This is very disturbing. Does he live in Australia or else where?
Before my treatment, I was a danger to society and almost got fired! My fatigue was so bad that I was micro-sleeping while driving. I would conk out at work and got written up to HR and was threatened to lose my job. No one was treating me as if it was a condition, but like a personality problem.
Rollback to 2004, my family told me to get tested just because I was napping during any time I would watch TV and I finally did in 2005. The test was several electrodes and said I was negative for apnea. My condition just got worse and it started to affect my driving and work in 2014. I also started coughing all the time for a year. After the threat of being fired, I asked my doctor to get retested. Such a jerk, he just said if I lost weight, I would no longer have an issue. And he thought my cough was just allergies or acid reflux.
I was lucky my dad had a spare CPAP and he let me borrow it. WOW! Almost in one night, I was cured. My fatigue and cough and depression from them were gone instantly. I begged my doctor to get a test telling him my experience. He reluctantly allowed it.
The new test that just attached to two fingers recorded my sleep and oxygen levels correctly. It showed I had only 5 minutes of deep sleep and stopped breathing 108 times per hour. My oxygen was dangerously low. During this whole time I was so glad that I had my dad's machine. I think it was almost 2 weeks before I got my own machine. I was in a group appointment where 10 people were getting tested at the same time. There were patients in there that didn't even think they should be there but were there on the recommendation from their doctor. Made me think I had a real jerk of a doctor.
My point is that apnea is very treatable and people with apnea but without treatment are the only ones that can cause danger. After proving to my boss (who is actually a friend outside of work) that my behavior was a condition and not a choice, I still couldn't get things cleared up with HR. I even wrote to HR directly and got nothing back. They ended up laying everyone off including my boss so it didn't matter in the end.
Definitely get him treatment even if you side step the doctors. Learn how to get into the doctor menu of the unit (usually holding down the home+dial for ResMed or ramp+dial for Philips) so you can tweak the settings. The mask fit is so important. I've gone through 5 different models before finally finding the right fit. I'm using ResMed AirFit F20 (large full face) now and love it.
I will wake up if I am not getting enough pressure. ResMed's SmartStart is also "SmartOff" and I had a problem with this. It turned it self off (I guess due to a leak) and then it would come back on with SmartStart. It happened 4 times in a night and was awaken by 2 of them. I've turned off that setting. I like Philips had auto start but not auto off.
Do you think Max 11 is enough? I use 19 and I personally feel like something like 15 or below is suffocating. Have you tried the machine with no ramp to see how you do while awake? I like my lungs to fill to 70% before exhale.
Is "For Her" model add the max setting? I just have one setting on my AirSense 10.
I'm sorry you are currently not getting the treatment you seek. I think there is something for you that might take a few tries to find. I'll share my recent experience.
Recently I tried a new ResMed BiPAP trial machine plus new medium full face masks and had the awful experience of acid reflux at around 6:30am each day. The pain would last 6 hours and it felt like either a collapsed lung or heart attack would feel like. (I didn't have this problem while using my old Philips System One CPAP and large ResMed Quattro Air full face mask, but I was limited to 18 because my leak would be even worse than the 73% leak I had shooting too much in my eye.) I cranked it up to 25 inhale and 20 exhale and still had the problem. The machine would only push inhale if I triggered it. I really wanted it to sense my breathing rhythm and keep it going, but I guess they are not designed to do that. I even tried 25 inhale and 25 exhale to simulate max force CPAP and then even switching to CPAP mode at 20. I could not feel the extra pressure above 20. Honestly it felt like it was relative as if the 25 BiPAP == 20 CPAP. (I can tell the difference between 18, 19, 20 on my CPAP machines, so I am confused with the BiPAP.) The medium mask was too small because it barely would let me open my mouth before causing a leak.
I went back to my doctor and I told her that BiPAP doesn't work for me and the mask wouldn't let my mouth open to a natural degree. I was fitted with the large ResMed AirFit F20 and given a ResMed AirSense 10. This mask finally fits correctly which I think is the biggest contributor of the problems. I was able to set my machine to 19 and 20 without a leak, but I currently have it at 19 now. I'm able to get a great sleep pattern now. I also needed to turn off SmartStart because it would shut off on me even though there was no leak.
My doctor is surprised at my settings. No ramp, 18+ pressure. "That's a lot of pressure." ResMed still takes 10 seconds to ramp. Philips had a true 0 second ramp which I'll miss. I've tried low or average settings: I felt like it was full suffocation. I feel real comfort with my extreme settings and enjoy sleeping/napping/hanging out awake with the machine. I think if you can enjoy your settings while awake, it should then work well during sleep.
There is nothing wrong with the Philips System One. It just doesn't have "WiFi" so I couldn't get remote monitoring. I will definitely keep it as a backup/travel unit. I think the correct mask is the biggest factor in all of this.