Somehow I got the notion early on that a lower start pressure and a longer ramp time was what I needed to do for a happy relationship with my CPAP. Also, during the night, when I would wake up because of leakage I would hit the ramp button. This "only" went on for 13 years.
Since joining the board I started seeing comments in various postings that raised questions about ramp time and start pressure and I thought "hmmmmm". I started lowering the ramp time from 20 minutes and am now set on zero ramp time and have been there for four nights. I am actually sleeping better, have less leakage and feel more rested when I wake up. I have used the CPAP all night every night from day one (except for about 4 or 5 nights for medical reasons) and felt pretty smug about it but now I think what I was doing was probably reducing the effectiveness of my treatment significantly. I am seeing many benefits from this group but, so far, changing my approach to ramp time has been the biggie.