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Why the “hate” on the ramp feature?
#11
RE: Why the “hate” on the ramp feature?
(01-03-2022, 12:40 AM)Geer1 Wrote: My other recommendation is that if your set pressure is 12 then use a higher ramp start pressure (say 8 or whatever is comfortable) to improve the treatment received while in ramp.

I currently don’t know how to adjust my pressures, but have been reading some posts about that here so will definitely be looking into it. I have my first appointment with my doctor since starting therapy later this week. So these are helpful bits of knowledge.

Thank you for your insights.

(01-03-2022, 12:55 AM)staceyburke Wrote: Why are you using a stagnant pressure of 12?  Have you tried the autoset with a min and max pressure and used EPR?  We can help with your therapy if we can see what your night looks like.  We use OSCAR to get the data.  It is free download from this site.  You need a SD card no larger than 32 GB.  find the cheapest one out there. and post your oscar charts.

The pressure was set by my DME technician, and I don’t yet know how to change it. I plan to download OSCAR, but need to get an SD card first. I will see my sleep doc later this week and am hoping to talk with her about some of this as well.

It’s also possible that 12 is my max pressure? I tried looking at the Home Screen info, but it just says 12.
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#12
RE: Why the “hate” on the ramp feature?
I'm sure somebody here knows the magic button combination that provides access to the pressure-setting menu on your unit. On my ResMed 9 it's press-and-hold control wheel + info. You probably don't need OSCAR to set the pressure, but your probably do to interpret the effect of the changes. I suspect there might be limits to what you can set if you're getting a machine from a public health service or an insurer; I bought mine so I can break it if I want. Hopefully it won't break me Smile
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#13
RE: Why the “hate” on the ramp feature?
If you click on the "CPAP Setup Manuals" link up in the menu bar here, it will lead you to instructions to enter the clinical setup menus of most machines... and further down there are instructions for obtaining the Clinicians' Manual for most machines, so you can know what all those options can do. Quite useful!
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#14
RE: Why the “hate” on the ramp feature?
I recommend trying the auto ramp feature, particularly if your typical threapy pressure is uncomfortable and prevents you from sleeping. My wife has been using auto ramp for over 5 years without issue. Obviously some have issues with it not working but there's no harm in trying it out - it's easy enough to switch off again. Set your ramp pressure to the maximum that you find comfortable and that allows you to fall asleep (e.g. a couple of cm below a sensible min pressure setting for you).

Here's an example:
   
Steady breathing starts at 1:12:10, sleep determined at 1:14:20, therapy starts at 1:16:24 (pressure increase due to flow limitations starts from that point).
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#15
RE: Why the “hate” on the ramp feature?
My experience is that at best ramp is a p***-poor substitute for auto-adjusting therapy.

The basic way that an APAP works is that as long as you don't need pressure, the machine stays at minimum pressure. Then as soon as you need pressure, the machine pushes the pressure up. If you use ramp, then you are not allowing the machine to adjust the pressure to your breathing.

On some nights I am asleep within a couple of minutes of lying down. On the occasional night I am wide with insomnia for freaking hours. If I fall asleep in 30 seconds and start up the flow limits, my machine will push the pressure up very quickly. If I'm awake for two hours, then the machine sits at the minimum for two hours. If I were to set a 30 minute ramp, then on those asleep-instantly nights I've got no therapy when I'm asleep and not bothered by the pressure. If I have a 30-minute ramp and I'm still awake at the end of the ramp, then not only am I VERY P*ssed off at having insomnia, after 30 minutes I'm even more P*ssed off by the machine blasting pressure at my very awake face!
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#16
RE: Why the “hate” on the ramp feature?
Since you are at the beginning of your treatment I wouldn't change any pressures etc yet, doing so will just annoy your doctor. Stick with the prescription and see how things go and download and use OSCAR to get an idea if settings are satisfactory.

Melman on the first page had some links to downloading OSCAR and setting it up in his signature.
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#17
RE: Why the “hate” on the ramp feature?
(01-03-2022, 02:01 PM)Kmar13 Wrote: …Since starting my therapy, I haven’t been getting up in the night…

…and it’s worth all the fuss of getting used to CPAP just for that alone…
Smile
Disclaimer: The 'Advisory Member' title is a Forum thing that I cannot change. I am not a doctor and my comments are purely my opinion or quote my personal experience. Regardless of my experience other readers mileage may vary.
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#18
RE: Why the “hate” on the ramp feature?
(01-04-2022, 07:59 AM)Moriarty Wrote: …and it’s worth all the fuss of getting used to CPAP just for that alone…
Smile

10-4 on that one.   Used to be every single night..  not a single time since.

Being alert while driving is another biggie.

Grin
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#19
RE: Why the “hate” on the ramp feature?
From my own experience, I feel claustrophobic the instant I put the mask on if I can't feel the air coming through it, so I've either turned off the ramp or turned it to the lowest the tech will let me on the machines I've used since 2001.
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#20
RE: Why the “hate” on the ramp feature?
I am another one who hated ramp.    I would fall asleep, then the machine would get up to pressure and I would get leaks and wake up.    I used a full face mask the first four years, and  I started on high pressures .   I had to have my DME stop the ramp.    They didn't tell me that I could learn to make these changes myself!     (I was so overwhelmed.   Tired, too.)     Eventually I  found  Apnea  Board and worked at becoming enlightened.   Things have improved in many ways.
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