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Ramp Question
#1
Approaching two weeks of treatment. Untreated sleep study AHI of 114 was reduced to an AHI of 1.0 last night. Would post a screen shot of SH, but I can't yet...

So I have never had an issue with the initial pressure setting of 4.0. Have not wanted to change any settings yet due to looking for things to stabilize. That being said what should/would I expect to be different from increasing initial pressure to 5.0 and turning ramp to off. Turning the ramp to off is something that alot of people seem to prefer? Dont-know

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#2
I had ramp enabled when I first started using CPAP and a pressure range from 5 - 15. I would occasionally feel like I wasn't getting enough air when I first put the mask on, so I now have ramp off and a range from 8 - 13. For me, these settings are a lot more comfortable. I don't think ramp is really necessary after you get used to higher pressures.
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#3
(05-19-2015, 12:03 PM)OB-Left Wrote: ... Have not wanted to change any settings yet due to looking for things to stabilize. That being said what should/would I expect to be different from increasing initial pressure to 5.0 and turning ramp to off. Turning the ramp to off is something that alot of people seem to prefer? Dont-know
Without seeing charts it is hard to give any kind of feedback, but you won't really know until you try. The Ramp setting is a comfort setting and doesn't take anything special to turn it off. That you can change anytime.

I only used it a few days and never turned it back on again.
Current Settings PS 4.0 over 10.6-18.0 (cmH2O) BiLevel Auto
TNET Sleep Resource Pages
CPAP Machine Database
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#4
If your starting ramp pressure is below your treatment pressure range then most people turn it off. I have a problem getting to sleep with the mask on, so I use the ramp set at my minimum therapy pressure so my CPAP won't record any events until I'm asleep. The ramp feature allows a user to have a pressure setting from 4cmH2O up to the minimum treatment pressure.
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#5
If you're not experiencing any discomfort, then for you having the ramp on is fine. The one reason you might want to try not using it is because while the machine is in "ramp mode," it cannot detect/resolve your apnea events. That too may not be a big deal, but it seems to me that when our pressure settings are fairly low to begin with (starting at 5 in your case), then ramp seems a bit redundant.
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#6
Ok, looks like setting changed and I can post. So here is graphs from last night.

[Image: Screenshot%202015-05-19%2016.01.41.png][/URL]

Here is another graph from a few nights before. I see at least 5 events that were not counted before the green line. Whats up with that? Is it part of the Ramp effect? or due to pressure being too low?

[Image: Screenshot%202015-05-18%2017.20.26.png]

I'm assuming that just before 23:12 is when machine determined I was asleep and started ramping up the pressure?

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#7
Your stats don't look too bad, OB. Good job getting started.

Yes, I would turn off ramp, and set the minimum pressure to 7.

That's all I would do for now. Then, I'd let the thing run for a few days and see what happens.

Your leak numbers could be better, could be worse. But to do that you would probably need to migrate to a different mask. That's something that could be done of course, and it might actually help you dump on the remaining AHI.

But for now, I think you're ok, just a little low on the starting pressure.
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#8
You've been using this for two weeks you said.

Take a look at the data. Look at what the median pressure and the 95% pressure is for each day. Like, in the two days you presented in the screenshots above, you had 8.12 / 9/5 and 9.88 / 11.36.

IF it were my data, and the rest of the two days look like these two, and IF I were not obligated to leave my machine alone due to some compliant issue or a nosy doctor who thought he/she were G-d, here's what I would do: I would set the minimum to 7 and the maximum to 13. Then I'd observe the data for another 4 weeks. It is obvious the pressure of 5 is too low. Both nights it literally LEAPS from 5 to what your body needs.

And yes, turn ramp off. Ramp starts at 4 and slowly increases over whatever time frame you have set. It increases to the minimum pressure setting on an APAP or the treatment pressure of a regular CPAP. In your case, it is going from 4 to 5. Really useless.
PaulaO2
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#9
MOst long term users I've seen discuss the issue have sided with the ramp OFF setting. Me too. I feel suffocated with the pressure below 8 so that's where I start. My average pressures run 9 is, mayber 9.5 so that's a good floor for me. I;m comfortable at 8 and it is not far at all from my average.

OMMOHY
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#10
I never used ramp so I am unfamiliar. But curious. Is it that the xPAP CAN'T detect and so can't record those events, or is it that it DECLINES to record those events? It would seem that even at a very low pressure it could still measure the back pressure and identify events.

I have the xPAP on a table behind the bed, so it is out of reach. So, I use autostart. But I pull the mask away briefly to verify that it has started; otherwise I really could not tell. Ramp would probably interfere with that process.
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