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Attempting to post an image
January 29 was a significant improvement and the best OA you have recorded. Some of the obstructive apnea have downgraded to hypopnea, and the RERA index is pretty bad. The main issue remains obstructive, so that is actually good news. Leaks were high, but not out of control. It looks like a higher maximum pressure may be required, but I think you should remain at these settings for now. It usually take several days for a big change like this to fully settle in.

We can analyze graphs all day, but need to get your feedback on how things feel at this point. Is the pressure disrupting your sleep? Do you feel relatively comfortable?
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No disruption of my sleep. Did notice the leaking. Will tighten the mask a bit.
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What part of the mask is leaking? Cheek, bridge, nose, chin?
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It just covers my nose. Air leaked out the sides. A few days ago I had it too tight and it was irritating my skin so I loosened it way up. It makes sense that it needs to be a bit tighter.
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When you're ready to graduate to real comfort, get the Resmed Airfit P10 nasal pillows mask. It only touches the bottom of your nose, so mask seal is not an issue. As long as you are not leaking through your mouth, the nasal therapy will work for you. If you're waking up with dry mouth or air rushing from your mouth, then a different approach is needed.
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OK we have some more data now.  The first image give some summary data. Most interesting is the bottom showing the impact of increasing the pressure.

[Image: Q180sAAl.png]

Next are several nights with the original full face mask. 

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I will make another post with several days after the switch to nasal pillows. 

Any thoughts about pressure, full face vs pillows, etc. would be much appreciated.
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Here are a few days after the switch to nasal pillows. 

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This is unusual, but you have a long history of better results at lower fixed pressure at 7 cm. Maybe turn off ramp, and try fixed pressures for a while and see where the best results end up. 6, 7, 8, 9. I actually see a trend that higher pressures are resulting in higher events. I think this tells us to dial it back to what was working, and try again, and do it with fixed pressures.
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Thanks for the reply. Isn't the ramp just a few minutes at the beginning?
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Ramp time and pressure are settable. It can be 45 minutes, or 5 depending. Looks like you're going 15-20. Any chance the really bad OA events are from tucking your chin and cutting off the airway. Some members have used special pillows or even soft cervical collars for that. If your head is tilted on a pillow in a way that causes a sharp angle at the neck it's common to see clusters of OA. Avoiding that, can make lower pressures work fine, and it might be an explanation for some of your recent results.
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