Getting Used to CPAP Therapy

CPAP unit

Verywell / Brandon Peters, M.D.

If you have been prescribed continuous positive airway pressure (CPAP) to treat your obstructive sleep apnea, you may wonder before beginning therapy: how can I get used to this? It may take a little effort to adapt to using the CPAP therapy machine, but by following a few simple recommendations you may find that it is easier than you expect to start using treatment. Let's discover how to use a CPAP.

Start Using CPAP With a Positive Attitude

First, approach the prospect of using CPAP therapy with an open mind and a positive attitude. If you start with the mindset that this horrible device is going to ruin your sleep, serving as both an inconvenience and a hindrance, you will find that your experience may quickly sour. Every minor setback will become additional evidence to justify your eventual dismissal of the treatment.

However, by starting with the attitude that though there may be initial hurdles, you will be able to make adjustments and that ultimately this device will help you—to sleep better, to improve your concentration, mood, and energy, and to aid your overall health—you will be more successful and rewarded for your efforts.

Selecting an Equipment Provider

One of the most important early decisions in embarking on treatment with CPAP is the selection of a supply company. You may be provided a list of companies by your sleep doctor and, in some cases, the equipment can even be provided by physician offices.

These durable medical equipment (DME) providers will help you to get set up with the therapy that your sleep doctor has prescribed. Although most people are treated with CPAP, you may alternatively be prescribed machines that deliver bilevel (or BiPAP or VPAP) or even more sophisticated settings like ASV.

These suppliers are businesses, so make certain that they provide you with good customer service. A key initial role of the equipment provider is to fit you with your first CPAP mask.

Choosing Your First CPAP Mask and Getting It Right

Selecting a CPAP mask is a really important step in beginning treatment, and overall success or failure can hinge on the decision. It is best to select a mask that fits your individual needs. You will want to take into account the anatomy of your face, including the shape of your nose and how easily you can breathe through it.

The presence of facial hair in men can influence the choice. You also want to consider if you are likely to breathe through your mouth, especially at night during sleep, as this may lead to leak if it does not resolve, sometimes with other treatments (such as septoplasty or allergy medication). If you have claustrophobia, this may also be an important factor.

In general, it is best to select the smallest mask that you can tolerate (such as nasal pillows or a triangle-shaped external nasal mask). This will reduce the amount of surface area and decrease air leaks and pressure marks on your face.

Masks are like pairs of shoes: one size does not fit all, and you should choose one based on your individual preferences. If possible, get fitted properly and even try the mask on in the store; if it doesn’t work out, try to exchange it in the first month for a replacement option.

Practice With CPAP Before Using It at Night

Once you have picked up your equipment and taken things home, you may want to initially practice with the CPAP to help yourself acclimate to it.

The first time you use CPAP may be slightly uncomfortable, and some people even suffer from insomnia if they put it on at night and can’t fall asleep right away. This can be improved by practicing a little before using it the first night. Set up the machine in another part of the house where you can be comfortable, perhaps in the living room.

At first, ease yourself into the mask itself. If you have claustrophobia, you may want to simply hold it up to your nose (or nose and mouth) with the machine off. If this makes you feel anxious, try to take slow and deep breaths.

If necessary, simply pull the mask back off. Try to extend the amount of time you hold it to your face gradually, letting the anxiety dissipate as necessary. When you are ready, apply the headgear straps that hold the mask in place. Continue to breathe slowly and deeply until you feel comfortable.

Next, you are ready to connect the mask to the tubing and CPAP machine. Once all the connections are made, turn the device on. Most often, the device starts at a lowered pressure setting and gradually increases the air pressure the longer you use it (a feature called a ramp setting). This allows you to fall asleep easily, but it will also help you to practice with it. If the pressure starts to get too high, you can reset it by turning the machine off and back on to lower it again.

Take slow and deep breaths with the mask and pressure on. You will find that the air pressure fills up your lungs and makes it easy to breathe in. Conversely, as you breathe out you may feel a little resistance. You will hear the air escaping from the exhalation ports on the mask that allow carbon dioxide to escape.

This resistance is initially a little uncomfortable, but keep at it: it gets easier. Try to focus your mind on taking full, even breaths. Keep your mouth closed. If you open your mouth with a nasal mask, you will feel the air rush out (following the path of least resistance).

Once you establish a comfortable breathing pattern, perhaps after a few minutes, focus your attention elsewhere. Do something you enjoy: watch a little television or a movie, read a book or magazine, listen to some music, or get on the Internet. Distract yourself and keep using the CPAP for 20 to 30 minutes.

This will help you to associate the CPAP with something that you enjoy doing, and you will be more relaxed when you use it at bedtime. If you need more time to adjust, extend this period or try again later. There is no rush to start using at night, but if you struggle you may need to reach out for help.

You will find that by spending a little time adjusting to the CPAP while engaged in a relaxing activity, it will be easier to use it at night. If you struggle, spend a little more time practicing during the day in the first week, as much as you need.

It can also help to go to bed 20 min to one hour later than usual during the first week or two so that you fall asleep faster with the mask on.

Most people will find that after a few days and nights of persistence, the initial adjustment to using it is eased. Although ultimately it may vary from days to weeks, hopefully, you will start to yield the benefits of treatment that you desire.

Get Help If You Struggle With Early CPAP Use

Importantly, if you run into difficulties, get help early. Prompt interventions that correct early problems will ensure that the therapy is successful for you over the long term.

Be in touch with your equipment provider or sleep physician during the initial adjustment period if you run into trouble. These providers can also remotely monitor your use to arrange an intervention if you are having problems. It may also be possible to adjust pressure settings remotely to improve comfort.

A Word From Verywell

With early support, careful mask selection, and a little practice, you can easily get used to CPAP treatment for your sleep apnea. You are not the first person to experience problems, so speak up about anything that interferes with your use. If you struggle, be vocal and get the help that you need to optimize the experience.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Brooks R. The American Association of Sleep Technologists. Top 10 most common CPAP mask problems and discomfort (& how to solve them).

  2. American Academy of Sleep Medicine. Tips for CPAP.

Additional Reading

By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.