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Ramp Feature
#1
Another question from a 2 week CPAP beginner!

Is it common for experienced CPAP users to turn off their ramp feature if their machine is Auto set and they can handle the pressure right away? So is it also correct that if the ramp feature is turned off, then they might never reach their maximum pressure during the night unless the auto takes them there to provide air during an Apnea event?

I am still trying to understand some of the basics that are available to me so that I can be proactive in my therapy.
Thanks and Happy 4th!
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#2
I turned the ramp feature off after my first night. I am usually starved for air with the mask on and a pressure of less than 8. OK - I may be some kind of a prevert, but one of my favorite parts of the day is when I put my mask on and feel the air start to flow in.

If you are on an auto, the machine will never go to the maximum pressure unless that is what it needs to. Or unless it is badly broken. The ramp feature has nothing to do with it.

I don't know about the Dreamstation, but the PRS1 560 Auto has a feature where if you run it with wide open settings (or any settings where your minimum pressure is a long way below your effective therapy pressure), it will start closer to your required adjusted pressure from the last session. It is called Opti-Start and I am expecting it made it to the Dream Station model. On the PRS1 it is enabled in the clinician menu.

OMMOY
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#3
Ramp is considered a comfort feature. All it does is start out at 4 and slowly increase to the minimum pressure if APAP or the set pressure if CPAP. The user can set the time span for the ramp to run and I think even the starting pressure can be changed (instead of 4). So, for example, if your pressure is set to 6-10 and you have it set for 15 minutes, it will start at 4 and slowly increase to 6 over 15 minutes.

The treatment pressures of the APAP is independent of the ramp setting. If you need the maximum setting during the night, it will go there whether ramp is set or not.

Since your minimum pressure is 6, you probably don't need the ramp feature to be on. Give it a try to see if you can handle it without it. You can set the pressure to increase over a short time span, say 5 minutes, if it helps.
PaulaO2
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#4
I use ramp and the way I heard it was that IF you have a problem with the therapy pressure, the ramp starts you out at a more comfortable pressure and should not reach your minimum therapy pressure until after you are asleep. you will then cycle someplace between minimum and maximum therapy pressure as needed to stop obstructive apneas and hypopneas.

If you are comfortable at your minimum therapy pressure then there is no reason to use ramp. Many people get comfortable with their minimum therapy setting over time and turn off ramp.

Unless you are on an ASV machine.
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#5
Oh my gosh! This is exactly what was happening in a new user's graphs earlier this week. I had never heard of this feature. It seems like a good idea, except the PR algorithm's "hunt-and-peck" pressure changing feature was then lowering her pressure down to the 4-6 range.

This is so frustrating

I'm going to put a link in that thread to your explanation of Opti-Start.

(06-30-2016, 09:58 PM)OMyMyOHellYes Wrote: I don't know about the Dreamstation, but the PRS1 560 Auto has a feature where if you run it with wide open settings (or any settings where your minimum pressure is a long way below your effective therapy pressure), it will start closer to your required adjusted pressure from the last session. It is called Opti-Start and I am expecting it made it to the Dream Station model. On the PRS1 it is enabled in the clinician menu.

OMMOY

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#6
I believe that the Opti-Start feature on the Series 60 Apap is calculated every 30 hours, then after the 30 hours...resets the minimum start pressure to what it considers optimal.
It will stay at that new minimum start pressure unless you change it yourself.

Not sure if this feature works the same on the DreamStation.
OpalRose
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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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#7
OpalRose -

I don't you are describing Opti-start, From the 560 user manual, p. 9 -"Opti-Start Feature - This feature allows your device to use your most recent sleep performance as an input to your next Auto-CPAP therapy session. The goal is to start your therapy closer to your adjusted pressure." That would be useful when somebody has a machine that is truly fully auto, but set to wide open settings to get them closer to an appropriate start pressure. Example: pressure range of 4-20, but patient's 90% number is 10.5. Rather than start out at 4 and have to work its way up to 10.5, the machine might start at 9 so it doesn't have to go a long to get to an effective therapy number. It is the same thing that most seasoned members advise on the list when somebody new says "My set pressures start at 4 ..." and we tell them to tighten up the auto pressure range.

I think what you were describing is Respirionics Auto-trial mode where for the first 30 days it runs in APAP mode and then switches to fixed CPAP mode at the 90% level. Then it will occasionally adjust through what they call CPAP-Check mode where it will repeat an APAP cycle monthly (IIRC) to verify or adjust the fixed CPAP pressure?

OMMOHY
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#8
OMy,
No, I wasn't talking about a-trial.

I'm wondering if the Opti-start feature has been upgraded from the 560 to the DreamStation. I've never used it, only reading what's in the manual.

My manual for the 560 states that the algorithm is based on the 90% pressure and is calculated every 30 hours, but the DreamStation doesn't specify 30 hours.....it reads....

ADVANCED AUTO-CPAP ALGORITHM ADJUSTS TO YOUR CHANGING NEEDS
The DreamStation Auto is an advanced APAP machine that monitors your breathing for flow limitations and adapts to them, automatically adjusting therapy throughout the night to ensure you're receiving the optimum pressure for a comfortable and successful sleep.

DreamStation Auto goes a step beyond traditional APAP therapy with Opti-Start. When Opti-Start is enabled DreamStation Auto will begin each therapy session at a pressure that is close to the previous session's 90% pressure, in order to reduce the likelihood of residual events at the beginning of a therapy session.


So, I'm assuming this means that if opti-start is enabled, and as you stated, a wide open pressure is set, lets say 5-20, and the 90% pressure is 10cm, then the opti-start feature will not start at 5, but something closer to 10.

My question is this: Based on above example..... If opti-start decides to start at 10, does it always stay above 10, or would it drop down to start pressure of 5 if no Apneas?


OpalRose
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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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#9
We were talking of two different manuals. I was quoting the user manual and you were over in the forbidden clinician manual. My apologies.

OMMOHY
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#10
(07-01-2016, 11:51 AM)OMyMyOHellYes Wrote: We were talking of two different manuals. I was quoting the user manual and you were over in the forbidden clinician manual. My apologies.

OMMOHY


No problem...I'm always doing something "forbidden". Big Grin

OpalRose
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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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