What is more important: treating sleep apnea or insomnia?

It's an interesting question. I wasn't even aware I had obstructive sleep apnea until my doctor asked me if I snore a lot and I told him it depends on who you talk to, me or my wife. He suggested I have a sleep study done and I was diagnosed with severe obstructive sleep apnea and having been using a CPAP since being diagnosed. There's some information on your question in the following article.

-- Insomnia vs. Sleep Apnea: Symptoms, Diagnosis, Treatment
https://www.healthline.com/health/insomnia-vs-sleep-apnea
Sorry to hear that your BIPAP is not helping with your ability to sleep. Have you discussed the problem with your sleep medicine doctor to see if they may have some suggestions?

I've had both, and I say treating the apnea is more important.

If your machine isn't helping you, it may need some adjustment. But please don't give up on it.

Have been discussing with the technician who has made many adjustments including starting with CPAP and moving to BiPap to see if that would help. Lots of adjusting with BiPap settings. I have gotten to the point where I can fall asleep most of the time but wake up after 1-2ish hours (which is a nice sleep) and can't fall back to sleep with BiPap on. Lol, it's like I got a nice couple of hours of sleep and now am wide awake! Have an appointment with both doctors soon and will discuss. I am really trying hard to make the BiPap work but it's so bad for actual sleeping.

Hi;
I too have moderate-severe obstructive sleep apnea. I started out with an AirSense 10 apap, but titrated to a bipap in the sleep lab.
Real world was a different story. No matter how we tried to adjust the bipap it was a “disaster” in my dr’s words. AHI went through the the roof.
I went back to the apap and have been doing better with that, though it’s not ideal. Something to consider.

BTW, did they try the apap mode on your cpap(min and max pressure) before switching you to bipap? I am also a disaster with a fixed pressure.
I know this is a “no-no”, but I’ve learned how to get into my clinical settings(it’s easy, lots of info on YouTube). In the beginning, it was the only way I got my ahi into single digits.
Just be careful and make any changes gradually.

I did try the automatic mode on the CPap - it was better but still awful - I guess less awful? I am currently using the automatic setting on my BiPap as the titration settings and the adjusted settings (when the titration settings failed) were both bad. Technician said that is all they can do with setting adjustments. Are the automatic settings on BiPap different from an APap machine?

My apnea is mild. I have switched to an over the nose connection which is better for me, but still feel the sleep I get while wearing it is not great so I still try to do my required four hours and then take off the divice and get some real sleep. Haven't discussed this with my sleep doc yet. Waiting for the results on whether the CPAP addresses the low oxygen levels connected to the apnea.
I hear you on what is best. Wish I had a good answer for you. Please post here if you get an "official" answer. I'm interested.

I wish I knew the answer to that.
I do remember that there was a minimum exhale and a maximum inhale setting, plus a pressure support setting that allowed both to slide if needed.
I don’t know what to tell you except to start watching YouTube and learn as much as you can on your own. I like Nick the Aussie’s stuff.
My experience is that all technicians and sleep doctors are not created equal.
Also maybe visit an ENT and see if nasal or throat surgery could help you.

I’ve also found cpap talk.com and apnea board.com very helpful.
Can you describe the major issue making the machine so awful? For me, it seemed to be that we never could get the machine synced with my breathing. It was either trying to “drop out” from under me
before I was through inhaling or increasing the pressure before I was through exhaling.
Are the pressures too low or too high? My sleep dr recommended opening up the pressures on my apap from 10min to 20 max when I was having high numbers a couple of years back. It worked. Just because you have the max all the way up doesn’t mean it has to go there.
Just some ideas.

The biggest problem is the sleep position I have had all my life -- like a starfish; on my face. I try to sleep in other positions, but even when I can get to sleep, I wake up back in the usual. So I stay half awake to prevent the mask being pushed off. The over the nose is working better as the head gear does a better job of holding it in place. Plus this has a vent for the extra air to escape through.

Are we discussing the same machine? Mine is called a CPAP. Yours is an Apap? I was told my doctor set the levels.

Anyway thank you for your suggestions and your response. I will look into all you have suggested.

Cheers,
Dana