After losing 150 pounds?

[Julie]

Ramp is not automatic (unless you entered it and then didn't turn it off). It's a choice, so you have to decide about using it, needing it, vs just choosing a setting for it. Most of us don't use it at all unless our min. pressure setting is very high and we can't tolerate going straight to that when putting the mask on, so we set a ramp time (to ramp up to min. setting), but should be aware that until that is reached you're not being fully treated from 'go'.

[projecttoday]

Oh, so it's the little triangular-shaped button I was just holding down for provider settings. As long as I don't press it when I start using the machine, I am NOT ramping. Correct?

[Julie]

Don't know your machine, but theoretically... do you not have the manual?

Actually, you may be referring to 'autostart' vs hit-the-button whenever you start... that's another feature entirely and not about ramping.

[projecttoday]

Yes, I have the manual. So I think I'm okay. Thanks. (Auto-start is enabled.)

[Julie]

Look up ramp in the manual. Decide how much ramping time you want to spend before hitting your scripted min pressure and then decide whether to use it at all. If not, turn off the feature entirely.

[projecttoday]

I set the ramp time to 0, so I guess that means the ramp feature is inactive.

[Pugsy]

Oh, so it's the little triangular-shaped button I was just holding down for provider settings. As long as I don't press it when I start using the machine, I am NOT ramping. Correct?

Correct.

If you don't push that little button there is no ramp going on even if you did have it available in the menu.

Setting it to 0....effectively turns ramp off in the menu...so even if you push the ramp button it won't do anything.
That setting is for how many minutes ramp will use IF your push that little triangle button to engage ramp and start at a lower pressure.

If you need ramp in terms of comfort...use it...the Respironics machines will suspend ramp if you have an airway closure happen (you fall asleep before the end of the ramp period and maybe the airway collapses a bit) and increase the pressure in an effort to open up the airway.
Now other brands of machines may not do that but Respironics will. So it will still fight airway collapses even in ramp. Might take just a minute or 2 longer than if no ramp was used (depends on when you fell asleep and how the the ramp period was set for) but it's not like you would go the entire ramp period with no help on fighting airway collapses.

Don't do the Opti Start thing...that isn't all it's cracked up to be and also don't ever do the EZStart thing..that's a really poor option for just about everyone except someone who only needs maybe 5 cm pressure all night.

[projecttoday]

I'm now 2 nights on APAP. Numbers still seem to be jumping around. I'll post some in a couple of days. Thanks for staying with me.

Opti Start is off. What is EZStart? I don't see it on the setup menu.

[Pugsy]

What is EZStart? I don't see it on the setup menu.

It's a disaster waiting to happen...be glad you can't find it.
Not sure why you can't see it for some reason...but you aren't missing a thing except another big hurdle to effective therapy.

[projecttoday]

Okay, but you've peaked my curiosity. What is this thing that I must avoid?

Are you sure you have the right machine?. I see no mention of it in the manual.

[Pugsy]

I thought it was available on the 60 series machines but maybe I dreamed it and it's only available on the DreamStation.
It severely restricts/limits the machine to really low pressures ALL NIGHT LONG instead of letting the machine respond to events like it is supposed to.

Example....maybe your settings are minimum of 8 and max of 15...and maybe the machine feels the need to go to 10 for some reason.
With EZStart...it starts out at 4 and might max out at 6...never even hitting the original minimum of 8 much less the 10 or more you might need. End result is often a truck load of apnea event flags and people wondering why in the hell the machine in auto mode isn't doing much increasing. Eventually it will work its way up to the 8 cm minimum and finally be able to do what it is supposed to do but it might take 2 to 4 weeks to get there....and that's an awful lot of time to be having boatloads of apnea events. I have seen AHI's in the 20s with EZStart enabled...turn it off and let the machine go to the minimum straight away (or with a little ramp) and the AHI drops to maybe 1 or 2. Dumbest idea Respironics ever came up with. If someone needs help adjusting to the pressure...use of more ramp time would be a better choice.

[projecttoday]

I see. No, that's not on my machine.

[Pugsy]

Sorry to have confused you...I thought it was a feature on the 60 series machines as well as the DreamStation.
Oh well...now you know what to avoid if you ever get a DreamStation machine...
and maybe someone else reading all this will learn something.

[projecttoday]

someone else reading all this will learn something.

Indeed, that's what we're here for. Thanks.

[projecttoday]

Here is an update. Unfortunately, there seems to be no change (to my eyes, at least). Let's see if I can get these images in line this time. This is from the night before last. Numbers continue to jump around, so I wouldn't say this is typical, since there is no typical. I couldn't get it all in the image the way Pugsy did in his post a few posts back. I can' post more.

Sleepyhead 20190113 1.png (84.36 KiB) Viewed 699 times

Sleepyhead 20190113 2.png (26.63 KiB) Viewed 699 times

I take it I have a leak problem. Any help is appreciated.