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[lars4life]

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[lars4life]

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[DaveMunson]

I gave it up almost right off. I almost always fall asleep right off and could not stand the thought of waiting 45 minutes to get to sleep pressure.

Hook it up, turn it on, blast away, dream. I suppose I want 'sleep pressure' when I put the mask on. You?

[JointPain]

45 minutes would drive me nuts. On my old Resmed S6 I would usually start each night with ramp time of five minutes. That seemed to give my old nasal mask a chance to seal better than going straight to sleep pressure.

When I first turn the CPAP on at night, I don't mind it too much, but if I have to get up for a bathroom break during the night, I find it a bit tedious. I liked my old S6 better than my new S9 in that the S6 had separate buttons for each ramp setting, so I could just go straight back to sleep pressure.

I did increase the start pressure up to 6 cm which helps a bit.

Now that I'm using the nasal pillows I might give up on the ramp, but I'm trying to not change too many things too quickly.

[Pugsy]

Never used it. Not once. Never even tried ramp. Never felt the need. Starting prescribed pressure was only 8 cm and I made a game of seeing how long it took me to be comfortable with it. I used the first few minutes to do some slow meditation breathing as part of the game.

Now I do see the value in it for any reason a person wants to use ramp or feels the need to use ramp. Doesn't matter the reason. Any reason is just fine. For however long a person wants or needs to use ramp. Strictly personal choice. Especially for someone prescribed pressure in the double digits. For a newbie that will feel like a hurricane.

[kteague]

I have always used the ramp - way too much at first because I rarely got to my prescribed pressure. Did I need it - no, but it was how my machine was set up, and when I complained about trouble staying asleep, I was told to just hit the ramp when I woke up - well that was every few minutes. But I continue to use it for a few short minutes, not for comfort, but because it takes me a bit of fidgeting and coughing to settle in and I don't want that to be in my data. It's personal preference. I don't think anyone who prefers to use it needs to feel it is a crutch, it is a legitimate comfort feature, so if one finds it comfortable, it's fine. I just feel bad for those who like when I was new, get a machine set at 4 for a long ramp time. Just makes sense to me how long to set the ramp time should be individualized so as not to leave quick sleepers unprotected.

[Goofproof]

Yes, all you really need is a positive outlook. I started at 14 cm, no ramp, as I wanted the pressure there to cover any events I might happen. Jim

[idamtnboy]

Wondering how many people use the "ramp" during start up of their machine?
Is it helpful? Does it help ease you into your pressure settings?

Yes, 5 minutes from 6 to 9.4. It was set at 15 min when I got the machine. I cut it back within a few days. I tried one time without it but didn't like the full pressure blast, but that was like within the first week. The current ramp works good and I just haven't gotten around to trying again without it. Probably could get along w/o it, but changing it is low priority.

[msradar65]

I used the ramp for the first week. Then stopped. It was becoming annoying since my normal pressure is 8cm.

[LaurieP]

I just started and was having a hard time if I got up in the night to put the mask back on because of the pressure being 11. I learned about the ramp feature on my machine from here and it really has helped me get comfortable at night before falling asleep and things ramping up. I don't think I could do this without it. I might change the ramp time as I'm not sure what it is set at but I'm doing fine right now so probably not a big deal.

Laurie

[jtm]

I tried the ramp at first but found as the pressure increased leaks would develop. Now just try to inhale as the machine turns on, after a few breaths I don't realize it's even on.

[Muse-Inc]

Used ramp in the begining at 45 mins, gradually reducing it over time until it was 5 mins. which I used until I got my APAP 2+ yrs since beginning CPAP therapy. Ramp made it possible for me to be fully asleep before my CPAP went to full pressure. Now, with an APAP and EPR set 'on,' I tolerate higher initial pressure.

[snuginarug]

I used ramp once or twice, but I have a low pressure, just 9. To me, it always seemed a comfort feature, like c-flex and epr, but reading I find it helps some seal better, which is interesting., I hadn't thought of that aspect. At any rate, cpap is all about comfort. You can't sleep if you're not comfortable, and that's the whole point... to sleep. I don't see ramp at all like training wheels, more like the firmness of a pillow... some like soft fluffy pillows and some like firm pillows that hold their shape. It just depends on the individual's comfort. (Personally, I like firm pillows.)

[robysue]

I'm someone who goes back and forth on using the ramp. I've actually reset my EPAP from 4cm to 4.5 just so that I can hit the ramp button in the middle of the night when I wake up with an overstuffed stomach full of air. The ramp brings the IPAP down to where I no longer feel like a goose being fattened up for foie gras, which in turn lets me get back to sleep much more quickly.

I think the *major* problem with ramp is incorrect settings. In my humble opinion, the way the ramp OUGHT to be set up is this:

• Starting ramp pressure SHOULD BE only a couple of cm's lower than the patient's therapy pressure. That should be enough to provide some relief at the start of the night---particularly with EPR, Flex, or a similar exhalation relief system turned ON. And the time for the ramp needs to be long enough for the patient to fall asleep and this means it needs to be long enough for the rate of increase in pressure to be subtle enough for the patient to not notice. And note: Having the pressure go up by 2 or 3 cm in, say 15 minutes, is a whole lot more comfortable than having the pressure increase by 6 cm in 15 minutes. (I'm thinking of the "typical" patient titrated around 10cm with the default starting ramp pressure of 4cm instead of a more appropriate starting ramp pressure of 7 or 8 cm.)

But both the major manufactures have maded decisions concerning what the USER is allowed to change from the patient start up menu that prevent the USER from properly setting the ramp up from the USER/PATIENT menu:

• Resmed: On the S9, the Patient set-up menu allows the patient to choose the RAMP TIME and turn the ramp OFF, but does not allow the patient to increase the STARTING RAMP PRESSURE.
• Respirionics: On the System One, the Patient set-up menu allows the patient to choose the STARTING RAMP PRESSURE but not the RAMP TIME.

So unless a patient knows how to get into that Clinical menu, he/she cannot properly set up the ramp. And while just about everybody here knows how to get into that clinical menu, how many CPAPers are out there who DON'T know about this site and have a ramp that is BADLY set up and can't change it? And then have problems adjusting? And then quit?

[BusyLyn]

I've always used the ramp and C-flex features. I have asthma so I appreciate anything which makes it easier for me to exhale. My therapeutic pressure is 13 and C-flex has remained at 3. When my machine was delivered the ramp time was 20 minutes with a starting pressure of 4, which I immediately had the therapist increase to 6. Gradually I've upped the starting pressure until now, 6+ months in, the pressure is at 10. I tried a shorter ramp time of 15 minutes for a few days, but as Robysue mentioned above, I found that I was at my therapeutic pressure before I could fall asleep, leaving me wide awake and very uncomfortable.

I don't consider either C-flex or the ramp to be crutches, but instead comfort features. I turn on my machine, adjust my mask under full pressure, then hit the ramp button before turning out the light. I'm usually fast asleep long before the machine has fully ramped up. Once asleep, I have no problem with my therapeutic pressure and if I do wake up I usually just roll over without hitting the ramp.

But just as it is with masks and machines, comfort feature settings are very individualistic. To use them, or not, is your choice.

Lyn