Question about adjusting ramp pressure/changing to constant pressue

[bradweber1982]

I've been using my machine for almost one year. Phillips Dreamstation. This week I changed to a full face mask that goes over the top of my nose. It was suggested that I try that because of my large bed and constant side sleeping. It is much more comfortable than my old mask.

My question is this. I've had trouble getting consistent results. Most nights the machine goes into ramp mode very quickly. My pressure starts at 6, but within 20-30 minutes it is up around 12-14. This prevents me from falling asleep. I'd like to know if switching to a consistent pressure would help. Say, setting it around 7-9, because that seems to be very comfortable for me. Thanks for any help.

[Julie]

I think there's a misunderstanding about what the ramp feature is vs minimum (and max) pressure settings. You have a prescribed minimum setting of e.g. 6 or 9 or 12 and what the ramp feature (with its own settings that you experiment with) does is, over a specified time, rise only to the min. setting and then the 'regular' A- or Cpap operation kicks in for the night.

The machine doesn't 'ramp'' up from the min. setting to any other level above that due to the ramp feature, but behaves according to your level of obstruction and time it takes to overcome it at any given moment. It just goes up based on your last breath's level in anticipation of then stopping the next apnea (at whatever level it may end up at above the min. setting. You may get 50 potential apneas at higher levels over time, but hopefully the machine will be able to block them before they 'take'. But it's the machine moving up and down normally that's doing it, not the Ramp feature that beyond the time you've set for it to reach your min. pressure setting at the beginning of the night is not active. The majority of us turn off the ramp for good very soon after beginning to use Cpap at all and just put on the mask and 'go with' whatever the min setting is... that then goes up and down all night (unless set to do straight Cpap at one level) trying to block apneas.

I realize it can be confusing, but it's important to know the difference. Raising or lowering your min. pressure (prescribed) from e.g. 5 or 8 or 11 is how you eventually determine which min. setting is best for you, the one that interrupts most events overnight and you're always free to try those... BUT it's also best to do it based on results you see on Sleepyhead software rather than just randomly playing with numbers. But the Ramp is a different thing and should not be part of your thinking when it comes to finding at least a semipermanent min. setting. And can be disabled at any time. At no time does the machine 'go into ramp mode' except when you first put on your mask, and then it quits once the min. pressure setting is reached.

[bradweber1982]

Thanks Julie. I somewhat understand. My prescribed minimum pressure is 6. My max is 15. The issue I see myself running into is my pressure jumps while I am still awake, which causes me to stay awake longer, which then causes me to get frustrated at my mask and I take it off. Make sense?

[LSAT]

You have been using your machine for a year and these problems just started when you switched masks????

[D.H.]

The ramp is considered a "comfort" feature, not a "therapy" setting. Therefore, whatever makes you comfortable is just fine. You can disable the ramp completely, set it the lowest possible starting pressure and longest time possible, or anything in-between.

[bradweber1982]

You have been using your machine for a year and these problems just started when you switched masks????

No. I've been having these issues for quite a while. I've had problems using my mask all night since I started therapy. I constantly take it off in the middle of the night. I switched masks after reading some reviews about over the nose masks helping those who are side sleepers.

[Julie]

Turn off the ramp altogether. Start 'cold' at your min. pressure (the machine will do it auto) and don't freak out at the first rush of air, but just start breathing normally and in a minute you should be ok. IF not, then come back to this thread and give details.

[bradweber1982]

Turn off the ramp altogether. Start 'cold' at your min. pressure (the machine will do it auto) and don't freak out at the first rush of air, but just start breathing normally and in a minute you should be ok. IF not, then come back to this thread and give details.

Thank you. I'll try tonight and will update.

I've also ordered a mask strap to try to help with my leaks.

[Julie]

If you mean a chin strap, there are more effective and comfortable ways to deal with leaks.

[bradweber1982]

If you mean a chin strap, there are more effective and comfortable ways to deal with leaks.

It is more designed to decrease the leaks at my cheeks, which is the main problem I am having with my new mask.

[Julie]

Maybe I'm slow today, but... "leaks at my cheeks" ?

Could you explain please?

[BTS]

"leaks at my cheeks"

[LSAT]

Turn off the ramp altogether. Start 'cold' at your min. pressure (the machine will do it auto) and don't freak out at the first rush of air, but just start breathing normally and in a minute you should be ok. IF not, then come back to this thread and give details.

Thank you. I'll try tonight and will update.

I've also ordered a mask strap to try to help with my leaks.

The chinstrap is designed to help keep you keep your mouth closed...I don't think it will do much for "leaks at your cheeks". You may need mask liners.

[Goofproof]

Maybe I'm slow today, but... "leaks at my cheeks" ?

Could you explain please?

Mama always said, don't pierce your cheeks, the nose ring is enough. Jim

[OkyDoky]

I think he maybe talking about this Padacheek product that he asked about in another thread. http://www.padacheek.com/PAC_AntiLeak_Strap.html Looks like it may try to stabilize the mask. Haven't heard if anyone has tried it.