CPAP vs APAP

WillSucceed · Post by **WillSucceed** » Sun Sep 25, 2005 6:50 pm

By the way, Cvantsant, are you able to understand the 420E manual? I find it crazy-making!

Sleepless on LI · Post by **Sleepless on LI** » Sun Sep 25, 2005 6:58 pm

My mother always said that my mouth would get me into trouble.

And she should only know how much help it gives to others, too (I'm sure she does).

cvansant · Post by **cvansant** » Sun Sep 25, 2005 8:05 pm

WillSucceed,

I don't use the ramp either. My pressure requirements are low to start with. I responded just for clarity. My info comes the SilverLining manual and remote control screens.

Have a good night. Sleep tight.

Clif

rested gal · Post by **rested gal** » Sun Sep 25, 2005 9:48 pm

Buried in the discussion from the link I posted above, ozij had this to say about the 420E she uses:

You can choose the ramp starting pressure, you can choose the ramp time, and you can do all that for auto mode.

I presently use the ramp as an idicator of "awake enough to be annoyed, but not get up", So I set it at 5 minutes.

Clif is correct about the 420E having a true full ramp feature that can be used even in auto mode.

Saw it in my SL clinician manual, too. You're right, WillSucceed...that manual is a bearcat to make sense of.

WillSucceed · Post by **WillSucceed** » Mon Sep 26, 2005 7:46 am

I went back and re-read the manual last night as well ->still confused.

However, I think that some of the confusion is use of words... I've used the word "delay" because while the autoPAP is in ramp/delay mode, it is not making pressure changes relative to the patient's airway needs like it does in full autoPAP mode. I've used "delay" because the machine is delaying the onset of autoPAP treatment. When the delay time has expired, the autoPAP does begin assessing airway needs and deliveres treatment within the set pressure range.

What I did not realize is that the autoPAP would seem to be making a slow, steady pressure increase DURING the ramp/delay time period, moving the pressure from the programmed 'ramp/delay' pressure, over a specified period of time, until it gets to the programmed minimum pressure as set in the pressure range. When the ramp/delay time is up, the unit should have reached the minimum pressure as set in the range and then begin functioning as an autoPAP, adjusting pressure within the range as many times as needed.

What do you think, have we got this figured out? And, big apologies if I have screwed this up or misled anyone.

WAFlowers · Post by **WAFlowers** » Mon Sep 26, 2005 9:33 am

rested gal wrote:ozij, Willsucceed, WAFlowers, and others who use the PB 420E auto can attest to the fact that the 420E autopap does have a fully functional "ramp" feature that can be used even if the machine is set for auto mode.

Yep, although I found at the low pressure settings that work for me that I didn't really need to use the ramp. I think I've used it a total of 2 or 3 times in 2 months.

WAFlowers · Post by **WAFlowers** » Mon Sep 26, 2005 9:36 am

cvansant wrote:Unless I am reading the manual incorrectly that is not how the 420E works.

I concur.

If ramp time is not zero then ramp starting pressure can be set at anything from 4cm up to the initial pressure setting and the time can be set in 5 minute increments for up to 30 minutes. The pressure will start at the "initial ramp pressure" setting and increase over the course of the "ramp duration time" to the "initial pressure" setting. After that the pressure is free to move between the "Min pressure" and "max pressure" settings. And, "initial pressure" does not have to be min or max.

BTW: Data is not collected until after the ramp time expires or 15 minutes if the ramp time is less than 15.

You are partly correct. You accurately described how the ramp works but from what I've seen in SilverLining, data is collected during the ramp period. In fact, you can see the pressure gradually increasing until it reaches the lower end of the auto pressure range at the time the ramp times out!

I've even seen hypopneas and flow limitations and snores identified while ramp is enabled. The difference is that these are not acted on (no pressure change in response to the identified event) until the ramp times out.

ozij · Post by **ozij** » Mon Sep 26, 2005 10:00 am

And if you're really into fancy tweaking -
Not that I'm saying you should -

You should notice that in addition to the
ramp starting pressure, and
the minumum pressur, you also have an
initial pressure (ever without the ramp)and you can set your initial pressure to be higher than your minimum pressure.

O.

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

cvansant · Post by **cvansant** » Mon Sep 26, 2005 5:47 pm

Based on the Silverlining manual for the 420E

WS,

The ramp runs the pressure up to the "Initial pressure" parameter, not the "Minimum pressure" parameter.

WAF,

Interesting that you see recording so early. The manual explicitly states that session are not saved until after 15min or the end of the ramp when CPAP pressure or APAP initial pressure is reached.

Of course, this would not be the first time a computerized device was doing one thing, the software monitior reporting something different and/or the manual disagreeing with one or both. ........ There for a moment I got on my soapbox about software. Forget it. Too geeky.

Clif