Exhausted Discouraged : To Ramp or not to Ramp

lilsheba · Post by **lilsheba** » Tue Jul 17, 2007 4:52 pm

I just want to say the ramp up feature is a godsend. I'm new at CPAP, I've had my machine since Friday 7/13. My pressure was set at 16 so that initial blast is a little hard to take. I've set my initial ramp at 6, and in it's at 16 in 20 minutes. That works for me. I'm usually asleep by the time it hits full pressure.

cwsanfor · Post by **cwsanfor** » Tue Jul 17, 2007 6:04 pm

I tried ramping, but found that it did not serve me well. I felt air-starved at any setting much below my usual one, and also I found that I preferred to check leaks at approximately the pressure I would be sleeping at. However, other person's results may vary, and I don't regret trying it. It just didn't work for me. I kind of enjoy that first rush of air, it speaks to me of "time to sleep".

Maybe I should revisit ramping. I think that at 15/19.5 cm H20, I do not qualify as a "wimp", if that can be determined by xPAP parameters.

shippy · Post by **shippy** » Tue Jul 17, 2007 6:09 pm

Put me in the no ramp category !!!!

I am at a pressure of 16 cm's and i ramped up for about ten day's after i first started treatment before i tried it without ramping as an experiment. After the initial blast the c-flex kicks in and makes an adjustment or whatever and i go right off to sleep no problem. IMHO the ramp time is wasted therapy time that i could be at my pressure instead of a lower pressure (lower ramp pressure) which does me no good.

Dale

darthlucy · Post by **darthlucy** » Tue Jul 17, 2007 6:11 pm

snoresnout wrote:I've gone from 8 (per sleep test) to 8.5 and tonight will try 9. After almost 2 months of sleeping worse that before I started CPAP I am so damned discouraged.

What are the pitfalls or side effects of ramping up?

If snoresnout is increasing his/her pressure significantly above what the sleep test showed, isn't it possible that central apneas are being caused, and that might be part of the reason no improvement is seen? I personally don't think this self-"ramping" is a safe thing to be doing.

Guest · Post by **Guest** » Tue Jul 17, 2007 7:33 pm

darthlucy wrote:
snoresnout wrote:I've gone from 8 (per sleep test) to 8.5 and tonight will try 9. After almost 2 months of sleeping worse that before I started CPAP I am so damned discouraged.

What are the pitfalls or side effects of ramping up?
If snoresnout is increasing his/her pressure significantly above what the sleep test showed, isn't it possible that central apneas are being caused, and that might be part of the reason no improvement is seen? I personally don't think this self-"ramping" is a safe thing to be doing.

Agreed. And, EVERYONE needs to get a copy of their sleep study and prescription.

My initial post was to draw attention to my thought that "snoresnout" may be mouth-leaking or mouth-breathing. If the starting Ramp is set too low and/or too long, the effects are the feeling of air starvation and less-than-optimal therapy for the duration of the Ramp. Combine that with the use of a nasal mask and the probabilities of air loss increase greatly.

My second (controversial) post was to get more dialogue/participation into this thread.....which worked.

The problem/complaint/request-for-help "snoresnout" raised, has been one of THE most frequently seen on all the forums (IMO). YES, there a lot of other issues that can contribute to the lack of success in this therapy, but the probability of loss of therapy air seems to be the most prominent.

AND.....this is one of the issues/subjects that drives me crazy. The patients (apparently) aren't counseled properly by the "medical professionals" and it may be the reason that a lot of them quit therapy......they don't feel any better than they did before thay started. AAAAAHHHHH!!!!!

Den.

goose · Post by **goose** » Tue Jul 17, 2007 7:38 pm

Don't do the Tylenol PM unless you need the Tylenol for some other reason. Find some generic Benedryl and take 2 of them. It's the same dose without the Tylenol!!!!
I take 2 each night for allergy control -- the sleep factor is an added benefit!!

Hang in there - it gets better!!!
cheers
gg

darthlucy · Post by **darthlucy** » Tue Jul 17, 2007 8:15 pm

goose wrote:Don't do the Tylenol PM unless you need the Tylenol for some other reason. Find some generic Benedryl and take 2 of them. It's the same dose without the Tylenol!!!!
I take 2 each night for allergy control -- the sleep factor is an added benefit!!

Hang in there - it gets better!!!
cheers
gg

I hate to keep being the "nervous Nelly" in this thread, but I would also use caution in recommending doses of Benadryl/diphenhydramine. Two Benadryl tablets is 50 mg. For me, who is very sensitive to antihistamines, this would be way overdosing. I take Children's Benadryl, and if I take more than 1/2 tsp (6.25 mg) I have horrible rebound sleepiness, almost like a hangover, the entire next day.

goose · Post by **goose** » Tue Jul 17, 2007 9:43 pm

Good point darthlucy!!!!!
I only said 2 because someone said 2 Tylenol PM's......2 benedryl is the same 50mg dose without the other substance (Tylenol being liver toxic isn't really good for you -- especially if you don't really need it).
Everyone should dose themselves appropriate to their body's response to meds!!!!!!
I am also sensitive to most compounds -- Ha!! If I need pain meds it takes me an hour to take 2.....

Thanks for being the worry wort!!!! It's a necessary position!!!!
cheers
gg

Jeanie821 · Post by **Jeanie821** » Wed Jul 18, 2007 8:03 am

goose wrote:Don't do the Tylenol PM unless you need the Tylenol for some other reason. Find some generic Benedryl and take 2 of them. It's the same dose without the Tylenol!!!!
I take 2 each night for allergy control -- the sleep factor is an added benefit!!

Hang in there - it gets better!!!
cheers
gg

You mean that I'm not the only one who takes allergy meds before going to bed and putting the CPAP on?

You see, not only do I snore loud, I sneeze pretty darn loud, too! I'm afraid of sneezing into the mask and blowing up the machine!

goose · Post by **goose** » Wed Jul 18, 2007 9:45 am

Ha!!!! I can see the headlines now.......

"PAP machine explodes as user sneezes wearing Mask"

"Minor injuries were reported this morning as an xPAP machine explodes on an overnight stand. The luckless user, Jeanie821, reports that allergies caused a massive sneeze after putting on the mask.
The neighborhood has been evacuated as police are sifting through the parts and pieces in search of a possible terrorist link to the disaster........"

Sorry -- I couldn't help myself!!!

cheers
gg

cwsanfor · Post by **cwsanfor** » Wed Jul 18, 2007 9:47 am

You're not the only one. I take one Benadryl at night and a Loratadine in the morning.

Guest · Post by **Guest** » Wed Jul 18, 2007 10:01 am

goose wrote:Ha!!!! I can see the headlines now.......

"PAP machine explodes as user sneezes wearing Mask"

"Minor injuries were reported this morning as an xPAP machine explodes on an overnight stand. The luckless user, Jeanie821, reports that allergies caused a massive sneeze after putting on the mask.
The neighborhood has been evacuated as police are sifting through the parts and pieces in search of a possible terrorist link to the disaster........"

Sorry -- I couldn't help myself!!!

cheers
gg

Don't be sorry. That's pretty funny! I'm laughing about it myself!

I'm also copying this and e-mailing it to a friend of mine so she can have a good laugh too!

Jeanie821 · Post by **Jeanie821** » Wed Jul 18, 2007 10:02 am

Whoops... forgot to sign in...

Goofproof · Post by **Goofproof** » Wed Jul 18, 2007 10:07 am

I also take three kinds of OTC decontestants, starting at 11 pm, one at a time until 1 am bedtime, not supposed to but you have to breath. jim

snoresnout · Post by **snoresnout** » Wed Jul 18, 2007 12:45 pm

Thanks for all the replies...Proving that I'm sleep deprived I used the word RAMP when I meant TITRATE. On my own I've increased from 8 to 8.5 to 9 last night. Just wondered if there are any problems if the pressure is set too high . I'd suspect more leaks but none yet. My insurance only covers this basic machine and a mask every 6 months. I actually like my mask and with help here started taping with 3M paper tape which works quite well. My Dr's response to my mouth breathing woes was to send me to a Ear/Nose /Throat Guy for sinus polyps and gave me a script for a FF mask. He said I could do damage to my airways by taping. I breathe quite well through the nose all day long and through the night with the help of a steroid nasal spray??. If I did try a FF mask, what works well with a slight goatee? How about the hybrid masks? Any suggestions. As I said I've adapted well to the Mirage II. My Dr. doesn't think there's enough research to suggest a machine with software would be effective

There seemed to be some improvement last night with the 9 setting but I don't want to get my hopes up. Thanks again!

Exhausted Discouraged : To Ramp or not to Ramp

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