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Questions about re-starting therapy, researching before doctor visit
Here are SH charts for the last two nights, including my new machine last night.  I noticed sometime late in my sleep cycle that I was mouth breathing sometimes and noticed at least once that my P10 was leaking, though I don't see that reflected in the chart.  My perception is that I don't experience as much flow out my mouth if it's open so I don't notice it right away.  The P10 is vastly quieter than my Pico mask but did leave me hurting some by morning.  I'm not sure if that's something I just will get used to or if something needs to be changed (I'm using medium pillows).

I'd appreciate your thoughts.

Also, I received my dictated sleep study yesterday.  My doctor indicates I should be on "C-FLEX at #3 setting" at fixed pressure of 7.

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To make the P10 more comfortable for you, especially initially when your nares are getting more used to the pillows sitting on your nostrils. I would suggest a looser setting if possible initially. Try to set the strap wider apart with the lower one down by your neck and the upper one up near the crown of your head. It really doesn't have to be very tight to be effective. Going one size up can also help with the comfort (as well as the air flow.)

In the morning and during the day, use a good quality cream (Some suggest lansinoh) on your nares to help speed the healing of any micro skin irritations while you are getting used to it. After some time of using the P10 your nares will be used to it and you won't need the cream. At least that has been my experience. I love my P10s. Smile
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Thanks, I may try that cream. I think it mostly felt like bruising from the pressure, especially right below my nose. I will try adjusting the straps as you suggest. I have a fairly big head so that increases pressure.
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On mask comfort, don't dismiss the possibility that the large pillow may be more comfortable. You'd be surprised how many people are happier with up-sizing.

The advise to spread the straps is right on. Apart is looser, together is tighter.

I don't see anything I would change with regard to the machine. Excellent results! You seem to be doing fine at Flex 2, and I'd be surprised if you notice much difference at 3.
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Thank you again for the help.

Last night's comfort was better with just a slight soreness this morning. Comfort is quite remarkable, actually. The few times I awaken I think maybe I've taken my mask off as it doesn't seem like I'm on therapy. I did not notice any leaking at all last night.

The only slight annoyance I observe is for the first few minutes it seems like I'm not getting enough air and that I need to inhale with some effort to get the air I need/want. I'm wondering if I should just turn ramp off.

I'm also trying to figure out how to best arrange my hose. I did get tangled up once that I recall.

I still had two relatively vivid and detailed dreams last night, though they were not disturbing.

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I would lift your ramp pressure from 4, to set it at 6 for the feeling of not getting enough air , you may even be able to turn it off
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At a minimum pressure of 7 I'd just turn the ramp off entirely. I'm at 9 and I don't use the ramp at all, and it feels fine to me. Of course everyone is different, though.....
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I have done worse lately and am not sure really entirely what has lead to this.

I switched to the ResMed AirSense 10 AutoSet on the night of May 11th as well as P10 pillow.  As reportedly previously, my nose was a bit sore initially, mostly below my nose, actually.  I did turn off the ramp after two days of use since that didn't really seem necessary.  I have a bit of a deviated septum that was corrected once by surgery but still a bit of an issue and I developed a pimple on my septum that then became a sore and some blood by the fourth morning.  I switched from the medium sized pillow to the large size last night in hopes that would help.  It seemed okay at the beginning but around 4:30 or 4:45am I awoke and it seemed like my pillow was leaking a lot and I fussed with that for quite a bit and could not get it to stop but I don't really see the leak rate jumping up.  I figured that maybe my pressure was just higher at the time so I ignored it and finally went back to sleep.  I'm thinking I will go back to my Pico nasal mask until my septum heals at least.  I really liked how quiet the P10 is and would like to be able to use it.

My sleep doctor had wanted me to be on a fixed pressure of 7 and C-Flex setting of 3.  I don't know what that setting of 3 means.  Could that be the humidity level or is there some other setting?  I had told my doctor that I thought I'd get an auto machine and he said it was not necessary and that not everybody does better on auto but it seemed to work well while I used my dad's old PR machine.

I'm on EPR setting of 2.  Might that be the cause for any of the increase in events I'm seeing?

Any other ideas?

I will post my last night on my PR machine and all 5 nights of use of my ResMed machine.  The changes to my ResMed machine again was just the elimination of the ramp after the second night.  

Night of May 10th (PR machine)
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Night of May 11th (first night with ResMed and P10 pillow)
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Night of May 12th
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Night of May 13th (believe this is the night humidifier ran dry since I forgot to add water, I can run 2 nights on 1 tank of water)
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Night of May 14th
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Night of May 15th (using large sized P10 pillow, my most uncomfortable night in a while)
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Increasing EPR means your EPAP pressure is lower. If you like the feeling of the pressure relief, it is best to increase minimum pressure by the same amount you increase EPR. In other words, your minimum pressure went from 7/6 with EPR at 1, and it is now 7/5. Either change minimum pressure to 8.0 so that pressure is 8/6, or decrease EPR back to where you started. It is the reduced minimum EPAP that is causing increased OA and H.
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Overall your stats are looking quite good I have to say! A lot of folks would be quite satisfied with the way things already are. I wouldn't say you "have to" change anything. Nothing especially jumps out at me. But if you wanted to tweak things a little further...

My suggestions would be to:

a) Stick with the medium sized pillows for now. It could be that the Large size is just too large for you.
b) I would turn off Ramp entirely in your settings
c) I would put your minimum setting to 7.6 (or 8 as Sleeprider suggested) to see if these last few obstructive events could be diminished even further.
d) I would try turning off the EPR. For myself, it increased the CA events I always got and to be honest, you get used to not having it pretty quickly. By turning off the EPR you will have a more consistent pressure level at your minimum setting, instead of a variation when you exhale. Really it is just a comfort setting and you may or may not need it to be there. The "Flex" setting basically does the same thing on the Phillips machines.

Also, please check my signature on how to organize your Sleepyhead chart data. We do not need to see the mask pressure chart. Instead, Flow limit would be much more useful. Also turn off the pie chart... In any case all of the suggestions are in my signature on how to adjust your data. Including how you can drag the size of the horizontal lines to make all off the required charts fit and give them a consistent size. Also, for IMGUR images please try to save the largest setting possible. Makes it much easier to zoom in on the data when using a phone. There is also info in my signature on how to post your IMGUR images in the best way possible, to make them more easily readable.

In any case congrats. You are doing really well!
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