.

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#7
(07-31-2013, 10:27 PM)Paptillian Wrote: Hey Tez, I thought the machine only increases flow in order to compensate for leaks. I think the point of doing that is to keep the mask pressure where it needs to be to treat the apnea but no higher.
Thinking-about

Paptillian, I think we are agreeing, I can only talk for myself but sometimes I get hugh mask leaks like 35 L/min mainly due to movement and knocking my mask and my high pressure goes up to the highest level in my case 15. If I set that high pressure to 20, I'm sure it would go up to that to compensate. Then when the mask is put back in place, the pressure would revert back to the minimum pressure over time. Hope that makes sense.
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#8
Thank you all for your help explaining the ramp and pressure range features. it was very helpful.
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#9
I don't understand the leaks. I look at the machine and see the green face and then lay down. How do I know any leak is happening? Will I wake up? Is this something that will be shown on any software that is used to download the information, and will it show as leaks or as some have said as an apnea?
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#10
Which S9 do you have? If you have an AutoSet, then you can download data to ResScan or Sleepy Head and look at a graph showing leak level through the entire night. If you have an Escape Auto you won't be able to see anything except usage data.
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