Do you REALLY know your settings?

The ramp pressure of 4 that was Rx'd when I first got my machine made me feel like I was suffocating-but the doc had warned me about it and said to bump it up until I was comfortable.
I do like starting out at a lower pressure--so when using CPAP I set the ramp for the lowest pressure of my auto range--which is 8.

Hi Kathy,

Reading your post my heart goes out to you.

I'm only a month in, and count myself very fortunate to have had good experiences with my sleep study, local clinician and finding this forum straight away, which has answered the rest of my questions.

I also have an S8 Autoset and also prefer no Settling Time.

Thanks for posting your experience to help everyone else.

Cheers

Peter

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Hi All

More info on using the ramp can be found at -

viewtopic.php?f=1&t=54482&st=0&sk=t&sd= ... =mars+ramp

viewtopic.php?f=1&t=55010&p=514359&hili ... mp#p514359

cheers

Mars

HI Kathy
Dont get off your soapbox!! this is very important stuff and it clearly takes a while to figure out how to manage it all for what is best for each person. When we get started who understands any of this??
Turning off the ramp (set to start at 4 for 30 min) was my first step towards taking charge of my trt. 2nd step was to change the humidity setting. All the while trying to gets masks and pressures tweaked to get the best results I can arrive at for me. I just started all this in Nov and it is pretty daunting to have the DME drop off your stuff, "settle" you in a mask and say good bye after 20 min. If it were not for the knowledge and personal interest available on this forum I suspect that many of us would not persevere in PAP therapy. I hope that you can talk to your sleep doc and help him/her understand that there is a need for more thorough and effective follow up than most of us experience if all this PAP effort is going to work. I think my doc would not be happy at all to think I changed settings (that's for the doctor only!) whereas he should be supportive of that effort on my part.

Re the Ramp: I think the problem is not so much the use (or overuse) of the ramp as the fact that all too often the ramp is left on its default settings. I say this as one of those rare persons who does well at low pressures (max EPAP set to 6cm, 50+% of the time EPAP is at 4cm). When I had a fixed pressure of 8/6, I found that having my ramp set to start at 7/5 with a ramp period of 45 minutes was critical in fighting the aerophagia. Seems to me that rather than using the default starting ramp pressure = 4cm, it would be much more useful for techs to set up

starting ramp pressure = prescribed pressure - (2 or 3)cm

so that a person whose prescribed pressure is 10cm is starting at 7 or 8 cm of pressure instead of 4cm

Re Knowing the Settings: This is the equivalent of knowing the exact dosage and schedule for all drugs taken to manage chronic medical conditions. But this is another area where we OSA patients are treated as idiots: The patient menu on both of my machines prevents the user from quickly and easily checking what the machine's pressure settings are without the need to turn the machine is on; and when in Auto mode, there's no way to check the max and min settings from the Patient menu. Which is unlike a bottle of prescription medicine where the dosage amount and schedule are both clearly listed on the label. Add to this the fact that most of us have to ask for a copy of our prescription rather than being given it, and that can easily lead to nightmare scenarios.

And both the ramp problems and the not knowing the setting problems talked about in this thread point to the bigger elephant in the room: Nonexistent patient education for those just starting out on this adventure.

Those of us here represent the lucky few: The patients who for one reason or another decided we had to take our treatment into our own hands and become knowledgeable about both our condition and the machines used to treat it. How many of those 50% of OSA patients who simply quit using the machines and never go back to their doctor never discover a place like cpaptalk.com? How many simply give up because they have no idea how to try to improve the quality of their treatment and make CPAP more tolerable and are simply repeatedly told Give it more time by a doctor, nurse, PA, RT, etc. who does not use a CPAP and has no idea what it is really like to sleep with the mask night after night?

Once again I feel so sorry for people who have not found this forum.
I just can't imagine how they make it on their own.

Great thread!
My DME set my S9 at EPR 3 and Ramp at 20 minutes starting at 4 and Humidifier at 3. I experimented with different pressure settings and all of the above fro about 6 weeks.
When I finally turned off all the bells and whistles, my AHI dropped by 60%! Now I'm on CPAP and back to very near my prescribed pressure.

Things were so much simpler when I started. My first CPAP was either a 20 min ramp or no ramp. Never even had a clue as to what pressure it started with. I quickly learned (2-3 nights) that I was much better off with no ramp. Having learned that, I quickly turned ramp off on my second machine last November. I did, however, leave the DMEs setting of EPR=3 alone, which I've liked.

Was CPAPTalk even around in 1997? I didn't even think back then to look for such a forum, but I did last summer when I started researching for a new machine. It's a good thing, too, with all of the new features and data capture.

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There is a value to the ramp function.

Don't forget that a lot of people are very reluctant to use a CPAP machine at the start. Lots of people try a machine and then give up. For someone who's not used to CPAP and dubious about its value, the ramp function may help them get used to it. It may increase the number of people who stay with CPAP.

It's probably a good thing if the DMEs turn ramp on for new users. Now, that doesn't mean the ramp function isn't set wrongly by many DMEs. Even if it's a good idea, 4 is probably too low.

It would also probably be a good idea to reduce or eliminate the use of ramp after you use CPAP for a while.

That was a good thing about the legacy remstar machines. To get ramp, you had to push the ramp button. Unless you asked for ramp, you didn't get it. Presumably, after using it for a while, most people would stop using it.

Taking the posts here into account, I will start tonight with no-ramp! I know I can deal with the pressure, because when I wake up it feels like I'm breathing normally, it's only when I hit the off button that I suddenly notice there was pressure a moment before LOL