Treatment during ramp time

Suspend to me means to temporarily halt something...like what the Respironics manual says happens.
Then go back to whatever it was in the middle of doing.

With the Auto Ramp feature enabled on the AirSense machines once the person is asleep (or the machine thinks they are) the ramp isn't really suspended (to my thinking) but instead goes directly to therapy algorithm as it wouldn't be going back to ramp because the person is supposed to be asleep anyway.

But I suppose suspend could mean permanently end something if that is what ends up happening.

My personal opinion about the Auto ramp thing... I don't know just how accurate it is in terms of knowing for sure if a person is awake or asleep simply by the breathing pattern.
If it was that easy to figure out if a person was asleep or not...how come they haven't figured in some way of not flagging events while awake?
So...remember I am from Missouri and things have to be "shown" to me before I believe them.
I really hope they (the machine makers) can come up with some way to tell for sure if a person is asleep or not and final result is that we no longer have to try to figure out if a cluster of events was from SWJ or the real deal. It will make my work a whole lot easier. I wish I had a dollar for every cpap user who goes directly to panic mode because of a cluster of anything right near when they turned the machine on and they most likely was still awake. It's usually centrals and they think they are dying of heart disease when in reality it's just the machine flagging awake breathing irregularities and scaring the devil out of people.

This thread was started to answer a basic question:
1. Does the ramp or auto ramp feature have significant enough negative effects to recommend that no one uses it, regardless of situation? I have seen someone new to CPAP asked to try ERP because they were having trouble exhaling into pressure. I have also seen someone new to CPAP being told to turn ramp off because they are not being treated without asking if they are having problems falling asleep while using CPAP. Without knowing if they are having any events during the ramp time anyway.

as for those that think that anyone that uses ramp or auto ramp just needs to "man up" and not use it, well it is only one of several comfort features and therefore I assume that they also recommend that we should only be using basic CPAP without humidifier and sleep in the open air, cooking over a camp fire to be "real men". Their choice, but I think most would disagree. I don't have a need to make myself more uncomfortable in an attempt to prove that I am a man.

as for the "logic" that most users don't use a feature as a reason to also not use a feature, then you are suggesting that we take a poll of what type of CPAP most use and everyone should switch to that. If this logic worked we would all be using basic CPAP and no one would ever have started using APAP, BiLevel or ASV machines. It also assumes that someone new to CPAP is the same as someone that has been on CPAP for 10 years or even one year.

I did come across a list of what Resmed looks for to determine sleep state
1. any snore
2. apneic event (this was listed as a specific number within a specific timeframe, none of which I remember)
3. 30 consistent breaths

No idea how accurate this method is

When I first started I had difficulty breathing and going to sleep with the low ramp pressure not the other way around. But at the same time until I came here I didn't know that ramp was the problem. So it can be comfort for some and uncomfortable for some. If a new user is having difficulty with breathing and falling asleep the pressure and time of ramp should be investigated for each individuals comfort.

I want every "comfort" feature available at my disposal and I don't want to be treated like a baby because I choose to use a comfort feature. I may or may not choose to use them but I want them available and I want the choice to be mine what I use or don't use.
I talked about it a while back when someone told someone that using a comfort feature was like using training wheels on a bicycle...I feel that it is degrading to say that to someone and I won't ever do it and if someone said it to me I would want to bitch slap them across the room.
But that's me.
Everyone is entitled to their opinion and most of them think their opinion is the one that matters.
Hey...I am just like everyone else but I try real hard not to put someone down just because what they do isn't what I would do.

I try to explain the facts and educate and point out pros and cons and let a person decide themselves what they want to do based on learning the facts. It takes me longer to compose responses and hence sometimes my short novels but I try to be thorough whenever I have the time and I can.

Humidity, ramp, exhale relief....I feel can/are all an integral part of successful therapy and thus more than "comfort" because like I said above...if I am not comfortable I am not going to sleep well (if any) and that sort of is the most important thing here....I gotta get the sleep first for the machine to work it's magic on my OSA. Sure not everyone needs/wants humidity or ramp or exhale relief but those that do shouldn't be talked down to or like they are small children needing training wheels. It's a pet peeve of mine and I don't often speak up on it because I know that those that do talk to people that way aren't going to see how it could hurt someone's feelings or they don't care because their opinion is the only one in the world that matters. It's a war I realize I can't win and I prefer to save my energy for those wars I stand a chance of winning.

FWIW...I never used the ramp. Didn't really feel that I needed it but I can empathize with those that do feel they need it.

PoolQ wrote:This thread was started to answer a basic question:
1. Does the ramp or auto ramp feature have significant enough negative effects to recommend that no one uses it, regardless of situation? I have seen someone new to CPAP asked to try ERP because they were having trouble exhaling into pressure. I have also seen someone new to CPAP being told to turn ramp off because they are not being treated without asking if they are having problems falling asleep while using CPAP. Without knowing if they are having any events during the ramp time anyway.

WRONG, having Auto Ramp wasn't mentored in orgional post. After 10 years I'm pretty sure I've seen about everything, the good, the bad, and the ugly. ERP OR (EPR), wasn't what the post was about either.

as for those that think that anyone that uses ramp or auto ramp just needs to "man up" and not use it, well it is only one of several comfort features and therefore I assume that they also recommend that we should only be using basic CPAP without humidifier and sleep in the open air, cooking over a camp fire to be "real men". Their choice, but I think most would disagree. I don't have a need to make myself more uncomfortable in an attempt to prove that I am a man.

as for the "logic" that most users don't use a feature as a reason to also not use a feature, then you are suggesting that we take a poll of what type of CPAP most use and everyone should switch to that. If this logic worked we would all be using basic CPAP and no one would ever have started using APAP, BiLevel or ASV machines. It also assumes that someone new to CPAP is the same as someone that has been on CPAP for 10 years or even one year.

Not everyone here wants to be a Man or Woman, but most of us had the Option, and if you have enough money you can get it changed.

If you want to use the RAMP, but can't understand it, go ahead and use it, it's there, and usually it's not life and death, many people don't understand the equiptment they use, most of it is simple enough for most people, if not professionals can help. In Life Sometimes You Are The Windshield, Sometimes You Are The Bug! That's Life. Jim

PoolQ, what is wrong with you?

No one said you should quit ramp to 'man up', but have suggested quitting it because (as Pugsy pointed out in her notes) until the ramp reaches your scripted pressure, you are being undertreated... actually not treated at all to speak of, at least with most popular machines, so unless you absolutely cannot function at all without the ramp, you're better off trying to stop using it. That's all!

Julie,

Yes indeed someone did suggest that anyone using the ramp should just man up, it was NOT you. Man up, training wheels, knee pads and on and on.


"at least with most popular machines" older ones yes, newer ones NO IF they have auto ramp then YOU ARE getting treatment. Even with the older ones using ramp only exposes you to the risk of an event for less than 10% of sleep. Obviously we think differently about this and we both think that we are in agreement with Pugsy. Very interesting.

FYI you are the person posting that caused me to even ask this question. so basically I disagree with your entire last post and I think you are misleading new users that have newer machines, which is the ONLY thing I am talking about.

So right back at you "what is wrong with you?" since you put it so politely.

OMG.

Julie wrote:OMG.

I guess Julie goes on his "foe list" too. He's scoring points left and right.

Maybe he's not sleeping well. We know it's not the RAMP, surely he's got it set on Magic Auto Ramp, must be the knee pads or pineapple hat.

The list is getting longer. What does foe list stand for, is it any think like fake fur. Jim

I got in on this conversation late, and as I was reading thru all the responses, I was yelling at the monitor... no good ! Poole... I'll probably get on your foe list.... but... you take on Pugsy... good luck.... She LETS me... and I lose... good luck! You really need to man up about ramp. You stick around here long enough, you will hear the "training wheels" comments. The part I was yelling about was the MODE you use. It eventually was addressed. Don't assume everyone uses an autoset OR... like me... a bi-level machine in the cpap mode. Ramp in the cpap mode will not likely treat an event because you need to obtain full cpap pressure to treat your events.
Sheriff

PoolQ wrote:SO I am sure it's just me, but I get really confused when people post that you get no or almost no treatment if you use the ramp feature on CPAP machines.
I have no idea why that would be considered accurate.

I have read the manuals and the machines all respond to an event during the ramp time by increasing pressure, just like at any other time.
My prescription calls for use of the ramp, so I am at prescription pressure during the ramp.

Are the posters suggesting that I go against my Doctors advice?
Yes... we do it all the time....

Are the posters suggesting that the manufacturers are incorrect about how the machine behaves during ramp?
I thought we were supposed to avoid giving medical advice and it sure sounds like telling someone to not do something the Doctor told them to do is giving medical advice.

We do it all the time...

Please be nice and explain to me what I am missing.

Sheriff Buford nope you don't make my list. Everything you said makes sense and is logical. It's not disagreement that causes me to add anyone to my list, it's magical thinking, or sometimes just being always wrong, or just blasting away at people and then it usually takes months of it. I don't really need to man up about anything, choosing to no longer read a post by someone is different than being upset by what they posted, see below, I really just don't care. I am not mad or upset. I had a great talk with Pugsy and some others, that I found very interesting, useful and informative.

I am not taking on Pugsy and I hope I made that very clear in my posts. I also Cleary said that I agree with everything she posted, I assume that Pugsy and I can have an intelligent conversation without resorting to name calling.

It is amusing that when I say back to someone, what they said to me I get an OMG in return.

For the rest of those that have a problem with little old me putting you on my foe list, well I really don't care. I don't care if I get half the members on my foe list. I don't care if you try and use more 6th grade insults. I hope I made myself understood, I just don't care. I don't care if you post to each other and complain about me. I don't care if you try and get others to agree with you.

Oh Oh someone has his nickers in a knot and needs a nap or.. if Dorie were still here she would say "Time out, in your corner!"