Is my Ramp Time causing my wakeups?

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jlsmithseven
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Is my Ramp Time causing my wakeups?

Post by jlsmithseven » Tue Jun 28, 2022 2:38 pm

SO, I decided to wear my Airfit N30 for my nap to see how it would do. I forgot I had this mask but it's very similar to the Dreamwear version I used to wear all the time. I have always been trying out different masks, but I feel like there is a pattern here. I just took a nap for a little over 30 minutes and I know I was pretty much asleep for most of it. Right at the end of my ramp time, I woke up. I never really messed with the Ramp time settings, and left it on AUTO. But after some good success messing with my Humidity/Temp settings instead of leaving them on Auto I'd thought I'd try it out. Can anyone make anything of this?

https://ibb.co/Yj3LcT1

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zonker
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Re: Is my Ramp Time causing my wakeups?

Post by zonker » Tue Jun 28, 2022 3:12 pm

jlsmithseven wrote:
Tue Jun 28, 2022 2:38 pm
Can anyone make anything of this?

https://ibb.co/Yj3LcT1
well, we don't have anything to compare it to. if you have another chart from a different sleep session, you could see if this happens all the time or just the once. if you compare enough charts, you can see if it happens always or not as well. or maybe just a certain percentage of the time.

you said you see a pattern, but you haven't shown us any pattern.

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Miss Emerita
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Re: Is my Ramp Time causing my wakeups?

Post by Miss Emerita » Tue Jun 28, 2022 4:59 pm

As Zonker says, you want to do a little research on your past charts. Are you seeing wake-ups at the end of your ramp time? You might be able to tell by zooming in on your flow rate at the end of the ramp to see whether you have irregular awake breathing at that point, as opposed to regular asleep breathing.

You can also do some experimenting. Try turning the ramp off and see what happens. You might actually like having your full EPR of 3 right from the start of your night. Experiments usually need a few nights before you can draw conclusions from them, especially if you're giving yourself a new PAP experience.
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jlsmithseven
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Re: Is my Ramp Time causing my wakeups?

Post by jlsmithseven » Tue Jun 28, 2022 5:52 pm

Sorry I guess I just jumped the gun as to why I have so many nighttime wakeups. The nights I don't wake up (only happened once this past year) , or the nights I wake up 1 time MAX, I feel amazing the next morning. That is how I would like to feel at least 5/7 days of the week , not just once a year. Is this unacheivable? I do toss and turn in my sleep sometimes as well, which might be causing a lot of issues. I usually like to be on my back for a while then turn.

As you can see here, if this is any help, the first night I noted that I got amazing sleep. I can see the flow chart is very steady all night and looks great. Then the next screenshot, you can see I took the mask off for a few hours because I couldn't stand it. Is there anything major you see here that could be causing my issues?

https://ibb.co/gzMqnKM
https://ibb.co/r5vWsdN

Sorry that second one I was actually trying my full face mask and couldnt stand it. Here is a more direct comparison using the same nasal mask, I think I used Dreamports for both of these Nasal ones.
https://ibb.co/cwwVdWz

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Dog Slobber
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Re: Is my Ramp Time causing my wakeups?

Post by Dog Slobber » Tue Jun 28, 2022 6:14 pm

There is nothing to suggest you woke up because of Ramp, or more specifically Ramp ending.
  • You do not have Ramp set to Auto, you have it set to timed at 30 minutes
  • You woke up prior to Ramp ending, it was less than 30 minutes and your pressure had not achieved your minimum therapy pressure
  • When one is in Timed Ramp, especially at 30 minutes, the pressure increase is so gradual there really is no discernible difference between pressure at 29:50 and 30:00
You woke up about 30 minutes after napping, and because your a pattern seeking human, who is desperately seeking a resolution to a sleep maintenance problem, found a pattern that didn't really exist.

Having said that, I think it's more likely for you to awaken because of (Timed) Ramp, than Ramp ending. On ResMeds when in Timed Ramp your machine is not monitoring your therapy not responding to therapy needs by increasing pressure. You could very well be experiencing events and not know it.

Solution: Turn off Ramp, or switch to AutoRamp.

AutoRamp behaves very different on ResMeds. It keeps pressure at the configured Ramp pressure and then will exit Ramp should it detect you're asleep or should it detect events within it threshold. It will then start normal therapy mode.

BTW, I don't think you're doing yourself any favours with such a low Ramp pressure. Your therapy needs may very well buch higher that 4. I also think that your therapy pressure of 7 is too low. Looking at your other graphs, we see some abrupt pressure increases prior to wake-ups. You may be experiencing sleep disruptions and waking up before your device addresses them completely.

I would:
  • Set Ramp to Auto
  • Set Ramp pressure to 7
  • Set Therapy minimum pressure to 8, and see how it goes, we want to flatten that pressure trace a bit.

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jlsmithseven
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Re: Is my Ramp Time causing my wakeups?

Post by jlsmithseven » Wed Jun 29, 2022 4:31 am

Thank you I will try that this evening. I just know I’ve tried to up my pressures before and the comfort wasn’t the same for me I had a hard time with it and I believe it caused me to wake up feeling very bloated and gassy. I did however try the same settings as the night I got good sleep (first picture graph) and I actually slept pretty well. But I understand why I should have more pressure I just have a hard time with it

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jlsmithseven
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Re: Is my Ramp Time causing my wakeups?

Post by jlsmithseven » Wed Jun 29, 2022 4:57 pm

I set my pressures according to what you said. The only thing that worries me is that starting pressure of 7. If it's too much, do you mind if I move it back to 5? I've been steadily trying to increase my minimum pressure and I've had it at 4 a long period of time, only worked my way up to 4.4 but I think with some time I could get it to 7. I just know its pretty uncomfortable for me, I dont get that suffocating feeling like some do at low pressures.

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Miss Emerita
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Re: Is my Ramp Time causing my wakeups?

Post by Miss Emerita » Wed Jun 29, 2022 6:39 pm

It’s fine to move up incrementally as you follow DS’s advice.
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jlsmithseven
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Re: Is my Ramp Time causing my wakeups?

Post by jlsmithseven » Thu Jun 30, 2022 3:15 am

So, I used the settings you suggested. I learned a lot last night which is great, but still some concerns. First, I learned that nasal strips help me more than anything. I was using Nasal Strips prior to therapy because they were the only thing that helped me semi-enough get good sleep. I've been using them randomly lately to test to see if they'd help. Well, last night with my AirFit N30 Nasal Mask I used them and the pressure setting at 7.0 it felt like I could breathe so much better than having that at the 4.0 starting. So that was fantastic! A little bit of back and forth between breathing out pressure but it wasn't bad. I fell asleep fast enough. The bad news is, it looks like my AHI went up to higher than 3.0. It looks like all the events happened prior to waking up, and I think I was pretty awake at that point because I slept well. Not really sure there as you can see how many clear airway events took place. It also looks like I had a few leaks which I don't remember either. Another bad thing is my throat was realllly dry this morning. I drank some water and it's much better, but I'm not sure how to clear that up. Overall I feel pretty good and am excited to see if these settings will help me. Does anyone notice anything vastly different from the charts? I also woke up at least 3x to use the restroom, so that hasn't really improved yet but I did fall right back asleep.

https://ibb.co/xhBPq9h

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Dog Slobber
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Re: Is my Ramp Time causing my wakeups?

Post by Dog Slobber » Thu Jun 30, 2022 6:10 am

I see the batch of Centrals.

Whenever I see batch of centrals at the beginning or end of a session, I always consider the potential for awake breathing. Especially since there aren't any significant centrals elsewhere.

Let's try another couple nights.

Your experience about breathing easier is typical, most of us have a lot of trouble drawing air at 4cm.
Last edited by Dog Slobber on Thu Jun 30, 2022 7:26 am, edited 1 time in total.

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jlsmithseven
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Re: Is my Ramp Time causing my wakeups?

Post by jlsmithseven » Thu Jun 30, 2022 6:57 am

Yes most of the night went very well. Regarding the 4 pressure, that was the only thing I could stand before because anything over that made me feel too much pressure . I think with the nasal strips and mask I’m using, it allows me to draw so much more air and it felt amazing to be able to get that much air at once. Before it was just too much but it felt like I finally could breathe through my nose again. I’m excited to see these results.

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Re: Is my Ramp Time causing my wakeups?

Post by Pugsy » Thu Jun 30, 2022 7:06 am

I would bet my last dollar that the batch of centrals at the end of the night were more related to being awake or half awake than anything else.
You might want to take a crash course in evaluating flow rate breaths for being asleep or awake if you continue to see little batches like that.
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Re: Is my Ramp Time causing my wakeups?

Post by Janknitz » Thu Jun 30, 2022 1:48 pm

jlsmithseven wrote:
Thu Jun 30, 2022 6:57 am
Yes most of the night went very well. Regarding the 4 pressure, that was the only thing I could stand before because anything over that made me feel too much pressure . I think with the nasal strips and mask I’m using, it allows me to draw so much more air and it felt amazing to be able to get that much air at once. Before it was just too much but it felt like I finally could breathe through my nose again. I’m excited to see these results.
When I wake up in the morning, I'm reluctant to take my CPAP off, because it feels great having that airflow. I really like it.
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jlsmithseven
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Re: Is my Ramp Time causing my wakeups?

Post by jlsmithseven » Fri Jul 01, 2022 3:29 am

Last night was not as great. I forgot to take my Claritin earlier in the day. I did a saline rinse, saline spray and flonase before bed, but still woke up halfway through the night really congested. So then I decided to put my full face mask on and that thing is terrible. So this data isn't great and I did not sleep great but the pressure still seems good with my nasal strips helping a lot.

https://ibb.co/FzGj9TH

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jlsmithseven
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Re: Is my Ramp Time causing my wakeups?

Post by jlsmithseven » Mon Jul 04, 2022 4:35 am

So last night I slept amazing. I think I got over whatever infection I had this weekend. I also got the Wellvue Ring 02 sensor to monitor my SPO2, which is something I did when I first started my journey. My blood oxygen was dipping into the low 80s pretty much every night and I learned that was not good at all. So it's awesome that I can integrate that into my CPAP data and see how its working. Last night as you can see went very well. Once I see the flow rate graph look pretty stable I know I slept good. I think these settings of 7 pressure ramping to 8 is really catching all those apneas that were waking me up. Should I stick with this for a while now? Or can I be testing other things?

https://ibb.co/cCL5Tyq