Do you use ramp?

[joeljjk11]

I have experimented with it and I seem to feel better when I turn it off. There is no real reason for this because my AHI is not better when I have it off, I can’t explain it. Has anyone else experienced this? What is your opinion of ramp?

[Pugsy]

No. Never have used the ramp feature but not because I didn't necessarily "believe" in it one way or the other.
I simply didn't feel the need. Even when I was using a minimum of 10 cm on my first apap machine. I was okay with starting out at 10 cm.

Ramp is simply a comfort feature and it's like all comfort features in that it's use is up to the individual and what THEY seem to feel like THEY need so that they can easily fall asleep.

Remembering what I have always said.....sleep is our primary goal because without sleep none of this stuff matters.

Some people like easing into their minimum or fixed pressures and some actually like going full right from the beginning.
There's no right or wrong. There's only what works for each individual and people shouldn't go comparing what someone else does to what they do and expect to get the same results. Each person is going to have their own individual preferences, wants and needs with everything cpap...from masks to exhale relief to using the ramp or not using the ramp.

Do what you need to do so that you fall asleep easily and as quickly as possible....that's the primary objective.
Doesn't matter how you get it done.....only matters that you get it done.

[ups4]

I would say, generally speaking, that ramp is useful for new patients trying to adapt to high pressure while first going to sleep. Based on what I've heard, many people find low pressures of 4 cm-6 cm to be uncomfortable and require a higher starting pressure. Using the ramp at these low pressures could give the feeling of suffocation or of being air starved.

Different people tolerate different pressures, so it's hard to say what's best. Whatever is most comfortable for you is what you should use. I've never used it and my minimum pressure is 9 cm. I suppose someone with higher minimum pressure requirements might find it useful, though.

[Dog Slobber]

I use ramp, but *not* to help me ease into ny starting pressure, though I did when I was new.

I now use ramp so I will know if there was ever a power failure, or machine restart, instead of an break in OSCAR/Device reporting of data problem.

My start pressure (IPAP) is 12.2, my ramp pressure (IPAP) is 12. If there is ever a break in my therapy trace and the pressure is 12, I know there has been a power cycle. The difference of .2 cm of pressure is negligible and the ramp time is 5 minutes the shortest possible.

The other reason I used ramp, (and sadly can't use any more because I now use an AirCurve) was to see how long it took me to fall asleep. The AirSense AutoSet has a feature called Auto Ramp. Auto Ramp attempts to determine if you are asleep by your breathing pattern. It was very accurate for me, so I could tell how long it took me to fall asleep and would know if my machine was power cycled.

Unlike Timed Ramp, ResMed's Auto Ramp will monitor events and switch from Ramp Mode to therapy mode if it detects enough events.

The conditions that Auto Ramp switches from Ramp mode to Therapy mode are:

• 30 minutes of ramp time
• Sleep onset (30 consecutive stable breathes)
• 5 consecutive snores
• 3 obstructive apneas or hypopneas within 2 minutes

[Pugsy]

I always found it amazing how different people had different perceptions of what pressures felt like.
Case in point.... the people who complain about the hurricane of pressures with 4 cm and the other people who complain of suffocating at 4 cm.

Different people perceive differently things just differently. It is just the way it is and while some people might privately roll their eyes when they see someone complain about the "massive" pressures of 4 cm...it is what the other person is feeling.

What I have always privately rolled my eyes at are the ones using a minimum pressure of 5 or 6 and they say they "need" a ramp of 45 minutes. I privately feel "whatever dude". IMHO using exhale relief would be a better option and with the 5 cm minimum pressure they can't even make use of whatever exhale relief might be available.
Never mind that if they have exhale relief of some sort and they still use the 4 cm ramp starting point so the benefits of exhale relief won't even kick in.

My personal opinion is that the default settings from the factory should be a higher minimum (like 7 cm with ResMed) and the max exhale relief. Those settings would be more likely to be more comfortable than just starting at 4 cm for the bulk of the people starting cpap/apap....and have ramp turned off by default to start with.

[zonker]

used ramp my "rookie year" and haven't since.

[chunkyfrog]

I think it was about a month in when I shut the ramp off.
I like not having to wait for that wonderful rush of lovely air.
It relaxes me, puts me in a peaceful state of mind.

[palerider]

Ramp is another one of those "it doesn't matter what other people like to do, do what works, or feels best for YOU" things.

Just like humidity. I normally use none, Pugsy uses a lot, and that's perfectly fine, you can't decide what works for you by asking what works for us.

If you're fine with the pressure when the machine starts, then don't use ramp. If you feel it's too hard to breathe against the small pressure (remember, not even enough to blow up a balloon), then use ramp.

[CPAP2017]

I tried it the first few days but found that just as I was drifting off it would ramp up. The change would wake me up. That was several years ago. Haven't since.

[FatBruno]

I just started therapy a couple weeks ago, and I've already turned ramp off. I was only using 5 minutes anyway, but I barely noticed it anyway. The change didn't matter much to me, but perhaps someone with a stronger minimum might want it?

[Rock Star]

Ramp and heat are both like training wheels. I used them both early on.

It is worth pointing out that on the older cpaps no events were scored during the ramp period.

[Pugsy]

It is worth pointing out that on the older cpaps no events were scored during the ramp period.

It's still that way on some brands and/or some modes.
ResMed today with their new models don't record anything during ramp.
No leak, no events, no nothing except pressure.

Even in auto ramp when events might happen and get flagged...ramp is suspended first and then it might flag something.
Ramp has to end first though...either by the time limit or the fact that the machine thinks the person is asleep.

[Okie bipap]

I use 15 minutes of ramp. I start my ramp EPAP at 12 cm and my treatment EPAP is 16 cm. My pressure doesn't change a whole lot during ramp. From, experience it usually takes me 10 to 12 minutes to fall asleep most nights. I use the ramp time to prevent my uneven breathing pattern showing up as apneas.

[TheDuke]

NO. I started using CPAP before ramp was generally available (1987)) and did initially find exhaling against 10 cm annoying, but by the time 10 years later when I got a machine with ramp I had no desire to even try it. Now I have tried it once, and felt suffocated with just 4 cm pressure. Just incidentally, there is a wild onion/garlic plant in my boyhood Blue Ridge Mountains that SOME people eat and enjoy. But not I!
I agree strongly with Palerider's post regarding use of the ramp feature-what's the old saw, Different strokes for different folks??