Using Ramp Feature (and making it work)

[Hang Fire]

What's brutal about people explaining their experience with the ramp?

He ain't seen nothing yet.

[WindCpap]

The auto ramp on the air sense 10 works extremely well. I haven't missed a minute of full pressure therapy. My normal pressure is 9 and my ramp pressure is 8 with a ramp only epr of 3.

[SimbaLion]

What's "brutal" is the tone of some of those negative responses. Snark and condescension make the difference between a useful (negative) reply and one that, although possibly trying to make a good point, turns in to the "unwelcome wagon."

[Gasper62]

Wow, DW. Apologies if I offended you. Not my intention. It is important (IMO) that newbies be made aware of what kteague pointed out.

[Heart Jumping]

What's "brutal" is the tone of some of those negative responses. Snark and condescension make the difference between a useful (negative) reply and one that, although possibly trying to make a good point, turns in to the "unwelcome wagon."

^^^ This x 100. ^^^ (although I think it's more rude than brutal, though I can see where it mighy feel that way to someone looking for help or trying to help)

I find it especially disappointing on a forum where people are vulnerable and coming to talk about health problems. However I figured out on one of my first days here that it's just the way it is, the only thing that stops it is moderation and this forum is hands off. Luckily I've been flaming on the Internet tubes for many years so even though I'm a newbie here it didn't scare me off .

[Wulfman...]

Even with my beginning (prescribed) setting of 18 cm., I didn't use Ramp.
But, after trying that for about an hour, I reset my machine to 10 cm. and was quite comfortable with that setting for a year.
Then I experimented with 11 and 12 and an APAP range of 10 - 15 to confirm that my self-selected pressure of 12 cm. was spot on.

I have never used Ramp and never felt the need.

Hope that wasn't too "brutal" for anybody.


Den

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[Heart Jumping]

The auto ramp on the air sense 10 works extremely well. I haven't missed a minute of full pressure therapy. My normal pressure is 9 and my ramp pressure is 8 with a ramp only epr of 3.

So you find that just a single point makes a difference?! Interesting. How long do you have it set to ramp from 8 to 9?

[ButtermilkBuoy]

The auto ramp on the air sense 10 works extremely well. I haven't missed a minute of full pressure therapy. My normal pressure is 9 and my ramp pressure is 8 with a ramp only epr of 3.

So you find that just a single point makes a difference?! Interesting. How long do you have it set to ramp from 8 to 9?

He's using Auto Ramp, so no time is set.

AutoRamp: This comfort feature uses sleep onset detection to keep pressure low before delivering full therapy pressure as soon as the patient falls asleep to enhance therapy compliance. - See more at: http://www.sleepreviewmag.com/2014/08/r ... BT19t.dpuf

How does the machine know when you are asleep? Probably when your breathing becomes steady and low. ???

[ChicagoGranny]

The auto ramp on the air sense 10 works extremely well. I haven't missed a minute of full pressure therapy. My normal pressure is 9 and my ramp pressure is 8 with a ramp only epr of 3.

So you find that just a single point makes a difference?! Interesting. How long do you have it set to ramp from 8 to 9?

It's a difference of one on inhale.

He is using EPR 3 for the ramp only time period. So the difference on exhale is about 4 cm.

[Heart Jumping]

Ah, got it! I was just curious, I already turned ramp off for myself on the second night.

[Pugsy]

How does AutoRamp work?

It's a feature available on the new AirSense machines when in auto adjusting mode.
It's supposed to sense that you have gone to sleep and then it starts accelerating the ramp upwards by 1 cm per minute until the minimum pressure is met.

So assuming the machine does indeed get it right that you are asleep and it begins the increase in pressure and assuming that some sort of airway collapse is beginning AND assuming that the 1 cm per minute gets you to a point where the collapse is prevented then it will treat the airway collapse...that's a lot of assumptions and I suppose works okay if the machine doesn't need to go very far to attain a pressure where the airway doesn't collapse but there could be a potential issue if the minimum pressure is higher and the machine can't get to it soon enough with the 1 cm per minute increase.
Like if a person's minimum pressure is say 15 cm and they go to sleep when the pressure during ramp is 7 cm then it increases 1 cm per minute...that's 8 minutes before it gets to 15 and in theory the airway could collapse during that ramp up to 15 cm time frame. So there is the potential for it to work well when someone doesn't have far to go to get to their minimum pressure (assuming it gets it right about a person being asleep) but might not work so well if one goes to sleep and the airway starts collapsing long before the machine is done with the 1 cm per minute thing.

What the machine doesn't do is say "OMG the airway is collapsing and I need to do something" and then go do it......it's responding with the increase in ramp speed to the person being asleep and not to any warning signs of the airway trying to collapse. Any apnea events that might get prevented during the auto ramping up time frame is a byproduct of the machine thinking a person is asleep and a coincidence.

And all this is dependent on the machine getting it right as to when a person goes to sleep and how accurate that is.

From the AirSense manual

https://sleep.tnet.com/home/files/resme ... -guide.pdf

[Pugsy]

I have never needed the ramp either but I would never make fun of someone who wanted/needed to use ramp....and some of the comments here were making fun.
I hate the references implying that we aren't grown up if we use some sort of comfort aid...or implying that my _______ "insert male appendage" is bigger than yours because I don't need ramp and you do.

For this therapy to work we have to first get to sleep and anything that helps us get to sleep better/easier/faster is fair game to try in my book.

[DWaldman]

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[Wulfman...]

Forget it... Sorry I tried to help somebody new who might be struggling by giving them some positive info. You people only want to hear from those with problems so you can strut your stuff... What a sad lot you are.

The newer machines include a feature called ramp, which starts out at a low pressure, then increases it after a certain set time. From what I have learned from the forum, is that many people do not use the ramp feature. When I first got my machine, I set the ramp to on, and tried it. Did Not like It. So I turned it off. After over 30 days, (ok, I am newbie) I decided to revisit the ramp feature. Now I am mechanic by trade, so I am always looking for ways to make things work. That said, I decided to revisit the ramp feature.I have an S9 Autoset, set to 9.6-17. When I first put on the mask, (aloha pillow) it runs up to 9.6. I spend a few moments breathing against the pressure, nothing major that a few mouth open exhales don't make me comfortable. So, here is this feature, unused, that I just had to explore. I put on my mask, and using auto-start, I watch at what pressure I feel "natural", it is about 7.5. So last night I set the ramp start to 7.5, and time to 5 minutes. WHAT A DIFFERENCE. Not just when I first settle in to sleep, but when I have to get up for a B.R. break. So some of you might want to reconsider revisiting the ramp feature and tuning it to your preference. Just my opinion, YMMV.

Well, you expressed your opinion and we responded with ours and why most of us don't or have never used Ramp.

I don't know what your "problem" is with that. Seems to me that you're the one dishing out the "brutal" condescending remarks now.


Den

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[ChicagoGranny]

most of us don't or have never used Ramp.

According to this poll, viewtopic/t55010/Poll-Results--Ramp-Set ... hread.html, 25% of the respondents were using ramp.

Forget it... Sorry I tried to help somebody new who might be struggling by giving them some positive info. You people only want to hear from those with problems so you can strut your stuff... What a sad lot you are.

At least one person in the poll, viewtopic/t55010/Poll-Results--Ramp-Set ... hread.html , thought that the "cpap ramp is the work of the Devil".