APAP Ramp-up

I'm looking for help in understanding how APAP's ramp up their pressure. I'm using the new M Series APAP from Respironics. Is it correct that when it detects blockage it goes up in stages (rather than continuously)? If so, how fast does that occur, and is there a limit to the number of stages it will go up? I read somewhere that it only goes up 3 cm, and then if that doesn't work, it goes down 2cm to see if it's a central apnea. Is that right, and if so, does that mean that the low end of your pressure range should never be more than 3cm from the highest pressure you think you'll need?

toss out everything you read, it is not even close or you didn't understand the read correctly.

If you have a M series Remstar Auto, then it does have a new feature called Auto:Ramp. Auto:Ramp is a comfort feature, designed to allow you to more easily fall asleep by using a lower pressure. Previously, this feature was found only on straight CPAP machines. With the M series it brings the feature to the autopap. It is a great feature and can be used in many ways.

Lower pressure = less noise = less leaks = more comfort = easier to fall asleep

With the M series Auto, you can enable Auto:Ramp. For example, let's say your titrated pressure was 14cm. You are a newbie and that pressure makes it difficult to fall asleep, so with Auto:Ramp you can:

Set Auto:Max=14cm
Set Auto:Min=10cm
Set Auto:Ramp=6.5cm
Set Auto:Ramp Timer=30 minutes

Now, when you put on your mask and press the On/Off button, the machine will turn On at the Auto:Min pressure, in the example 10cm. If 10cm pressure is still too high you press the Ramp button, pressure now drops down to the Auto:Ramp pressure setting, in the example 6.5cm. It will then start the 30-minute timer and increase pressure every 5 minutes until it reaches the Auto:Min pressure, in the example that is 10cm. Now the machine begins autotitrating from 10cm to 14cm. If it sees a flow limitation, hypopnea, snore or apnea it will increase pressure up to the Auto:Max of 14cm to clear them.

The Auto:Ramp is a great feature if you know how to set it up and use it. Optionally, it can also be used as a "Settling" feature where it delays therapy for a set period of time. Some people have artifact events that happen when they first fall asleep, these can cause the machine to increase pressure prematurely thereby interrupting your entry into deeper sleep. When Auto:Ramp is used for Settling it delays any response by the timer value, so in the example above it could be 30-minutes. You can have Settling with a lower pressure or keep it the same as Auto:Min, then it becomes only a Settling timer when you press the Ramp button.

So:

Auto:Ramp can be from 4cm to Auto:Min pressure setting.
Auto:Ramp timer can be from 05 minutes to 045 minutes.
Auto:Min pressure can be from 4cm to 20cm.
Auto:Max pressure can be from 4cm to 20cm.

[quote="twinzama"]I'm looking for help in understanding how APAP's ramp up their pressure. I'm using the new M Series APAP from Respironics. Is it correct that when it detects blockage it goes up in stages (rather than continuously)? If so, how fast does that occur, and is there a limit to the number of stages it will go up? I read somewhere that it only goes up 3 cm, and then if that doesn't work, it goes down 2cm to see if it's a central apnea. Is that right, and if so, does that mean that the low end of your pressure range should never be more than 3cm from the highest pressure you think you'll need?

Snoredog,
Thanks, but I think I used the wrong term for what I wanted to know. What I'm interested in is not the initial ramp up process, which I think I understand, but how the machine responds during the night to an obstructive event. Does it go up 1cm of pressure, then wait, then another, until the airway opens? And if so, then how fast does it do this and are there limits to how many stages it will go up (other than the maximum pressure point of the range)?

That's helpful. Thanks. Does Respironics (or anyone else) publish an explanation of how this all works? If the machine is learning about my patterns as it goes, I'm inclined to leave it alone for awhile and see if things improve. But if it's stopping the process of increasing pressure after going up 3cm, then I may have to increase my minimum pressure so it can get high enough, fast enough, to help.

Most of us have found our best results come from using 2cm below our best cpap pressure and 2 cm above, I also have set my top pressure at my best cpap pressure, because of the machines snore response.

My best cpap pressure is 15cm, so I use 11cm to 15 cm. I don't allow the machine to go higher because for me 15.5cm causes centrals. Jim

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

Thanks. I think I'm going to have to do some trial and error on this. Is there a way to adjust this M Series machine without having to go to my sleep doctor each time?

Yes.

First, however, it would be extremely wise to get Encore and a card reader so you can see what you're poking around with.