Can Ramp Give False Sense of Successful AHI?

While I've seen lots of mention lately about ramp pressures, the feature's pros and cons, and personal preferences, one aspect of it I haven't seen mentioned since I was new around here is that one is "unprotected" during their ramp time. Funny, I remember reading it, asking questions and getting answers when setting up the "Settling" feature on my autopap machine, but was too impaired to grasp how dire of an impact it had had in my own initial "failure to thrive" on cpap therapy.

Now I have some questions to see if I am understanding it correctly.

During the ramp time any obstructions are NOT 1) treated, 2) recorded, or 3) reported, right?

Are all three aspects universal or based on the machine?

Is that true for both the Ramp and Settling features?

Is the term Ramp for straight cpaps and Settling for autopaps or is that too general or just plain inaccurate?

So, if for instance you have a 30 minute ramp and woke up three times during the night and hit the ramp button to restart your machine, that's 2 hours of your night at an insufficient pressure with possible untreated events. Yet your AHI could look great because whatever happened during that 2 hours is not factored into your data, right?

Would appreciate some clarification.

I'm fortunate to be one of those folks that even though I wake up and get up frequently, I fall back asleep almost instantaneously, so my Settling on this my second machine is set for 5 minutes. I did that based on advice here that if one really needs to start off at a lower pressure, the time should not far exceed the time it takes one to fall asleep. I would venture to guess that this one thing influenced my adaptation to treatment as much as switching to an autopap did. But multiple changes simultaneously make it just a guess and nowhere near science. Hmmmm.

Kathy

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, AHI, Ramp, AutoPAP Machine

the Spirit doesn't have Ramp in AutoSet mode, only Settling. Settling has a range of 5 min (default) to 30 minutes Max Setting.

It simply delays start of AutoSet therapy for that period. There is no ramp of pressure associated with that feature like found on the M series Remstars.

When you first lay down for sleep you may move around this can cause noise to transmit down the hose and trigger the machine into a response. Or if you snore that can cause the machine to increase pressure before you actually are in the deeper stages of sleep.

Settling simply allows you to reach a deeper stage of sleep or "settle" before therapy begins. It does not record events during the settling period, so if you had a lot of onset events when first falling asleep they would not be counted in AHI. Those onset events can be mainly artifacts anyway.

AutoRamp: AutoRamp as found on the new M series Remstar Auto works differently. It works like a conventional Ramp found with CPAP where it increases pressure or ramps over time in addition it will not respond to events during the AutoRamp timer period. It is a combination of Ramp and Settling. It is more flexible, it uses a seperate pressure value not the Auto:Min setting. This allows you to have 2 min pressure settings, one for normal autopap operation and one for use with the Ramp feature.

You can have your Auto:Min set to 8cm, you can then have AutoRamp set to 6cm for 5-45 minutes. When Ramp is pushed it pressure will drop below the Auto:Min to the Ramp Start pressure which can be lower. It will then increment every 5 minutes until timer expires or Auto:Min is reached.

As usual Snoredog you have given great info ref. above and i think it will help Kathy and many others! Your info is clear, concise, and most helpful to all! I commend YOU and the other forum members who always give GREAT ADVICE! Just think that fact should be pointed out!


All the best,

Steve,
ufo13

Dont know if it is the reason of my decrease in AHI but now I'm using 15 min Settling.
Even after hitting start button I cough and adjust mask leaks, I think cpap was recording false AHI (don't know if it's possible).


(Sorry to bump Kathy 5 years old post but I don't wanted to post the same question again)

Not a problem. Either way.
Reminded me of Snoredog.
I think he was gone before I joined; but his posts were always good to read.
Somewhere up there--a doggy snickers.