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There are many things that can make CPAP use ineffective. Perhaps the most common would be leakage from some area. Mouth leaks can negate your therapy and you may not even realize you are letting the air escape from your mouth when you are asleep. You may notice a dry mouth in the morning, that can be an indication of mouth leaks. Another leak issue can be with the particular interface you are using. It may not be fitting properly or it could be that when you sleep your interface is being moved by your pillow or by the hose pulling it away from your face on one side. The other issue that may be affecting your therapy is your pressure needs. If you have gained or lost more than 10 lbs your pressure needs may have changed since you were titrated. Your doctor can help you resolve that issue. I wish you the very best in your therapy, it is a journey, and it does work very well when all the issues are resolved. I have been successfully using CPAP for over 4 years now. Do not give up. Karen