I modified my flex and ramp settings, is this dangerous?

chaotic · Post by **chaotic** » Mon Apr 06, 2009 6:05 pm

Hi all!

I'm a total newbie, into electronics, and am a geek. All this spells disaster for anything I own with a cord. I read the instructions all the way through, and happily mod my cell phones, stereo equipment, etc. But then, those devices don't keep me breathing at night.

So for some background, I did a sleep study with (and now own) an M-Series with ramp and flex settings. When I did my sleep study, they had it at a relatively low pressure setting and had both ramp and flex turned on. When I got my unit, it had both of those features disabled. They set me up at 9cm for pressure, and I requested a nasal pillow because of my goatee and they gave me an Opus 360.

So going from a nasal mask, low pressure, ramp, and flex to a nasal pillow with 9cm no ramp and no flex seemed like I had an industrial air compressor blasting up my nose.

Naturally, I found the instructions to enable the flex and ramp features and now have flex at the least forgiving setting, and a 30 minute ramp-up time starting from 4cm.

So my question is: is this dangerous? I imagine Kaiser thought it wise to set me up with those settings, but since there were MANY people that day maybe they just didn't flip that switch from the factory defaults. I don't want to endanger myself nor reduce the benefits of my APAP machine, but really want to continue using these settings if it's probably safe. I know most here aren't doctors, so I'm not looking for an official medical opinion.

Thanks!

elader · Post by **elader** » Mon Apr 06, 2009 6:15 pm

Welcome! No, you won't hurt anything. 9cm is not a lot of pressure, you'll get used to it. I don't use the ramp at all. When the machine starts up and blasts you with the pressure, push right back against it, it'll calm down relatively quick. Personally I think the ramp is not a great thing because they may have it set to start at like 6 or so and that is just not enough pressure for me to feel comfortable. In terms of the cflex, it's all about what you like. Some people don't use it at all. I use it on 2 or 3 - do what feels comfortable. Don't overestimate Kaiser and their medical know-how.

Many folks here adjust things that typically you wouldn't think about adjusting. As an example, I was titrated at 8 cm. My machine is data capable so I can see my apneas and such. As a result I tried the machine on 'auto' and after a while, could see my lowest number of events was at 10-11, not at 8. So I adjusted the pressure to 11 cm.

Don't be afraid to ask lots of questions here. It was a terrific resource for me. There are people here that know more than most sleep docs.

tattooyu · Post by **tattooyu** » Mon Apr 06, 2009 6:17 pm

I wouldn't think that is dangerous. The flex setting is for comfort.

A minimum ramp pressure of 4 cm is very low, at least for most people, but you have to go by how you feel. For me, anything below 8-10 (now) feels like I'm suffocating. I use a 30 minute settling time, which in auto mode simply starts at the minimum range for that amount of time to let you fall asleep. In regular CPAP mode, it is ramp. A lot of folks in CPAP mode find they don't need ramp once they get used to it.

I feel ramp is useful, even if the minimum pressure is set to your titrated pressure (in your case 9 cm) because it allows you to adjust how long it take for you to fall asleep before it starts recording data. So, in your case with a ramp setting of 9 cm, the pressure wouldn't change at all, only the time it takes for the data recording to kick in.

Again, if you feel you need ramp, by all means use it.

P.S. Don't forget to add your equipment in your profile (as text, not icons) under User Control Panel > Profile tab > Edit Equipment (on the left).

JoyD. · Post by **JoyD.** » Mon Apr 06, 2009 6:46 pm

Hi Chaotic,

"Electronic geeks" are VERY welcome here! Elader is right on . . . you'll get more information on this site than you will at your DME or doctor! There are some very intelligent, very electronic-savvy, people here who are also "hose heads" as well as others who have years of experience using CPAP and problem-solving the common issues we all seem to have.

What you're doing is not dangerous . . . you are just striving for comfort as a beginner on CPAP. For me, I can't tolerate LOW pressures (under "8") . . . I feel like I'm smothering. You may need to set your CFlex or AFlex to 3 to give you maximum comfort (it is an individual thing). My pressure setting is 13 and I use 10 as a ramp pressure . . . which doesn't bother me at all (I do have the CFlex/AFlex set at 3). Probably the reason 9 bothers you is because you are just not accustomed to ANY air blowing in your nose yet. Later, at a pressure of 9, when you are acclimated you may not even need ramp at all. That's why "tweaking" is a good thing . . . you adjust as the needs arise. That will continue for as long as you use CPAP.

Good to have you on board. Keep "tweeking" your machine as you need to . . . that's the key to successful therapy. Just wait until you get the software

Joy

DoriC · Post by **DoriC** » Mon Apr 06, 2009 9:24 pm

Tattoo, I just learned something new from you that's very important to me. I didn't know that in ramp setting the card doesn't record data. I've been taking the card out and having to stay awake for 1/2hr or so until my hubby falls asleep so the card won't record all his settling down noises, then I put the card back in. He doesn't use ramp feature but now I can leave the card in, set the ramp to his pressure for 20 or 30mins and get to bed myself. You're my hero! Dori

builta · Post by **builta** » Mon Apr 06, 2009 9:55 pm

DoriC wrote:Tattoo, I just learned something new from you that's very important to me. I didn't know that in ramp setting the card doesn't record data. I've been taking the card out and having to stay awake for 1/2hr or so until my hubby falls asleep so the card won't record all his settling down noises, then I put the card back in. He doesn't use ramp feature but now I can leave the card in, set the ramp to his pressure for 20 or 30mins and get to bed myself. You're my hero! Dori

Hi DoriC,

Tattoo has a ResMed XPAP. You have a Respironics XPAP. His comments about recording data and ramp are interesting but I don't know if what he is saying applies to Respironic XPAPs.

Does anyone have any feedback. It would be nice to know.

chaotic · Post by **chaotic** » Tue Apr 07, 2009 1:57 am

Thanks for the great information all!

I don't have a card reader nor software yet (any recommendations? This site is a wonderful forum, but a wiki or reference page without the need to do much extra sorting through data would be wonderful!), but hopefully I can get that soon.

It is something I get used to throughout the night. The first time I used the machine at the constant 9cm setting I thought it had a problem at night because when I woke up it felt like very little pressure. Perhaps a setting of 6 or 7 to start the ramp would be worth trying.

Thanks again for the advice. I am amazed at how busy this board is, and how patient you all are with the flood of new questions. Thanks for the support, I hope to help the community with my experience as I gain it as well!

cflame1 · Post by **cflame1** » Tue Apr 07, 2009 5:20 am

Chaotic,
Unfortunately... unless the machine that you have listed is incorrect... you won't need either. Your machine is not fully data capable. The only information that you would gain by using a card reader and software would be the number of hours used.
In order to get more data you'd need to have either an M series Pro or an M series Auto.

Sleepy Boy · Post by **Sleepy Boy** » Tue Apr 07, 2009 9:01 am

JoyD. wrote:Hi Chaotic,

"Electronic geeks" are VERY welcome here! Elader is right on . . . you'll get more information on this site than you will at your DME or doctor! There are some very intelligent, very electronic-savvy, people here who are also "hose heads" as well as others who have years of experience using CPAP and problem-solving the common issues we all seem to have.

What you're doing is not dangerous . . . you are just striving for comfort as a beginner on CPAP. For me, I can't tolerate LOW pressures (under "8") . . . I feel like I'm smothering. You may need to set your CFlex or AFlex to 3 to give you maximum comfort (it is an individual thing). My pressure setting is 13 and I use 10 as a ramp pressure . . . which doesn't bother me at all (I do have the CFlex/AFlex set at 3). Probably the reason 9 bothers you is because you are just not accustomed to ANY air blowing in your nose yet. Later, at a pressure of 9, when you are acclimated you may not even need ramp at all. That's why "tweaking" is a good thing . . . you adjust as the needs arise. That will continue for as long as you use CPAP.Hi Joy: I use a ramp pressure of 7 and my maximum pressure is 13, I don't use the auto setting or the cflex. I wonder if I should? I struggle with mask leaks, and doesn't seem to matter what I do, but never tried the cflex or auto setting..Thanks, Larry..

Good to have you on board. Keep "tweeking" your machine as you need to . . . that's the key to successful therapy. Just wait until you get the software

Joy

DoriC · Post by **DoriC** » Tue Apr 07, 2009 9:28 am

Oh, Builta, you're right, that is THE question! Arrgh!! I'm sure one of the "pros" knows the answer and will reply soon. Thanks for pointing that out. Dori

Sleepy Boy · Post by **Sleepy Boy** » Tue Apr 07, 2009 1:11 pm

Hi Joy D
I don't know where my post went. I had your quote, but nothing else. I was wondering about having my machine turned to 'AUTO" and also using the cflex setting? I've never tried that. My ramp is at 7 and my top pressure is 13. Seems like I've been getting lots of leaks, just wondered if this would help?? Thanks, Larry...

chaotic · Post by **chaotic** » Thu Apr 09, 2009 9:55 pm

cflame1 wrote:Chaotic,
Unfortunately... unless the machine that you have listed is incorrect... you won't need either. Your machine is not fully data capable. The only information that you would gain by using a card reader and software would be the number of hours used.
In order to get more data you'd need to have either an M series Pro or an M series Auto.

I updated my machine, but in case it doesn't show up it's an M Series BIPAP Plus with Bi-Flex. The bottom of the machine says:
REMstar Plus MSERIES
200M
BiPAP

Does this mean that I can't get much out of the card?

Thanks!

preemiern · Post by **preemiern** » Fri Apr 10, 2009 2:49 am

Hi Chaotic...your machine is fully data capable, so with the software and card reader, you will be able to get all of your information

I modified my flex and ramp settings, is this dangerous?

I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

Re: I modified my flex and ramp settings, is this dangerous?

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