I had a similar problem when they set my auto at 5 - 20. The drastic change in pressure can cause real problems. You could try adjusting your mask and headgear at 17 or 18. I'm not sure which S9 you have, does it have a "Mask Fit" feature? If it's an AutoSet it does, if it's an Escape Auto it doesn't. If it has "Mask Fit" you just go to the home screen and press down on the knob button for about three seconds. The pressure will come on and increase to your median pressure for the previous night. Now you can fit and adjust your mask and headgear so it won't leak at that pressure. After you have your mask fitted you can just wait three minutes and it will reduce to your low-end starting pressure or you can just click the knob to turn mask fit off and start the therapy the way you always do. The only problem is that when the pressure decreases the mask might mash against your face a little tight and this might cause some leaks. It's worth giving it a shot though. If you don't have mask fit then you can use the clinician menu to manually change the settings in order to adjust the mask and headgear; or, what I used to do when I had an Escape Auto and didn't know how to change pressure settings was to put the mask on and fake snore 'till the pressure got up to 15 - 19, then adjust and fit the mask, turn the machine off and turn it back on again to start at the lower pressure.
What has really helped me in dealing with leaks and mask fit is narrowing my pressure range very slowly over a long period of time. My PAP can only go between 16 and 20 now and my pressure usually runs at about 18. This has really cut my AHI back also. Maybe you should talk to your Doc about trying to get that range narrowed down.
Welcome to Apnea Board! In my experience, the Liberty hybrid mask was a very difficult mask to get a good seal throughout an entire night and when I was using one, I was using a fixed CPAP pressure setting of 10. Your min/max range and the ramp is going to make it very difficult to get this mask to work for you.
I agree with you that it's a great mask because of its small footprint. However, if you can't sleep through the night, then it's not providing effective therapy. I tried a number of things to try and get a better seal with the Liberty but nothing worked, so I moved on to the Quattro FX and that has been the best mask for me. Many nights, I will get zero leaks through an entire night and when I do get leaks, they are very minimal and of short duration and never anything strong enough to wake me from my sleep.
Also, I used to use Padacheek mask liners when I first started therapy because they made the mask more comfortable to wear, however I found that I got higher leak rates when using them than without them. I stopped using them for awhile and within a short amount of time, I became accustomed to the mask without the need for a mask liner.
So maybe try sleeping without the liners and/or keep searching for another mask. Masks are a very personal thing and while the Quattro FX works great for me, your experience with it might not be the same. Good luck!
We're all family here...you can call me B36 if you'd like!
I always use full pressure to check the fit with as well. I never use the ramp feature.
After getting a good seal I just sit up and breathe for several minutes to acclimate.
When I was starting out I was getting sore chest muscles and sore sinuses for a few days but
your body adapts to the pressure and now sometimes I will awaken from some external event and
feel like the air pressure is normal. I have to check the machine to make sure it's working. (it's very quiet)
Thank you so much! I will try reducing the ramp time tonight and also use the mask fit feature - I didn't know about that!