Don't worry about ramp. If necessary, start at a lower pressure and increase it slowly over a few days. Wear the machine during the day while you're reading or watching TV to get used to the pressure. If necessary, start at a pressure that doesn't adequately treat your apnea, but you can stand wearing the machine. Then increase the pressure until your apnea is adequately treated.
After a few weeks, even at full pressure, you'll probably find you can't even feel the pressure and have to put your hand in the airstream or lift up the edge of the mask to tell it's on.
If you get an Auto machine, if the pressure bothers you, temporarily reduce the maximum pressure to a level you can live with and increase it bit by bit.
Doctors and DMEs are sometimes pigheaded about setting pressure. It's possible to change the pressure yourself if necessary.
By the way, sometimes ramp or a low pressure can make things worse because you get a feeling of not getting enough air.
Don't get the F&P Icon. The superior data collection offered by the PRS1 or S9 machines is important. With the PRS1 or S9 you can see every single breath and every single breathing problem for the whole night.
Here are some examples of the data you yourself can get from an S9 or PRS1 machine of the correct models. http://sourceforge.net/apps/mediawiki/sl...sers_Guide
The BiPAP/VPAP (generic term "bilevel") machines are not strictly "better" than the CPAP/APAP machines. They do allow more "exhale relief" where they reduce pressure on exhale. They generally go to a pressure of 25 vs. 20 for the CPAP.
A bilevel machine can help with difficulty exhaling, but I think most people will readily adapt to the pressure when exhaling
In particular, the ASV machine (ResMed VPAP Adapt or PRS1 AutoSV Advanced) is not necessarily an improvement unless you have some form of Central Sleep Apnea (CSA.) When used on a "normal" apneac, it may be "rough" on you because it decides when it wants you to inhale and you may feel it's forcing you to breathe on its schedule, not your own. If you have CSA, you need an ASV. Others should avoid it.