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Well, I had such a rough time during my titration study, only slept 42 minutes the first one so had to do a second titration study and only slept 98 minutes that one so I was more than happy to start out w/the Ramp feature. I was able to fall asleep at home w/it set for 30 minutes the first week, so the second week I dropped the Ramp to 20 minutes, the following week I quit using it.

I was grateful for the Ramp feature those first two weeks tho. My pressure is set quite low to begin with but I think those two weeks w/Ramp helped me learn to keep my mouth shut as at first I was running into the air building up in my mouth and my ears plugging uncomfortably and I had to learn to adjust to that.

I do think the Ramp feature is a good option for newbies just starting out but I doubt it is a feature that any of us need to use for very long if we are serious about complying w/PAP therapy and not fighting the whole idea. Just my nickle's worth.

I've only been using cpap for 6 nights but I started without the ramp because I liked the rush, but found
1) I was getting lots of leaks from my airseal mask (sorry I don't know which one they gave me, it is blue with a floaty silicone film next to the skin, the mask kind of "hovercrafts" off the face) and
2) I was getting mouthfuls of air and waking up puffing air out of my lips like I'm playing trumpet, also a very dry mouth.

I found using the ramp stops these problems, though I don't like waiting the 20 mins for the "rush". I worry that it's not actually working.

good luck to all fellow newbie hoseheads!

Di

Thanks, folks, for you thoughts.

I was so astounded by the dme's admonition that neglecting to use the ramp would always lead to air lost through the mouth. As I stated earlier, I had never read a word about that, and I have read for years. He is not the kind of guy who would welcome questioning. As I have an HMO who will completely pay for the cost of my machine, I am biting my tongue in attempts to keep my mouth shut. I want a new auto with c-flex.

I probably shouldn't have titled the topic using the word crutch. I did not intend to offend anyone. I had been reading another topic that used the term ramp as crutch and just borrowed term that for my title.

I agree with all who said that whatever increases compliance and comfort should be used.

Best wishes to all.

I have only had my leash for about a week now and I have a setting of 14. Without the ramp feature and the c-flex, I probably would have ran screaming from life. The ramp starts at 7.5 and only lasts for 20 minutes. I do turn my machine on full pressure, adjust my mask, sit for a few minutes and then hit the ramp button. It gives me some time to relax before the gale force winds hit.

If I would have read this thread before I started, I would have been very discouraged to realize I wasn't 'doing it correctly. I believe you have to crawl before you can walk. I figure I would have an event without the machine, so the fact that for 20 minutes (10 of which I am trying to get comfortable, remembering to turn on the humidifier, arranging the hose, etc.) I am at risk . . . so be it - it's better than not putting on the mask!

I do thank all of you who provide your vast experience and thoughts to help all the newly diagnosed "air-challenged" folks like me!

Now, I'll be the first to admit that I know very little about this stuff yet, but I think anyone who uses an "auto" xpap and says the ramp is a crutch is just a tad hypocritical.

With the auto, aren't you only getting the pressure that the xpap determines you need at a given moment? Aren't you somewhat ramping the night through since your machine is using minimal determined pressure?

IMO, using a bilevel and ramp, allows the algorythm to get in sync with my breathing and to adjust as the pressure increases. For me, it seems if I start out full force from the start, I do not breath normally for a while. This feature lets me normalize my breathing sooner, which if I'm understanding my machine, is important for proper application.

I usually go to sleep very quickly. As soon as I turn the machine on, it needs to be at full pressure so I can check for leaks before I fall asleep.

I read through all of the preceding posts, and finally Rooster hit upon the factor that influenced me. I tried "ramp" a couple of times, but I'd get to sleep, and then be rudely awakened when the blower got to max, and all the leaks started leaking. I prefer to start at 14, adjust the mask and then I usually get right off to sleep. Ramp is not a crutch, but a feature. Use it if you like it, don't if you don't

Just goes to show, all posts should start with "imho" and end with "ymmv".

CPAP'ing is a very much individual thing. Do what works!

George