I am dealing with very similar issues and am very frustrated. I was diagnosed with sleep apnea years over 20 years ago and was unable to tolerate the mask at the time. Over the years, the fatigue only got worse so I have, after trying multiple masks and different devices, been recently pretty consistent with use and getting my AFI down below 5. However, I am still exhausted and it doesn’t seem to relate to CPAP use. I too, wonder if the waking during the night with loud noises coming from the mask leaking, or constantly readjusting it during sleep when the mask moves and air blows all over my face, is interfering with my quality of sleep just as much as apneac events? I can have a good night sleep ‘according to the device’ and still feel very tired, etc. No other explanation exists for the fatigue. My labs are good, no other health problems, etc, etc, and I have felt this way for years. The only constant is sleep apnea and I feel its still not being treated effectively so not sure what to do at this point. I’m so wanting to be one of those people that use it for five months and say their life has turned around and they are finally feeling well rested and “normal.”