My RAMP Horror Story

I try to be attentive to newcomers for any clues about the possibility of misuse of the ramp feature, but sometimes the issues aren't apparent. Just felt someone might benefit from my story and didn't want to count on my ability to spot the need...

For several months I suffered trying to use CPAP (many years ago). Couldn't keep the mask on for more than a few minutes without snatching the mask off feeling like I was suffocating. I was so exhausted I fell asleep instantly but was back awake in minutes. Trying to be obedient to instructions, every time I woke up I just hit the ramp button to start over. My mind was in no condition to figure out or understand that hitting the ramp every few minutes was condemning me to spend nearly all my night at the low end of ramp, as it was set for a long ramp period starting at a pressure of 4. I was almost never getting therapeutic pressure. My health and sleep spiraled downhill even worse after starting CPAP, and I believe this misuse of the ramp feature nearly became the final nail in my coffin. Thankfully I found my way into the chat room here where it was suggested I shorten my ramp time and increase my ramp starting pressure. It was the beginning of my successful CPAP use.

If you are one who wakes very frequently and hits the ramp every time, please rethink your strategy. The very thing that is intended to help you could be contributing to your difficulty adjusting to CPAP. For those that like to use the ramp feature, I suggest that you set it to the shortest time and highest pressure tolerable for your situation. Every minute you sleep in ramp is potentially time spent unprotected from apneas. You want to minimize that possibility.

Just couldn't get this off my mind tonight. Hope it helps someone.

Thanks KT, I never used the ramp feature so that isn't an explanation for my difficulites. But excellent advice to people to be on the lookout for this issue. I am sorry you suffered so much but am glad you figured out what was going on.

49er

kteague wrote:I try to be attentive to newcomers for any clues about the possibility of misuse of the ramp feature, but sometimes the issues aren't apparent. Just felt someone might benefit from my story and didn't want to count on my ability to spot the need...

For several months I suffered trying to use CPAP (many years ago). Couldn't keep the mask on for more than a few minutes without snatching the mask off feeling like I was suffocating. I was so exhausted I fell asleep instantly but was back awake in minutes. Trying to be obedient to instructions, every time I woke up I just hit the ramp button to start over. My mind was in no condition to figure out or understand that hitting the ramp every few minutes was condemning me to spend nearly all my night at the low end of ramp, as it was set for a long ramp period starting at a pressure of 4. I was almost never getting therapeutic pressure. My health and sleep spiraled downhill even worse after starting CPAP, and I believe this misuse of the ramp feature nearly became the final nail in my coffin. Thankfully I found my way into the chat room here where it was suggested I shorten my ramp time and increase my ramp starting pressure. It was the beginning of my successful CPAP use.

If you are one who wakes very frequently and hits the ramp every time, please rethink your strategy. The very thing that is intended to help you could be contributing to your difficulty adjusting to CPAP. For those that like to use the ramp feature, I suggest that you set it to the shortest time and highest pressure tolerable for your situation. Every minute you sleep in ramp is potentially time spent unprotected from apneas. You want to minimize that possibility.

Just couldn't get this off my mind tonight. Hope it helps someone.

I agree KT!! My first night I thought I was going to suffocate!! Fortunately, I recognized it from work situations using a self contained air pack. I fumbled to find how to turn it off and that was the last of the RAMP. For me, I don't see why they even offer ramp. If you need a pressure, you need that pressure. When you've set yourself up to get air from only that source, why would ya want to set it for 50-80% of what you need!??!?! I've helped a couple friends get used to their therapy and ramp has always been part of their frustration. ... just my experience. Your mileage may vary....

Thanks for sharing that. As one who sets pts up on cpap we do review the ramp feature because sometimes its the only way for pts to begin using the therapy. Not being used to a pressure rushing down your nose scares most pts and ramp usually helps them get used to wearing the machine. Its good to remember though that sometimes ramp can be abused or can be the cause of problems. I will say that we will have the pt put on the mask and try out the cpap and the ramp feature and will specifically ask if they feel like they are now "short of breath" with the ramp on. If they say yes then we increase the starting pressure. Hopefully that helps the pt, but your post reminds me to keep this (ramp problems) in the back of my mind when diagnosing pts that are having trouble.

Sadly even though I kept going back to the doctor telling him exactly what I said above, he could not figure out after me repeatedly saying I couldn't tolerate it for more than a few minutes that the problem was during the ramp period. I had a machine with no data, and he just kept telling me to keep trying to get used to it. Never a discussion of adjusting the ramp. And he had the nerve to get nasty with me after I found this site and told him I needed a data capable machine to figure out what was going on. He refused to back me changing my machine, but at my insistence he finally compromised and ordered a two week trial on an autopap - after thoroughly disrespecting me. It was my last visit ever with him. In the interim I got a good deal on a used data capable machine from a concerned board member. But without the discerning eyes of members here, I still wouldn't have known the ramp was the main issue, and that the revealed needed increase of 2 points in pressure was not the end-all solution to my problems.

teachcsg wrote:Thanks for sharing that. As one who sets pts up on cpap we do review the ramp feature because sometimes its the only way for pts to begin using the therapy. Not being used to a pressure rushing down your nose scares most pts and ramp usually helps them get used to wearing the machine. Its good to remember though that sometimes ramp can be abused or can be the cause of problems. I will say that we will have the pt put on the mask and try out the cpap and the ramp feature and will specifically ask if they feel like they are now "short of breath" with the ramp on. If they say yes then we increase the starting pressure. Hopefully that helps the pt, but your post reminds me to keep this (ramp problems) in the back of my mind when diagnosing pts that are having trouble.

My experience with the ramp feature was a bad one too. Thankfully I was working with a RT at that time who suggested I turn off the ramp feature. That cured my initial problem of feeling suffocated. Perhaps d/c ing the ramp might help others.

Jen

I had a mixed response to the ramp setting.

I quickly realized it did not help me fall asleep--in fact it sometimes woke me when the full pressure came on, and I did feel like suffocating at 4, so I turned off the ramp feature within the first few days.

BUT, I did have claustrophobic panic attacks at first--and woke from sleep in a panic until we finally got my optimal pressures dialed in (home titration). The only thing worse than feeling claustrophobic in the mask was having the air blasting me at full blast--these panic attacks were probably happening with obstructive apneas, so I'd wake in a panic with a hurricane in my face. Often in those cases, being able to tame the storm by hitting the ramp button kept me from ripping the mask off my face altogether. So there was a benefit to having that available in my case.

I think newbies should be shown how to adjust and turn off the ramp settings, so when they get to the point where the air pressure seems too low, they can turn the automatic ramp off, and they need a thorough explanation of what the ramp button does if they feel the need to use it during the night.

kteague great topic.

I used the ramp feature for a couple of weeks but realised that if I used it too many times during the night I would be affecting my therapy. I haven't used the ramp feature for at least 5 months now. I had a stupid RT tell me I 'must' use the ramp feature as that would help my eardrums from perforating at a pressure of 17. She just wouldn't/couldn't understand that the pressure level of 17 would perforate my ear drums wether I used the ramp or not. As I hired an APAP for 1 month proved my pressure never went above 10.

I still feel like crud, although that is for another thread (debating whether to start one or not)

Thank you for taking the time to write such a helpful post. I am sure many people will benefit from what you have wrote.

Yes, thank you KT, excellent post.

Bryan