Newby Question

Remember Science 101...keep your variables to a minimum so you can best know which change gave you what result.
You changed 2 variables last night...not a good idea.

Keep the ramp. It hurts nothing to have it being used. With the Respironics machine being in auto mode if something should happen during ramp that needs more pressure the machine will suspend ramp and go right to work doing what it needs to do.
ResMed won't do this but your machine will when in auto mode.

Use 7cm minimum for a few nights and get yourself to feeling better and sleeping better and the next time you want to try more minimum...go with 0.5 cm and not the full 1.0.

It's not an urgent thing that you need more minimum anyway...it's a maybe it will help thing.

People tend to get in a rush and want to change things quickly and sometimes that is not such a good idea. The body needs some time to adjust. Some people more than other people.

Here's a little story I like to share with people to show why "give it time" is also important.
Some time back when I was trying a new bilevel machine I was doing what you are doing trying to find optimal pressures to get optimal results. I picked a pressure that gave decent results...AHI around 3 ish and decided to use it for 6 weeks without changing anything.
At first the 3 ish nights were rather sporadic...and some nights were down right ugly but I resisted the urge to change anything and slowly I noticed that the 3 ish nights got to be more consistent and even some less than 3 ish nights would happen.
Over the 6 weeks the AHI slowly reduced so that I started seeing AHI of 2...then 1.
By the end of the 6 weeks my AHI had reduced 50% and was consistently running between 1.0 and 1.5 with even an occasional drop below 1.0. And I never changed anything during those 6 weeks.

And I wasn't even new to cpap therapy when I did that experiment...I had probably 3 years under by belt.

There is a lot of truth to the "give it time" thing...let the body and mind adjust. I know the knee jerk reaction is make changes fast to get good results fast but sometimes we just have to give it some time. Unless there is an urgent need to change something RIGHT NOW...give it some time. IMHO you are not at a point where it is urgent that you change anything.
Yeah, more pressure might help...but it also might not and you already found out that more caused some problems.
Back up and regroup and then decide how best to proceed.
Figure out your own personal limitations...sounds like more minimum also caused some aerophagia issues...it's common.
Sometimes we have to compromise a bit to keep the aerophagia monster away.

Very sound advice Pugsy--after last night I've been thinking along those same lines. Re: Science 101, I knew better, but I did it anyway That's good to know info regarding the Respironics adjusting during ramp in auto mode, which reminds me, thank you for sending the link for the clinician manual. I've downloaded and read both it and the user manual. I read about the different flex settings while in APAP (1, 2 or 3). I experimented with each of them while awake and I could not perceive any difference, so I left it at 2, which is what it had been set to previously when I received the machine a couple of years ago.

Thank you again!

When I was using Respironics I always liked A Flex at 2 better than anything else.
CFlex....I couldn't tell that it did anything no matter at what setting but AFlex I kinda liked the way it felt.

One time I decided to try doing without AFlex so I turned it off (had been using it for years) and that was a really bad idea.
OMG did my body say "what the hell are you trying to do lady"
Worst night ever on any machine...had aerophagia from hell so bad I was sick all the next day. My sleep quality went totally in the toilet and I woke up a gazillion times that night and my pressures which normally were fairly stable went all over the place including up to 20 for a long time (no wonder I got a visit from the aerphagia monster).
I never repeated that experiment. The results were so bad I didn't even want to confirm anything. Turned my AFlex back on and never looked back. To this day I prefer some sort of exhale relief and I simply won't go without it.

Sometimes when we do an experiment we learn what a bad idea that experiment was. We always learn something though...even if all we learn is to never do that again.

Haha, what were you thinking lady!? I'm done experimenting with A-Flex!
PS, last night was the first time ever I'd had aerophagia.

Sometimes there's a fine line between causing the aerophagia monster to come calling and having him stay away.
Maybe yours is the 7 cm minimum or maybe 7.5 wouldn't be bad. If/when you try more minimum again you might get an answer to the question "where is my line".
Might have been a fluke...might not have been a fluke but sometimes the line is there.
Was my line AFlex...dunno for sure and I don't want to go do it again just to find out.

The minimum pressure is where the machine spends probably the bulk of the night with some excursions upwards that are relatively brief and don't cause a problem so much but the constant slightly more minimum might be the line in the sand to wake up the monster.
If that is the case...for me having the monster come calling is worse than the AHI of 2...and I would gladly be happy with the AHI of 2 ish or even a little more maybe. That monster when he comes calling can be really nasty for some people.
I totally empathize with the people that have to battle him all the time. I have had him come 2 times where it was really ba20 incd. I don't want that again.

I am lucky now...so far about the worst I get is relieved with a big burp as I get up out of bed and no pain at all.
When it was bad I hurt something awful and had nausea too. I don't do nausea well. I can stand pain better than I can stand nausea.
Might be related to the 24/7 nausea and vomiting I had when I was pregnant....24/7 every day for 5 1/2 months. Ever since then I don't do well with nausea of any kind. Also why I only had 1 kid. At 6 months pregnant I had lost 12 lbs and was down to 92 lbs and had a 20 inch waist. I was that sick.

Wow! I can't even begin to imagine that--I'll consider myself lucky to have had only the one, mildish experience then--further, never to have been pregnant! I'll definitely be cognizant of the line!

Ok, it's been a couple of weeks since I've posted on my original topic here so I thought I'd provide an update. After the hellish night I posted about a couple of weeks ago I must have freaked myself out because for about a week it would take me over an hour to fall asleep when it normally takes 5 minutes or so. Also, I'd wake up a few times during the night and then have similar problems getting back to sleep. Often my total time asleep would be 5 hours or less for the night during that week. I was hyper-focused on my breathing for some reason--I've never done that before. The scariest sensation I'd have is just as I would start to doze, I'd panic that I wasn't taking my next breath...when there was plenty of air flow. Those nightly graphs look very similar to the June 16th graph I posted earlier.

Anyway I finally put my settle-down pants on, focused on not freaking out and set my mind to dealing with the min air pressure adjustment. I've fluctuated between 7, 7.5 and 8 min pressures. They all feel similar to me when I'm trying to fall asleep, so the 8 min pressure doesn't bother me while awake nor asleep.

So looking at these last graphs, I find that they're definitely better than my previous 2 year history. However, the nightly results are somewhat inconsistent with leaks, apneas, etc. I know now it's just a matter of sticking to one pressure, letting my body and mind get used to it and hope for more consistent results (as Pugsy's "give it time" story illustrates).

One other thing. My girlfriend says the night before last (26 June graph) she heard an air leak twice during the night--it's possible the nasal pillows pulled away just enough to cause a leak, but I keep it pretty tight...cinched up to just before it gets uncomfortable. So I started wondering if maybe my mouth was open...I did wake up with dry mouth that morning. So last night I taped my mouth shut as I've read many people do. I successfully wore it throughout the night and didn't wake up with dry mouth. But looking at the graphs, I don't see any significant differences other than a longer red flat line pressure reading than normal...several events occurred during that time. I don't know what to make of it really. Any thoughts on the taping/results or the big picture?

PS, my AHI scores have never been consistently so low