Any Help Appreciated! Struggling with CPAP, OSACR Data included

Basic Facts: 51, 6'2, 175lbs, 18AHI

please excuse this rambling post but I'm so tired I'm struggling putting my thoughts together.

So I'm back after a few days, still exhausted and frustrated with CPAP. I've only skipped 4 days in 8 weeks. I even use it for naps. I'm still feeling much worst than I did prior to starting CPAP. I've been on CPAP 8 weeks and it's only getting worst. Just 8 weeks ago I was running four miles 4x a week. I was functioning a pretty high level, though over the last few years I noticed some extreme morning tiredness and cognitive stuff that was affecting work day. I always had to go to bed very early. Since staring CPAP I've been utterly exhausted and sleepy all the time. Luckily I'm not working in my field as if I was I would have to take leave. I feeling all the extreme effects of lack of sleep and sleep apnea that I read about. The other day I had to nap in my car after dropping my daughter off at school. Once I got home I spent the whole day on the sofa until pick up time. Sometimes I get worried that something else is wrong with me but having recently had my physical with blood work I think tis is all a result of lack of sleep or bad sleep.

I will say that at this point I'm use to my P30I mask and the CPAP noise does not bother me anymore. I've also figured out the nasal pillows and don't get many audible leaks and when I do I can easily reseal the pillow even when half asleep. After seven weeks of CPAP my DR noticed lots of leaks. About a week ago he told me to try taping my mouth. I did that for a few nights reflected in the the OSCAR charts I posted. Even with tape my leaks are very hight 45-50 L/M. I don't understand how that's possible. I am not waking up with my mask of my face. Sometimes I wake and I can hear small nasal leak and fix it. My mouth is totally tapped shut. However even with these hight leak rates I'm getting the lowest AHI yet. For weeks I was getting 7-15 AHI. Can there be a Inverse correlation between mask leaks and AHI events?

I wonder if something is wrong with my machine/hose/mask. I often wake about 3-4 hours after falling asleep and check my leak numbers. Last night they were at 45L/m and in morning it was the same number. However when I look at my leaks on Oscar it shows that I was having leaks well after I checked my leaks on machine but the number is the same? I imagine the leak number should be higher

Any input would be greatly appreciated!

PS- my doctor has prescribed a sleeping aid to "help me get over the hump" hope it helps!

https://imgur.com/a/q4169Pu

Your biggest issue is the high leak rates. They should be under 24 L/min. When you go over that you get the grayed out areas. Also the machine does not report apnea events during those grayed out time where you are over 24 L/min. With no events your pressure decays down to minimum. The high leaks are giving you a false low apnea event frequency because the events are not being reported.

You might get some improvement by turning on EPR and setting it at 3 cm full time. But until you solve the leak problem the machine really cannot operate. It seems possible that you are displacing the mask off your nose while sleeping. One of the things I do is use a satin pillow case to let the mask slip easier over the pillow without it being pushed off my nose.