Going Up the Ramp Tonight

[Luthie2006]

Going up a Ramp tonight: I am a newbie and would just like to see what your opinions are regarding this. I was originally set on pressure 4 cm on the APAP machine without a CPAP titration.
The sleep clinician read the limited data card on the Res Med Escape and said I was at 12 air pressure for 3 nights in a row. The rest of the nights I pulled it off for the past 2 weeks. The doctor told her that he wants me to start at 8 cm and ramp up to 12 in a matter of 20 minutes. He thinks that all my awakenings are due to that the air pressure was so low at 4 cm that I kept waking up when I would enter REM sleep, either because I was going through apneas or because it was too much pressure for me. What do you think of this air pressure for a newbie on an APAP machine, 8 cm and ramped up to 12? This is unfamiliar territory to me. Thank you so much.

[sc0ttt]

Why don't you just see if you can fall asleep on 12 without the ramp first?

Personally I never liked the ramp function.

[Julie]

Most of us turn off the ramp within weeks if not days of starting out unless our scripted pressure is really high (>15, etc.). I started (I believe) around 8 - whatever the high was set at - and just couldn't be bothered with ramping - started too low to be comfortable and once I got over the initial 10 secs of air blasting in, it was a lot easier than going into cold water to not use the ramp again. Now my settings are 8 and 12, usually end up around 9-9.5 most of the night, and it's easier than combing my hair... it's a lot more trouble fidgeting in bed to get comfortable!

[The Latinist]

No, it doesn't make sense. It sounds like your machine is being set to straight CPAP at a pressure of 12 cm. We understood that you were getting an APAP with a minimum pressure of 8 cm and a maximum of 12 cm.

[HoseCrusher]

I happen to be one that really likes the ramp function. But you need to use it correctly. My pressure is around 12.5 (I am using APAP so it floats around there). I start off at 9 and ramp up over 15 minutes. I never feel starved for air and after a few minutes I can settle in very comfortably. I believe in being comfortable while using xPAP and find that when properly used the ramp feature adds a little additional comfort.

I learned the "hard way" that with an optimum pressure of around 12 you don't want to set the ramp to start at 4 and have it work its way up to your normal pressure over 30 - 60 minutes. Just use the ramp to "take the edge off" of using xPAP.

On the other hand if you have no concern for creature comforts, shut the ramp off.

It is an individual choice...

[library lady]

I too like the ramp. My thought is that as a brand-new user, it might be best to use the ramp for at least 2 or 3 days to see if you like it, and my reasoning for that is that this will allow you to get used to additional pressure. A pressure of 4 is too low, I think, but I'd suggest that even if you decide to turn it up a little the ramp is still a good way to start.

[9forus]

I use the ramp on mine. It starts at 8 then goes to 12 in 15 minutes. When I start at 12, my ears pop like crazy. But going from 8-12 they are fine besides maybe one pop when I first swallow after starting therapy.

[hyperlexis]

Use the ramp button -- there's nothing at all wrong with doing so. That's exactly why its there after all. I used to be at 4, then progressed higher and higher to 7-20. Now I had another study and am at 12-20, and am sleeping much better and waking up more rested. However at 12 I now have to use the ramp to start. Its just too strong for me otherwise. So I can definitely recommend using it without worry.

[Luthie2006]

Thank you for your comments. It is much appreciated. It is not a CPAP but APAP, and the reason why the doctor wants me to start at 8 and ramp up to 12 is because for the very reason you stated, 12 is too hard to get used to. I am thinking that 8 will be too difficult even for me coming from a "4". and so the ramp will start and go up to 12 in 20 minutes The doc thinks this is the best way for me to slowly "ease" to 12 since my AHI was 12 on the data card.

[The Latinist]

There's nothing wrong with using the ramp feature. But the question is why his doctor apparently has set him up at straight CPAP instead of the 8-12 APAP range he told us in his other thread they were going to use. As I recall, he's never had a titration, and there's no way they got an accurate idea of his pressure needs from Escape Auto data.

[9forus]

There's nothing wrong with using the ramp feature. But the question is why his doctor apparently has set him up at straight CPAP instead of the 8-12 APAP range he told us in his other thread they were going to use. As I recall, he's never had a titration, and there's no way they got an accurate idea of his pressure needs from Escape Auto data.

I was under the impression they upped the lower pressure to 12 and left the upper at 20......

[Denial Dave]

I've got my ramp set at 10 minutes. It gives me time to get settled into bed before I get full pressure.

[Luthie2006]

Thank you. From what I understand it is not CPAP at all, but APAP, starting at a pressure of 8 and going up to 12 ramped in 20 minutes, and can go higher to 20 if needed.

[Drowsy Dancer]

Thank you. From what I understand it is not CPAP at all, but APAP, starting at a pressure of 8 and going up to 12 ramped in 20 minutes, and can go higher to 20 if needed.

I'm interpreting what you're saying is that your machine is now set for APAP with a range of 12-20, with a 20 minute ramp starting at 8.

[The Latinist]

Thank you. From what I understand it is not CPAP at all, but APAP, starting at a pressure of 8 and going up to 12 ramped in 20 minutes, and can go higher to 20 if needed.

I'm interpreting what you're saying is that your machine is now set for APAP with a range of 12-20, with a 20 minute ramp starting at 8.

Yes, from his other thread it seems his range is 12-20, which seems a little high since the data from his previous Escape Auto showed a 95% pressure of 12. I would have expected 10-14 or something like it.