I currently have a VPAP III

Ok let me try and help a bit. I do not like the VPAP III first off so let me go ahead and put that out there. In fact they are picking it up in the next day or so to replace it with an APAP. Anyway by your post and my little experience with the VPAP III I know what your problem is right off.

First I do agree with the other poster, don't screw around with whatever your prescribed pressure is before your operation. What I mean by this is your IPAP. I understand changing any other part of it because the rest is comfort settings. Ok the first thing I notices was you mentioned somethign like 18/6. So I am assuming you were prescribed 18 as I was. The high pressure is fine if that is what you need but I don't agree with your EPAP settings which is where it goes to when you exhale. You should be at about 4 or 5 less than your IPAP in my experience. So you should set it for 13 or 14 (I preferred 4 apart). This will keep you from getting punched by the air. THe next thing I saw was your inhallation time was set to 2.20 I would change that to at least 2.5 in case you take a large breath so you don't have to fight the machine. My last piece of advice is to use your RAMP setting for approximately 20-30 minutes which should allow you to fall asleep to gradual increas with pressure. As far as your mask leaks you need to crank down the straps as much as you can stand and make sure you was your face and keep the seal clean. All of that helped me with the VPAP III on 18.

Good luck. I hope that helps you.

sorry for the mistake...this was supposed to be a reply to antoher post please disreguard this message.