Any thoughts on reducing AHI after increase from new medicine

[cupcakechinchilla]

I am hoping someone can help narrow down what I can do to help lower my AHI. There was a visible increase after starting a new SSRI medication on March 15.

I have been on CPAP therapy since 2005. Late last year I received a new ResMed 11, but my doctor did not change my prescription from the default, he left it at 4-20. I eventually moved it back to what my previous prescription was, which is 11-15. I was doing great there for a while, other than possible mask leakage due to dry mouth since then. 

Anyway, on March 15 I started taking a new SSRI and almost immediately my AHI jumped from an average of 0.80 to between 3.00 and 5.00 each night, and I've experienced more daytime sleepiness over the past couple of months than I've had for years. I have tried ranges between 4-20, up to tighter ranges such as 11-13 and am currently trying 11-16 but I can't seem to find a good pressure. 

Can anyone see from the graphs below what might be happening?
 
Any help would be greatly appreciated!

INCREASE ON 3/15/2023
   

NO EPR
   

EPR 2
   

[gainerfull]

Have you considered asking for an alternative medication?

It looks like aside from the leaks which need a bunch of work you'll want to consider raising your minimum pressure if you decide to continue the medication.

[cupcakechinchilla]

Thank you for the feedback. 

This is about the third or fourth medication I've tried and so far it's been the only one that has helped with my condition. 

From what you can see, do the leaks look like they are coming from the mask or my mouth? 

Based on the data from the screenshots, any suggestion on the minimal pressure?

[staceyburke]

Take a look at your O events with EPR2. Notice that many of the events are grouped together. That show a good possibility that it is positional apnea. Also known as chin tucking where your chin drops down to your sternum cutting off your airway. 

This happens many times from back sleeping or bunching up your pillow and forcing your neck to kink. 

There are no settings to help this- you have to stay out of that position. Notice you have long stretches of time with no events. So check on how you are sleeping.