Ramp in CPAP and APAP

I joined this board specifically because I have seen much BAD information about using the ramp feature for a ResMed AirSense 10.

Ramp is straightforward to understand in CPAP mode, but less so in APAP mode. Many have stated they turn ramp off. This may make perfect sense, but may be very useful to lower AHI scores in either CPAP or APAP modes.

RAMP WORKS DIFFERENTLY IN CPAP AND APAP MODES.

I have my machine set for APAP with a starting pressure of 6 and a max pressure of 15. Most would claim it makes no sense to turn ramp on in APAP mode.

With ramp off, I often see many events (using SleppyHead) during the period while I am still awake (because of irregular breathing pattern).

Because events are not even monitored during ramp time, using ramp allows the machine to ignore events while you are falling asleep.

Even those who use APAP will benefit from using ramp. it will cause the pressure to remain low for the entire ramp time. Then auto sense will kick in and start to adjust the pressure. BUT all events prior to ramp time will be ignored.

Those of us who use APAP and see events while falling asleep can significantly lower our AHI score by using ramp even in APAP mode.

SO RAMP CAN BE VERY USEFUL EVEN FOR APAP USERS!

Even CPAP users can see lower scores by turning ramp on to ignore events during the time they are falling asleep.

I know I am a new poster and expect much hate mail, to which I shall probably not respond.

Art Cominio

ArtCominio wrote: ↑

Fri Jun 28, 2019 10:28 am

Those of us who use APAP and see events while falling asleep can significantly lower our AHI score by using ramp even in APAP mode.

SO RAMP CAN BE VERY USEFUL EVEN FOR APAP USERS!

Even CPAP users can see lower scores by turning ramp on to ignore events during the time they are falling asleep.

I know I am a new poster and expect much hate mail, to which I shall probably not respond.

It's not a contest, 'lower scores' aren't going to win you anything.

Ramp is only actually "useful" if it helps you get to sleep easier, not if it 'improves your score"... heck, if you want, I'll give you a gold star right now and you can move on to focusing on more important things.

Your choice.

ResMed machines don't flag anything in regular ramp...nothing.
So lower numbers doesn't mean they didn't happen...just they didn't get flagged.
We don't know if the machine is ignoring asleep real events or awake sleep/wake/junk events....so it is possible that the lower AHI means sub optimal therapy if the person goes right to sleep and a truckload of real events happen while the machine is ramping up.

Now the AirSense machine do have AutoRamp available and that's a whole different can of worms...and that's assuming it works as planned.

Now Respironics machines...depends on the mode and the settings and the model machine. There is some potential for flagging during ramp depending on parameters available.

ArtCominio wrote: ↑

Fri Jun 28, 2019 10:28 am

Because events are not even monitored during ramp time, using ramp allows the machine to ignore events while you are falling asleep.

Even those who use APAP will benefit from using ramp. it will cause the pressure to remain low for the entire ramp time. Then auto sense will kick in and start to adjust the pressure. BUT all events prior to ramp time will be ignored.

This is not true.

When in AutoSet mode, while in AutoRamp mode the device does monitor events. It monitors them so it can end Ramp prematurely (if needed) and enter traditional AutoSet mode.

Specifically, AutoRamp has 4 triggers where it can exit Ramp mode:

• When it believes you're asleep (30 breaths of stable breathing)
• 30 Minutes
• 5 consecutive snore breaths
• 3 OAs or hypopnea in 2 minutes

In order to exit out of AutoRamp mode because of Snores, OAs or Hypopnea, it must be monitoring them.

I hate you.
Just wanted to fulfill your expectations.
We aim to please.
JPB

jimbud wrote: ↑

Fri Jun 28, 2019 11:25 am

I hate you.
Just wanted to fulfill your expectations.
We aim to please.
JPB

jimbud wrote: ↑

Fri Jun 28, 2019 11:25 am

I hate you.
Just wanted to fulfill your expectations.
We aim to please.
JPB

So kind, considerate and accommodating!

palerider wrote: ↑

Fri Jun 28, 2019 12:20 pm

jimbud wrote: ↑

Fri Jun 28, 2019 11:25 am

I hate you.
Just wanted to fulfill your expectations.
We aim to please.
JPB

So kind, considerate and accommodating!

Well when Julie ripped you for being so mean, I took it to heart.
If just in spirit(or sport?).
JPB

jimbud wrote: ↑

Fri Jun 28, 2019 12:29 pm

palerider wrote: ↑

Fri Jun 28, 2019 12:20 pm

jimbud wrote: ↑

Fri Jun 28, 2019 11:25 am

I hate you.
Just wanted to fulfill your expectations.
We aim to please.
JPB

So kind, considerate and accommodating!

Well when Julie ripped you for being so mean, I took it to heart.
If just in spirit(or sport?).
JPB

Hurt my feelings, that did!

ArtCominio wrote: ↑

Fri Jun 28, 2019 10:28 am

I joined this board specifically because I have seen much BAD information about using the ramp feature for a ResMed AirSense 10.

while we wait patiently for links and data to prove this-

Pugsy wrote: ↑

Fri Jun 28, 2019 11:06 am

so it is possible that the lower AHI means sub optimal therapy if the person goes right to sleep and a truckload of real events happen while the machine is ramping up.

That's only likely to be an issue if a very long ramp time is set.

For a 5 minute ramp it is quite inconsequential.

billbolton wrote: ↑

Fri Jun 28, 2019 5:18 pm

Pugsy wrote: ↑

Fri Jun 28, 2019 11:06 am

so it is possible that the lower AHI means sub optimal therapy if the person goes right to sleep and a truckload of real events happen while the machine is ramping up.

That's only likely to be an issue if a very long ramp time is set.

For a 5 minute ramp it is quite inconsequential.

True especially if the OSA is on the mild side but we often don't know all the particulars.
I have had 17 events in 17 minutes....I wouldn't want to be letting those slide unless I had no choice and I for sure would want to know about them.

For someone with an untreated AHI of 100....there is the potential for quite a few events to happen even in 5 minutes. That's almost 2 a minute and even in 5 minutes the potential for oxygen desats.
Not the end of the world but not something I would want to happen.
I just offer the information...up to the user how they want to apply it to their situation.

One of the few features about the Respironics that I find superior...in ramp it still flags everything.
I wish ResMed did because I don't like guessing.

Most people turn off ramp because they feel like they cannot breathe at lower pressures.

If someone has a higher than expected score, a look at the data will help determine what may be happening. I've never seen what you describe on data charts I've seen.