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.
07-01-2016, 09:24 AM
(This post was last modified: 07-01-2016, 09:45 AM by OpalRose.)
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.
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?
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?
We were talking of two different manuals. I was quoting the user manual and you were over in the forbidden clinician manual. My apologies.