CPAP Ramp Pressure start

SirGaspAlot · Post by **SirGaspAlot** » Mon Jul 23, 2018 12:05 pm

What is a good start and ramp time? My therapy pressure is supposed to be 6cm-22 cm with PS of 4.
Thanks in advance.

Slartybartfast · Post by **Slartybartfast** » Mon Jul 23, 2018 12:20 pm

At 6 cm, you won't notice the pressure. I'd leave the ramp off and just strap on and start breathing. If you had a very high minimum pressure, like 10 or so, then maybe the ramp would keep you from being startled by the sudden inrush of air. The ramp feature appears to exist to help new users get used to the otherwise sudden onset of pressure. I tried it for a few nights, and found it wasn't necessary. My starting pressure was 8 cm.

mrcrayola · Post by **mrcrayola** » Mon Jul 23, 2018 12:25 pm

I've had the opposite experience. It's not an issue of being startled, but rather, being inflated like a balloon and struggling against the onslaught of pressure. I have found that, rather than allowing me to ease into sleep, I have to spend time constantly adjusting the mask to close leaks and the like, often finding my sleepy state of mind now being fully alert and frustrated.

I recognize that some folks think ramp usage is for sissies (at worst) or counterproductive, but I still find it a useful feature that let's me get into the rhythm of taking larger-than-normal breaths and ease off into dreamland while the CPAP ramps up.

Cheers!

SirGaspAlot · Post by **SirGaspAlot** » Mon Jul 23, 2018 12:29 pm

Thanks, Ill bump it to 6 I think, Its at 4 for 30 minutes.

mrcrayola · Post by **mrcrayola** » Mon Jul 23, 2018 12:31 pm

Try 6 but set it at 20 minutes or less, if possible. 30 minutes sounds more like the main highway than the ramp.

Uff Da · Post by **Uff Da** » Mon Jul 23, 2018 12:35 pm

Like Slartybartfast, I found the ramp rather useless, so I dropped it. Mine, however, was set at 4 on auto, and since I didn't get to sleep for hours at first, I don't know how long it was before the machine was tricked into believing I was asleep and started building the pressure, set for 8-18. I now just let it start at 8 without ramp and it works for me. I might even decide to bump it up to 9. I'm sure what is comfortable will vary from one individual to another.

Okie bipap · Post by **Okie bipap** » Mon Jul 23, 2018 2:29 pm

I would recommend you try without the ramp feature being used. I presume four setting is minimum EPAP of 6, and maximum IPAP of 23. If this is the case, ramp will start you off at minimum EPAP of 4 and IPAP of 8. This only two cm under your treatment pressure which is a very small difference.

palerider · Post by **palerider** » Mon Jul 23, 2018 2:46 pm

SirGaspAlot wrote: ↑
Mon Jul 23, 2018 12:05 pm
What is a good start and ramp time? My therapy pressure is supposed to be 6cm-22 cm with PS of 4.
Thanks in advance.

You don't need ramp for a 6 min pressure.

Gator5000e · Post by **Gator5000e** » Mon Jul 23, 2018 3:14 pm

How do you all feel about the Smart Ramp feature on the Dreamstation? I saw it described as follows:

"The Smart RAMP feature. This neat little feature monitors your breathing, and can tell when you go to sleep. When it detects you fall asleep, the AutoSet model goes into ‘active’ mode and can respond to any respiratory events that it detects. Previous models did not do this and would either ramp up too quickly (making it difficult to fall asleep), or too slowly (meaning sleep apnea events would go both undetected and untreated during this period). An excellent feature, and I recommend leaving it on."

Anyone have any thoughts on this feature? The recommendation came from this review (A couple of years old now but the machine doesn't seem to have changed).

https://cpapreviews.org/respironics-dre ... th-review/

palerider · Post by **palerider** » Mon Jul 23, 2018 3:40 pm

Gator5000e wrote: ↑
Mon Jul 23, 2018 3:14 pm
How do you all feel about the Smart Ramp feature on the Dreamstation? I saw it described as follows:

"The Smart RAMP feature. This neat little feature monitors your breathing, and can tell when you go to sleep. When it detects you fall asleep, the AutoSet model goes into ‘active’ mode and can respond to any respiratory events that it detects. Previous models did not do this and would either ramp up too quickly (making it difficult to fall asleep), or too slowly (meaning sleep apnea events would go both undetected and untreated during this period). An excellent feature, and I recommend leaving it on."

Anyone have any thoughts on this feature? The recommendation came from this review (A couple of years old now but the machine doesn't seem to have changed).

https://cpapreviews.org/respironics-dre ... th-review/

Auto ramp is a Resmed feature, not respironics.

The article is wrong. As evidenced by " the AutoSet model" which is a resmed machine.

Gator5000e · Post by **Gator5000e** » Mon Jul 23, 2018 3:45 pm

Ok. I do have a feature in the clinical settings called SmartRamp on my biPAP Pro machine I just got. Is it something different?

palerider · Post by **palerider** » Mon Jul 23, 2018 4:02 pm

Gator5000e wrote: ↑
Mon Jul 23, 2018 3:45 pm
Ok. I do have a feature in the clinical settings called SmartRamp on my biPAP Pro machine I just got. Is it something different?

Maybe I'm wrong, I'll have to check the manual tonight.

I'd be extremely surprised to have respironics name a feature on their machine the same as what resmed has had though...

Julie · Post by **Julie** » Mon Jul 23, 2018 5:19 pm

Why not just try 'no' ramp at all for a night... I think the majority of us don't use it beyond the first few wks, if that, unless at a very high setting - and yours is very low.

HoseCrusher · Post by **HoseCrusher** » Mon Jul 23, 2018 7:32 pm

I don't think it takes long to adjust. While ramp is a comfort feature you don't need a lot of time especially if the pressure differential isn't that much. 10 minutes or maybe even less is all that is needed in most cases.

For example: my minimum pressure is 12. I use ramp because I enjoy being comfortable. My ramp starts at 8 and runs for 10 minutes. If I still happen to be awake at the end of the ramp period I am totally unaware of any change in pressure and am totally comfortable.

palerider · Post by **palerider** » Mon Jul 23, 2018 8:05 pm

Gator5000e wrote: ↑
Mon Jul 23, 2018 3:45 pm
Ok. I do have a feature in the clinical settings called SmartRamp on my biPAP Pro machine I just got. Is it something different?

Ok, according to the manual, Respironics "SmartRamp" is:

Respironics wrote:When SmartRamp mode is enabled, the therapy device’s ramp function utilizes an Auto titrating algorithm during the ramp period. It allows patients the ability to stay at lower pressures during the ramp period, to improve their acclimation to therapy.
SmartRamp mode functions differently, depending on the therapy mode that the device is using.
*In CPAP or CPAP-Check mode, the SmartRamp applies the Auto-CPAP algorithm during the ramp period. The Ramp Start pressure becomes the Auto Minimum pressure during the ramp period. The Auto Maximum pressure during ramp is the CPAP or CPAP-Check pressure.
*In Auto mode, the SmartRamp applies the Auto-CPAP algorithm during the ramp period. The Ramp Start pressure becomes the Auto Minimum pressure during the ramp period. The Auto Maximum pressure during ramp is the Auto Minimum under normal Auto mode.
*In BiPAP or Auto-BiPAP mode, the SmartRamp applies the a modified version of the Auto-BiPAP algorithm during the ramp period. The Ramp Start pressure becomes the EPAP Minimum pressure, and the Pressure Support Minimum pressured is applied. The IPAP Maximum pressure during ramp is the EPAP or EPAP Minimum under normal BiPAP or Auto-BiPAP mode.
The SmartRamp period will terminate in either of two ways:
1) If SmartRamp pressure reaches the minimum pressure of the therapy mode selected, then SmartRamp ends, and the device continues to deliver therapy under the selected therapy mode, or:
2) If SmartRamp pressure does not reach the minimum pressure of the therapy mode selected by the end of the Ramp Time, then pressure is increased at a rate of approximately 1 cm H 2 O per minute. Once the pressure reaches the minimum pressure of the therapy mode selected, then the device will continue to deliver therapy for that mode.
If SmartRamp mode is not enabled, then the standard, linear pressure ramp mode is active.

Vs Resmed, (which doesn't call their feature "smart ramp"... they call it "auto".)

Resmed wrote:Ramp Time can be set to Off, 5 to 45 minutes or Auto. When Ramp Time is set to Auto, the device will detect sleep onset and then gradually increase from the start pressure to the minimum treatment pressure at a rate of 1 cm H 2 O per minute. However, if sleep onset is not detected, the device will reach the target pressure within 30 minutes.

So, back to my initial... "That's not a Respironics feature, the article is wrong.

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Mask	Humidifier

Additional Comments: Started June 19, 2018.

Mask	Humidifier

Additional Comments: Started June 19, 2018.