Do Comfort Settings Distort Performance?

[Nehpets]

Do the various comfort settings such as EPR degree, EPR full time vs Ramp only, Ramp time vs Ramp Auto, adversely affect CPAP efficacy or are they simply what they are said to be, individual preference comfort settings?

On becoming accustomed to my CPAP therapy, is it recommended to scale back comfort settings to improve performance efficacy?

Stephen

[staceyburke]

EPR is not just a comfort setting, it has real therapeutic value.  It stops the cpap from increasing pressure and it keeps airways open.   Use it - it helps.  The ramp is something that most of us do not use.  During the time the ramp is on you are not getting the therapy intended.  If you get up a couple times in the night and turn off the machine to use the bathroom for instance, the time you are not under the correct pressure can be over an hour or more.   I would not use auto on/off there have been many people that have had problems traced back to that feature...

[Nehpets]

.....  During the time the ramp is on you are not getting the therapy intended.  ......

It's reassuring to hear because that was going to be my follow up question. I find the startup time uncomfortable as there is virtually no pressure in my mask and I find the flopping of the air valve in my mask an irritant, until pressure builds.

So if I understand correctly, even for a beginner such as myself, and given my discomfort during startup, I would be advised to completely turn off ramp, correct?

Thanks for your help!

Stephen

[Gideon]

I prefer to have new users turn off the ramp, then if, and only if they need it to turn it on at s more reasonable setting for them..

EPR is marketed as purely a comfort setting. As others have said it is far from that. A common criticism of EPR is that it can cause an increase in central apnea. They never say that simply using any PAP device can do the same thing. Here Most of us understand that mechanism and if/when it occurs we react to it as needed then.

Settings such as humidity can, not will, but often will disrupt sleep because of comfort and that can definitely result in impacts to your therapy.

[dataq1]

If you are discomforted by ramp, by all means don't use it. 
However, using ramp for a short period of time is unlikely to impact the overall treatment. Consider this: if you employ ramp for 10 minutes out of 420 minutes of sleep time, do you think that fraction will significantly impact the overall treatment. 

You say that the flopping of the air valve (during a ramp) is disturbing. Could you please amplify on that? The "flapper value" should not be flopping about at any pressure. During the ramp period, the volume of air being supplied is more than enough to keep the valve in position. 

As has been pointed out EPR use is more complex, some people respond very well to various EPR settings, however with other people it creates unwanted complications.  

so....if you are discomforted by ramp, by all means don't use it.

[Nehpets]

You say that the flopping of the air valve (during a ramp) is disturbing. Could you please amplify on that? .....

If I breathe in and out into the mask while it's unconnected with no positive pressure, the inhale / exhale causes the air flapper in the mask to flap.  Consider it as an idiosyncrasy of mine, but I find the noise and the sensation irritating, so once the pressure builds, the flapper no longer flaps and all is then right with the world.   

I would characterize my reaction as a mild distraction from trying to fall asleep while becoming accustomed to my life with CPAP.

It's worth experimenting with ramp to see if I can quiet the demons...  

Thanks for your insights!

Stephen