Dreamstation Auto--Anyone NOT use the Smart ramp?

I don't know why I assumed my Smart ramp feature was set to be "on" by my DME, but when I looked this morning at my settings, it is not on. I proceeded to read an article on "Cpap Reviews" http://cpapreviews.org/respironics-drea ... th-review/ and see that this seems like a great feature to use, and the reviewer recommended to have it on.

So my question for you Dreamstation users--do you use the feature or not and if not, why not?

This article also helped me figure out the mystery of ramp vs. "Optistart" settings. I thought that the machine always started on the ramp pressure, which was set at 4 by the DMW/Dr. (hideously low for me) but when I turned on my machine using the power button (vs. the ramp button) the therapy pressure would read "7" and I wondered where that pressure setting was coming from. Now I know. The Optistart estimates the optimal pressure the CPAP machine should start at for you based upon your previous use of the machine.

Please let me know if I am wrong about the ramp feature only being used IF you actually hit the "ramp button."

Also--if you do turn the Smart Ramp on--does it give you the Optistart pressure until you fall asleep or whatever the ramp setting is set to?

I currently have set my minimum therapy pressure at 7--that's generally where the Optistart starts at, although two nights ago it was 7.5 and last night it was 8. My 90% average is usually it the 9.5's, 10's and a few 11's. Would it makes sense then to up my minimum therapy pressure a little closer to my 90% average pressure therapy, if I can tolerate it? I am clueless.

I don't use any ramp feature. Was helpful the first couple of days to get used to the machine, but have seen no purpose for it since then.

So you have both the ramp feature and the smart ramp feature off?

With a Respironics machine it doesn't matter if Regular Ramp or Smart Ramp is turned off or not.
Neither will come on (depending on what is selected) if the ramp button on the outside of the machine is not ever pushed.

Pugsy wrote:With a Respironics machine it doesn't matter if Regular Ramp or Smart Ramp is turned off or not.
Neither will come on (depending on what is selected) if the ramp button on the outside of the machine is not ever pushed.

I can always count on you to help me with my confusion!

So, then if I just hit the power button at night, the pressure the machine will start at is the "Optistart" pressure?

In your opinion, it there a benefit of using the Smart Ramp feature rather than the Optistart?

I stopped using Ramp after a few days. It helped me get used to the burst of air as the machine starts, but after that, I really wanted to be at my prescribed pressure as soon as possible. The ramp time can be set to various lengths of time (shorter or longer) or to zero, but as I don't use the feature any more, it doesn't really matter.

I think Optistart could be more beneficial than Ramp because it gets you closer to the range of pressure used the preceding night. For people who are not comfortable doing their own tweaking to pressure settings, it could be useful as it would skip the lower pressures to get to what is likely needed (as in a situation where the settings have been left wide open, e.g. min 4 max 20) faster than maybe Ramp--depending on the Ramp Time set.

Check your User Manual page 9, and the Provider Guide pages 2 and 5, for info on Optistart and Ramp.

My favourite feature is Automatic On--I just put on my mask and don't need to push any buttons to start the machine because it then detects my breathing and turns itself on. There's Automatic Off, too, but I haven't used that yet.

Jean

Soothest Sleep wrote:I stopped using Ramp after a few days. It helped me get used to the burst of air as the machine starts, but after that, I really wanted to be at my prescribed pressure as soon as possible. The ramp time can be set to various lengths of time (shorter or longer) or to zero, but as I don't use the feature any more, it doesn't really matter.

I think Optistart could be more beneficial than Ramp because it gets you closer to the range of pressure used the preceding night. For people who are not comfortable doing their own tweaking to pressure settings, it could be useful as it would skip the lower pressures to get to what is likely needed (as in a situation where the settings have been left wide open, e.g. min 4 max 20) faster than maybe Ramp--depending on the Ramp Time set.

Check your User Manual page 9, and the Provider Guide pages 2 and 5, for info on Optistart and Ramp.

My favourite feature is Automatic On--I just put on my mask and don't need to push any buttons to start the machine because it then detects my breathing and turns itself on. There's Automatic Off, too, but I haven't used that yet.

Jean

You are awesome! Thanks for this information! It is very helpful.

Sleeping Ugly wrote:So, then if I just hit the power button at night, the pressure the machine will start at is the "Optistart" pressure?

If that is the mode selected...yes.

Ramp won't do a thing unless you pus the ramp button.

Sleeping Ugly wrote:In your opinion, it there a benefit of using the Smart Ramp feature rather than the Optistart?

I don't like OptiStart...I don't want the machine deciding my settings...I want to decide my settings.

Ramp is comfort only...if a person doesn't need it then they shouldn't use it.
Now some people have higher starting pressures than your current minimum of 7.5 ....like maybe their pressures are in the mid teens...those people might find it useful t work up to that pressure slowly over a period of time.
We want people to be able to get to sleep and if fighting the pressure keeps someone from sleeping then by all means do what is needed to get to sleep.

Regular ramp vs Smart ramp....Respironics has always had a "smart ramp" when in auto mode...they just didn't call it anything special. In auto mode they would always increase the pressure and treat any apnea events that would pop up...and reduce once the offender is killed off if there is time remaining.
What is new is this used to be only available in auto mode..now it's available in fixed mode..

So if in auto mode...doesn't really matter which you choose if you want to use ramp.
If in fixed mode...by all means use Smart Mode if ramp is needed.

When I was using Respironics APAP..my minimum was 10...I never used ramp...I found that it took maybe a minute for me to be okay with the pressure.
I understand that not everyone is that lucky.

BTW the 90% pressure number isn't the holy grail that people think it is. It's too easily skewed and when evaluated it needs to be looked at long term...like for months...not days.

Pugsy wrote:

Sleeping Ugly wrote:So, then if I just hit the power button at night, the pressure the machine will start at is the "Optistart" pressure?

If that is the mode selected...yes.

Ramp won't do a thing unless you pus the ramp button.

Sleeping Ugly wrote:In your opinion, it there a benefit of using the Smart Ramp feature rather than the Optistart?

I don't like OptiStart...I don't want the machine deciding my settings...I want to decide my settings.

Ramp is comfort only...if a person doesn't need it then they shouldn't use it.
Now some people have higher starting pressures than your current minimum of 7.5 ....like maybe their pressures are in the mid teens...those people might find it useful t work up to that pressure slowly over a period of time.
We want people to be able to get to sleep and if fighting the pressure keeps someone from sleeping then by all means do what is needed to get to sleep.

Regular ramp vs Smart ramp....Respironics has always had a "smart ramp" when in auto mode...they just didn't call it anything special. In auto mode they would always increase the pressure and treat any apnea events that would pop up...and reduce once the offender is killed off if there is time remaining.
What is new is this used to be only available in auto mode..now it's available in fixed mode..

So if in auto mode...doesn't really matter which you choose if you want to use ramp.
If in fixed mode...by all means use Smart Mode if ramp is needed.

When I was using Respironics APAP..my minimum was 10...I never used ramp...I found that it took maybe a minute for me to be okay with the pressure.
I understand that not everyone is that lucky.

BTW the 90% pressure number isn't the holy grail that people think it is. It's too easily skewed and when evaluated it needs to be looked at long term...like for months...not days.

OK, let's see if I am understanding all of this:

If I had Optistart turned off and I hit the power button on the machine (vs. the ramp button), then the pressure I would get, is the minimum pressure I have set? And then the machine would automatically bump up the pressure in an effort to ward off any events I have and then return to the minimum pressure that is set once the event has ceased?

Sleeping Ugly wrote: OK, let's see if I am understanding all of this:
If I had Optistart turned off and I hit the power button on the machine (vs. the ramp button), then the pressure I would get, is the minimum pressure I have set? And then the machine would automatically bump up the pressure in an effort to ward off any events I have and then return to the minimum pressure that is set once the event has ceased?

That sounds right to me.

Are you using Sleepyhead to monitor your progress? The pressure chart for each night will show you what levels the machine used, from start to wake, so you can figure out just what each choice (power vs. ramp) gives you.

Jean

Soothest Sleep wrote:

Sleeping Ugly wrote: OK, let's see if I am understanding all of this:
If I had Optistart turned off and I hit the power button on the machine (vs. the ramp button), then the pressure I would get, is the minimum pressure I have set? And then the machine would automatically bump up the pressure in an effort to ward off any events I have and then return to the minimum pressure that is set once the event has ceased?

That sounds right to me.

Are you using Sleepyhead to monitor your progress? The pressure chart for each night will show you what levels the machine used, from start to wake, so you can figure out just what each choice (power vs. ramp) gives you.

Jean

Hi Jean,

Yes, I do use Sleepyhead! I am an addict, lol. I am trying to educate myself on all of the information it gives and what settings and features would be most beneficial for me. It can be very overwhelming to me. Especially when I literally got about 1.5 minutes of instructions on how to use the machine from the DME and part of that 1.5 was on how to clean it and how often to change the filters, etc.

Sleeping Ugly wrote:If I had Optistart turned off and I hit the power button on the machine (vs. the ramp button), then the pressure I would get, is the minimum pressure I have set? And then the machine would automatically bump up the pressure in an effort to ward off any events I have and then return to the minimum pressure that is set once the event has ceased?

Yeah, pretty much that's what would happen. It may or may not go back down to the minimum depending on what it thinks it needs to fight if it needs to fight something. I have nights where it never goes back down to the minimum once it goes up and then I have nights where it might drop down to the minimum fairly often. We don't sleep the same each night what with position changes and amount of REM or whatever.

Pugsy wrote:

Sleeping Ugly wrote:If I had Optistart turned off and I hit the power button on the machine (vs. the ramp button), then the pressure I would get, is the minimum pressure I have set? And then the machine would automatically bump up the pressure in an effort to ward off any events I have and then return to the minimum pressure that is set once the event has ceased?

Yeah, pretty much that's what would happen. It may or may not go back down to the minimum depending on what it thinks it needs to fight if it needs to fight something. I have nights where it never goes back down to the minimum once it goes up and then I have nights where it might drop down to the minimum fairly often. We don't sleep the same each night what with position changes and amount of REM or whatever.

I just want to give you a big 'ol squishy virtual bear hug, Pugsy! You have been so patient with me as I wade through all of this information. You have been SO helpful! I appreciate all the information!!

Sleeping Ugly wrote: It can be very overwhelming to me.

Yes, there's a lot of information to take on board. It's not hard stuff, just dense with details(!), so I get why busy medical people seem to gloss over material that turns out to be important to cpap users.

Just another example to me of how far North American society has shifted from a culture of "personalized customer service" toward one of "do it yourself if you want it done 'right'". It's all so exhausting.

I'm fortunate in that my resp tech has been willing to work with me doing my own monitoring; she's been good about answering questions, and I feel, so far, that I can look at her as a "team member." I'm due for my first annual review in another months or so, so I'll see how things go moving forward from there.

Gook luck with everything,
Jean

Soothest Sleep wrote:

Sleeping Ugly wrote: It can be very overwhelming to me.

Yes, there's a lot of information to take on board. It's not hard stuff, just dense with details(!), so I get why busy medical people seem to gloss over material that turns out to be important to cpap users.

Just another example to me of how far North American society has shifted from a culture of "personalized customer service" toward one of "do it yourself if you want it done 'right'". It's all so exhausting.

I'm fortunate in that my resp tech has been willing to work with me doing my own monitoring; she's been good about answering questions, and I feel, so far, that I can look at her as a "team member." I'm due for my first annual review in another months or so, so I'll see how things go moving forward from there.

Gook luck with everything,
Jean

Yes, there is a LOT of details and hard to adequately take in during such a short duration!

I am so happy to hear that you have a resp tech who works with you! That must be a wonderful feeling!

Good luck on your annual review! I hope it goes well and that therapy is awesome and beneficial for you!