Do you use the ramp function?

I'm curious how many of you use the ramp? What's your opinion? Personally, I'm not a fan but wonder if I'm in the minority.

I have never used the ramp. Over 15 years on cpap.

It's strictly a personal preference choice.

My ASV gives a pretty abrupt transition between ramp and therapeutic pressure, so I turned it off years ago.

I agree with Pugsy that it's a personal choice - up to a point. With many machines, there is no logging of events or therapy during the ramp period, so if you have a 45 minute ramp you're missing out on a lot of therapy. And if you wake up several times the non-therapeutic ramp becomes a very high percentage of the whole night. My advice is to use ramp if you must, but keep the period as short as you can.

After many years of not using ramp, I rather recently decided to try to autoramp.

Edited after reading DogSlobber's post. He quoted me correctly, but, since it was his suggestion I applied, I clearly misremembered some things.

I did it for 2 reasons:
The first was as a way knowing if the power blipped and I slept through it.
And the second was that I noticed my Polar watch reports sleep onset later than Autoset - and it made me curious.
So: my automatic ramp pressure is about 1 cm of water less than my therapeutic pressure, and I discovered therapeutic pressure kicks in when my breathing becomes regular (that is, I've fallen asleep). It correlates quite well with the time my Polar watch identifies my sleep onset, and the AS10 doesn't register events during those toss-and-turn-can't-fall-asleep ramp times. The maximum autoramp time is 45 minutes - then therapeutic pressure will kick in no matter what,

Keep in mind that I do better with fixed pressure.
I couldn't tolerate timed ramp when I started CPAP therapy all those years ago: there was no "autoramp then" and I would lie there tense an miserable waiting for that "terrible" rise in pressure so I could finally fall asleep.... didn't help me at all.

ozij wrote: ↑

Sat Jun 29, 2024 8:12 am

The first was that I read that after a power failure, when the power returns, it does so at therapeutic pressure, not ramp. So it's a way knowing if the power blipped.

I believe after an abrupt power-cycle, when power is returned, therapy starts at ramp again.

I have been advocating this for years. Set ramp to just under your minimum pressure, for the shortest time-span (or Auto-Ramp if you've got an AirSense), solely so you can easily see if a power-cycle occurred.

The one feature I really miss when I moved from the AirSense to the AirCurve was Auto-Ramp. For me, it reliably determined when I was asleep. So every-day, I could determine how long it took me to fall asleep.

And about those who claim, that when in ramp, therapy doesn't occur and events aren't flagged, that is only true with timed ramp, not Auto-Ramp.

With Auto-Ramp:

• Should you need a therapeutic pressure increase, you're probably asleep and therefore Auto-Ramp would have switched to Therapy Mode.
• On the off chance it doesn't move to therapy mode, it is still monitoring events and will switch to therapy mode, should it detect snore and or enough apneas/hypopneas
• On a properly configured pressure range, you ramp/minimum pressure should be sufficiently close to treating your sleep onset needs.

No. Hit me with that good pressure, immediately. It is my impression that most old sea dogs don't use it.

Dog Slobber wrote: ↑

Sat Jun 29, 2024 9:44 am

ozij wrote: ↑

Sat Jun 29, 2024 8:12 am

The first was that I read that after a power failure, when the power returns, it does so at therapeutic pressure, not ramp. So it's a way knowing if the power blipped.

I believe after an abrupt power-cycle, when power is returned, therapy starts at ramp again.

I have been advocating this for years. Set ramp to just under your minimum pressure, for the shortest time-span (or Auto-Ramp if you've got an AirSense), solely so you can easily see if a power-cycle occurred.

It was one of DS's post that made me try the Auto-Ramp at pressure very close to my therapeutic pressure - so clearly I had an incorrect memory of the reason.

The one feature I really miss when I moved from the AirSense to the AirCurve was Auto-Ramp. For me, it reliably determined when I was asleep. So every-day, I could determine how long it took me to fall asleep.

And about those who claim, that when in ramp, therapy doesn't occur and events aren't flagged, that is only true with timed ramp, not Auto-Ramp.

With Auto-Ramp:

• Should you need a therapeutic pressure increase, you're probably asleep and therefore Auto-Ramp would have switched to Therapy Mode.

As far as I remember, I don't see events flagged before the Auto-Ramp realizes I'm asleep.

• On the off chance it doesn't move to therapy mode, it is still monitoring events and will switch to therapy mode, should it detect snore and or enough apneas/hypopneas

I don't snore on that pressure, but I can say with certainty that the AS10 only flags flow limitations when it's in therapeutic pressure. I don't know what happens in APAP, since I use fixed pressure.

Looking at my data and going back a few years to my AirSense, when I had AutoRamp, snores are traced in both AutoRamp and Timed-Ramp.

Dog Slobber wrote: ↑

Sat Jun 29, 2024 9:44 am

And about those who claim, that when in ramp, therapy doesn't occur and events aren't flagged, that is only true with timed ramp, not Auto-Ramp.

I should have used more precise language, making it clear that while events (FLs and apneas) aren't flagged, they still are monitored.

The important point being; many here make the claim that while in Ramp, proper therapy can't occur. This is true for Timed-Ramp, but not AutoRamp, as AutoRamp has provisions to switch to therapy mode should therapy be necessary.

I use it. I fall asleep more comfortably at a little bit less than my prescribed pressure. As I'm falling asleep, my airway becomes more susceptible to collapse and the pressure it needs gradually kicks in.

I use a 5 minute ramp, at therapeutic levels, just to give myself a few minutes to rearrange myself and the mask to get comfortable and ready to sleep. I tend to hold my breath while tossing and turning (which I do a lot of during that 5 minutes), and I don’t want those to show up as events

I used to ramp, back when my minimum pressure was 23. You need a little ramp-up time to get strapped in for the big blow.

Now that I'm down to 10 (and falling) I don't ramp any more. But there's no shame in it.

Never!

I can't stand it. I've been using CPAP since 1999 (this month marks 25 years). I disabled it within a week!

Funny thing is, it got activated last night. I had to figure out how to disable it at 3 AM. That was so annoying!

loggerhead12 wrote: ↑

Mon Jul 01, 2024 11:23 am

I used to ramp, back when my minimum pressure was 23. You need a little ramp-up time to get strapped in for the big blow.

Now that I'm down to 10 (and falling) I don't ramp any more. But there's no shame in it.

Not to go OT, but you started at 23 and now at 10?

Did your apnea got "better?" Or did you discover you never needed that much pressure in the first place?

cabanalane wrote: ↑

Tue Jul 02, 2024 2:31 pm

Not to go OT, but you started at 23 and now at 10?

Did your apnea got "better?" Or did you discover you never needed that much pressure in the first place?

There are several factors.

I do believe (and my current sleep doc concurs) that the pressures prescribed from my original sleep study were too high.

Add in that I've lost a lot of weight, way into triple digits, and continue to lose it.

Combine that with the removal of my grossly inflamed thyroid last year, the size of two adult male fists. In one day my airway went from less than 2mm to normal width.

Also factor in that, at the suggestion of my endocrinologist, I've been on an aggressive elimination diet. I really don't want any more body parts removed due to inflammation, which is all over your body, including in and around your airway. My endocrinologist and regular doc monitor me continuously. The two of them are so shocked and happy about my results, it wouldn't surprise me if they started a new religious sect. They're definitely evangelists for an anti-inflammatory diet now.

All of that has added up to significantly less pressure, and I haven't bottomed out yet. My simple experiments involve reducing the pressure 1cm of H20 at a time, once every month or two. That's a huge whack of pressure removed, way more than the reasonable recommendations made here for changes to your settings. So far I haven't seen my average AHI increase to anything above 1.0. Perhaps there is some magic pressure number below which I won't need a CPAP machine at all. Fingers are still crossed. My sleep doc told me to go slow, and I'm doing that.

DreamDolphin wrote: ↑

Mon Jul 01, 2024 10:30 am

I use it. I fall asleep more comfortably at a little bit less than my prescribed pressure. As I'm falling asleep, my airway becomes more susceptible to collapse and the pressure it needs gradually kicks in.

Same here. I use auto and find it ramps up fairly quickly to my set level of 10 once I am asleep.