The Cleveland Plain Dealer had sleep experts answer reader questions ranging from new central sleep apnea information to how to get a child to adhere to a sleep schedule.

Q. I have apnea and use a CPAP machine. I have been told that some users wake up much more energetic and refreshed and others don’t. I don’t. Why is there this difference between responses? Am I doing something wrong?

A. Most users of¬†CPAP (continuous positive airway pressure) do note a positive response with therapy, including better sleep, awakening feeling more rested and better daytime alertness. However, this is not always the case. The first things we think of when someone is not having a good response has to do with the CPAP settings. The pressure settings may change over time, often the result of aging, weight gain or changes in other medical conditions. As such, it’s a good idea to get a reassessment of the CPAP setting to make sure it is correct for you now.

Other factors can influence the effectiveness of the CPAP, including if your mask is old (which could result in leaking), if you have a lot of nasal congestion, or if your mouth opens during sleep. Most of these issues can be sorted by taking a history and obtaining a few simple tests.