"Turn off the ramp"

I complained to my doctor about congestion (also I have a burning in my nose sometimes) and he suggested--to the congestion--that I "turn off the ramp". I don't know what that means, but if it is the 1, 2, 3, 4, 5 options I have played around with this without success. Help!

I don't think it's the ramp settings you need to fiddle with. The ramp is a comfort feature that starts you off at a lower pressure and slowly ramps up to your prescribed pressure after a period of time. Some people find it more comfortable to fall asleep to a lower pressure. But I don't think the ramp would do much for your issue.

Nasal congestion and that burning sensation happened to me when my humidifier was turned all the way off. When I upped the humidifier to level 4 the congestion and burning sensation in my nostril went away completely.

Do you have a humidifier attached to your machine? What is it set at?

All that "ramp" is is the low pressure at the beginning of the night that helps some people get to sleep. Sort of like jogging on the spot to warm up before you go out on your run. It is only mildly therapeutic and some people find it annoying. I don't use it. It would have nothing to do with your congestion.

The ramp feature is a comfort setting, it starts the pressure a little lower and ramps it to the normal set pressure over a few minutes. There should be a ramp starting pressure and time setting in the settings menu on your machine. On my machine, when I start it, I can push another button to activate the ramp, but I don't use it. I do find that when I have a stuffed up nose, after a little nose spray, the cpap pressure keeps it open, so your drs suggestion makes some sense.

Sometimes a higher humidifier setting can cause congestion/cold symptoms, so needs to be turned down. It's best to play with it to see what works for you.

Wantok wrote:I complained to my doctor about congestion (also I have a burning in my nose sometimes) and he suggested--to the congestion--that I "turn off the ramp". I don't know what that means, but if it is the 1, 2, 3, 4, 5 options I have played around with this without success. Help!

Go to this link and copy the instructions I posted and save them to a file on your computer.
It's essentially the text of the clinical setup guide for the System One machines.

viewtopic.php?f=1&t=101747&p=951212&hil ... ng#p951212


Den

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I agree with many of the other posts, and I have difficulty seeing how the ramp feature would cause congestion. The only link I can see is that perhaps during the time the ramp is in effect you aren't getting the pressure needed to keep your airway open. Snoring and Snorting can cause nasal/airway irritation and congestion. I can't get to sleep if I don't have enough pressure, and I also don't want to adjust my mask and then have a further pressure increase cause a leak, so I have never used the ramp feature.

I can have a lot of congestion issues, but I've noticed I have a lot less of a problem when I regularly (at least every couple of nights) run water through my hose to clean it. If I don't, I think bacteria can set up and sinus issues can become much more of a problem.

Wantok wrote:I complained to my doctor about congestion (also I have a burning in my nose sometimes) and he suggested--to the congestion--that I "turn off the ramp". I don't know what that means, but if it is the 1, 2, 3, 4, 5 options I have played around with this without success. Help!

If you mean the numbers that you can change with the round dial on a Phillips Respironics System One, they are the humidity settings. The humidity level may affect your feeling of congestion, but those settings do not turn off ramp.

Thanks all. I do find myself snorting sometimes. I also think this congestion problem happens around the change of seasons (which is not so severe as I live on the coast but still)?

I did go and look at the settings and I see that the humidifier is set to 4. I don't know if that overrides what can be adjusted outside the settings --on the top of the machine to the left of the hose-- but I am setting it at 3 and see how that works. When I adjusted it outside it didn't seem to help. I see my ramp setting is already at 0. I do not have "System One Resistance" as an option in this setting menu but I am guessing maybe I can't control that myself in that it sets the pressure. I do think my pressure may not be adequate as I think my apnea has gotten a bit worse or has changed (evidenced by the snorting which is a new phenomena).

Any further comments much appreciated. (I did wash my hose--long overdue I confess.)

Wantok - are you sure you fully understand the difference between pressure settings on the main machine and humidifier settings? The machine should be set at the number(s) found on your sleep study to be the optimum ones to treat your apnea by keeping your airway open - using a specific amount of air pressure to do that.

The humidifier has nothing to do with that basic set up... it's strictly used for extra comfort and facilitates using the machine if you need some humidity as the air pressure can dry out your nose, mouth (if your mouth opens when you sleep) and throat, but is not 'therapy' otherwise. Many people never use it, some only at certain times of the year depending on the climate, etc... but you talk about the setting (4) as if it were important to the air pressure of your machine, to catch apneas, so could you let us know that you do understand the difference between air pressure settings and humidifier settings? If your local climate is humid right now, you may not need a humidifier setting of 4 and can play with the settings or turn it off altogether (some people find a high setting causes nasal congestion). But it's not related to your prescribed air pressure settings.

I guess I wasn't clear. My understanding is that I only have control over humidification, both outside the machine and in the settings menu. Not air pressure. (I think my doctor's office has to change that?)

Ok, you certainly do have control, but haven't been shown how - a classic ploy to make the docs look good, you dumb and the DME's have control. Do you have a manual - is it the clinician's, or only the one they gave you that lets you adjust humidity but not a lot else? I presume you're using the PR S1 machine, but have no idea of the model # and you first must remove the humidifier (or at least the water) before turning the blower machine over - on the bottom should be a 'Ref' number with '60' in it, and it's which one (e.g. 560) that we need to direct you to the correct manual... let us know.

It's REF 560. Are you saying that my pressure is likely not correct and that is why I am having congestion?

No, I'm saying you're trying to use your humidifier setting as your air pressure setting, and they are two different settings! Forget the humidifier for now (or turn the setting from 4 to 1 for now). Your prescribed machine (560) pressure is the one your doctor or DME set the machine to so you don't have apneas. Nothing to do with the humidifier! Nothing!

All I suggested was your humidifier pressure might be too high at 4 for you to breathe comfortably, regardless of machine pressure setting, so experiment with the humidifier setting to see which works best for you. Don't try to change the machine (air) pressure for now though.

NOW, look on top of the machine near the dial... what words do you see there? That will tell you which type of machine you have (apart from the model #560). Once you tell us that, we can show you how to download the manual and how to change the AIR (not humidity) pressures if you want to.

The PR S1 model 560 is the PR System One 60 Series Auto CPAP
http://www.apneaboard.com/pr-system-one ... structions
How to get into the clinical menu at the link above.

If you want a pdf of the manual you can request it here. Instructions down near the bottom of the page
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
And you would request this one
Respironics PR System One 60 Series REMstar Auto with A-flex