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new ResMed AirSense 10 AutoSet
I am new to this. The VA gave me a ResMed AirSense 10 AutoSet The auto ramp time is set to 45 min. Is this for sleep detection, and cannot be set. In the resmed software it is grayed out. Do I have to go to manual? and set it. My start pressure is 4 and sometimes if feels as though I have trouble breathing.

I also tried the pillows mask but it caused sores in my nose and leakage from the side of my mouth (lips flapping). I now have the AirFit 10 full face mask which sucks for stomach sleeping or side sleeping because of air leaks.

any advice.

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If the ramp time is grayed out, then it is likely turned off. (Three settings: on/off, time, and where to start pressure.)
Ramp is worthless (and hence unusable) with a 4 cm-water starting pressure.

At minimum pressure = 4, many people feel air starved. Suggest minimum pressure of 6 cm-water.
Leave Ramp off. BTW -- purpose of ramp is to have the pressure come up while one is trying to fall asleep. Useful for some; unnecessary for many.

I side sleep with a full-face mask. It can be done.

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Hi Bob, welcome. You can change any of the settings on your machine by entering the clinical menus. It's not difficult, just press the control knob and Home button at the same time. The display will illuminate and indicate you are in clinical setting mode. Press the control knob to access the settings. It's a good idea to scroll through the settings and record their values before making any changes. Ramp time and minimum pressure can be changed. A starting pressure of 4.0 is simply too low for most of us. You will have to decide what is comfortable, or if you would prefer to turn off Ramp altogether. I'll suggest that 6.0 is more comfortable, and you may want to go higher. Most experienced users do not use this feature. I would limit ramp to the minimum time you need to adjust to the pressure comfortably. You can make it as little as 5-minutes or as long as 45 minutes.

While in the settings, you can scroll to the Options menu and select Essentials. You want to set this to "Plus" in order to see the AHI and other therapeutic data on the screen. When you are done making any changes or recording settings, just scroll to home, then highlight the Exit Clinical Menu and select with the control knob. This will exit the settings, and return you to User settings.

Auto ramp is designed to keep pressure low until a sleep breathing is sensed by the machine, then it fairly quickly ramps up to therapeutic pressure.

With regard to the Pillows mask, it is the most comfortable of the options. To prevent sores, you should increase the size of the pillows. You may think medium is right, but the pillows mask does not insert into the nares, it rests on top. Try a larger pillows size and see if that works for you. I hate to see you in a full face just because you didn't get fitted right.
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I too have the same setup. 4 start pressure was too low. Felt starved for air. Dr. Doesn't tell you how to change settings and I am not recommending it, but the internet is full of "how it's done". After 2 months of misery and research I did change my settings. I will apologize later.

I also had a fair amount of mouth leaks with the nasal pillows but with a chin strap, a CPAP pillow, and some patients, I have it under control. I am glad I did.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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When I went in for a sleep study they fitted me with pillows and jammed them tightly into my nose to make sure they sealed. I spent months hoping that the soreness would go away and in the meantime developed sores inside my nostrils from the pillows. I had read here that pillows were supposed to fit lightly but trusted my tech's expertise more. This is called learning the hard way! One day I switched my pillows from the Medium to Large, let them rest more loosely against my nostrils and now it's very comfortable. A lighter weight mask (Airfit P10) was an improvement too. I sleep on my side and occasionally my mouth would open and cause a bit of a leak. It wasn't a huge problem but I started wearing a chin strap, fitted very lightly, and it stopped periodic large leaks.
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Hi robert,
WELCOME! to the forum.!
Much success to you with your CPAP therapy and hang in there for more responses to your post.
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Honestly, I think the 4 pressure is there for children since most adults find it uncomfortable. I'd start with 6 as others have suggested. I used the ramp function for maybe the first 6 weeks, lessening the time over time. Some use it always and that's just fine. Currently, my pressures are set at 9-11 so it essentially acts like a ramp since I stay near 11 most of the night. Smile
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There's a Product called "AYR" and it comes in the Commercial name and some places carry an equivalent "generic" formulation of this product. You can get this at pharmacies, Wal-Mart and some grocery stores (usually in the pharmacy department).

Basically, this is a Saline Nasal Gel with Aloe. A buddy of mine turned me on to this product and said to put it around your nostrils before mounting your pillows to your nose.

Me, I put just a small drop on each of the pillow ports, smear the gel around with my finger, then put on my pillows.

Ok, so it takes a few times before it starts to feel normal. Now, don't use too much or you might hear it "gurgle" if air escapes between your pillows and your nostrils, but my nostrils haven't been sore yet!

Oh, and you can't smear your pillows, then set them down for 15 minutes then put them on because the product will evaporate.

Since the product is a Saline Gel, it won't harm the pillows in any way.

Hope you have as good an experience doing this as I am!

Good Luck!
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