Tips for common concerns when using CPAP

Continuous positive airway pressure (CPAP) is the most common treatment for Obstructive Sleep Apnea. This treatment uses a small machine that supplies a constant flow of air through a hose into a mask that the patient wears during sleep.

The most common problems experienced by CPAP users include trouble falling asleep with the mask, dry mouth and nose, and a leaky mask. These problems can often be overcome to make CPAP therapy comfortable and effective. Below are some tips for overcoming some of the more common difficulties of CPAP usage.

Trouble getting used to wearing the CPAP mask

On average, it takes three weeks to get used to wearing the CPAP mask. Wearing the mask during the day with the air pressure on can help reduce this time. Once you grow accustomed to it, get into the habit of using the device during naps and when you go to sleep at night. Persistence and good habits will make the adjustment period to CPAP therapy easier and faster.

Difficulty falling asleep

This is a very common problem experienced by many beginner CPAP users. Practice wearing the mask during the daytime to get used to it. The ramp feature on the PAP machine may also help, as it will begin by supplying air at a low pressure and gradually increase it to the prescribed level as you fall asleep. Finally, get into good sleeping habits: exercise regularly but not immediately before going to bed, avoid alcohol and caffeine at night, and go to bed at regular time and not before you are tired.


Some people experience anxiety and feelings of claustrophobia while wearing the CPAP mask for the first time. This can be overcome by becoming accustomed to the mask. First, practice holding the mask to your face with your hand. Then, practice holding the mask to your face with the hose attached to the machine while running a low pressure setting. Then, try using the CPAP machine with the mask and headgear while you are awake. Once you get comfortable with this, try falling asleep with the mask. If you are not able to overcome the feeling of claustrophobia over a prolonged period of time, talk to your CPAP equipment supplier. Switching to a nasal pillows mask may help with this problem.

Wrong style or size of a CPAP mask

Choosing the right mask for your CPAP therapy is a crucial step for successful treatment of Sleep Apnea. Work closely with your doctor and CPAP equipment supplier to choose a mask. Everyone has unique requirements and facial structures, so something what works for other people may not necessarily work for you. There are a variety of mask styles available; discuss the benefits of each one with your CPAP supplier. Try on multiple styles and sizes of masks to find the one that best suits your needs. Ask your CPAP supplier to show you how to adjust the mask and the headgear to best fit your face. In addition, keep in mind that just because you feel comfortable in a particular size of one mask, does not necessarily mean the same size will be best for you when using a different mask.

Difficulty getting used to forced air

This problem may simply be overcome by using the ramp feature on your CPAP machine. This feature starts at a low pressure and gradually increase to the prescribed pressure. This setting can be adjusted by your CPAP supplier. If this doesn’t solve the problem, you may want to switch to a different device type, such as bi-level positive airway pressure (BiPAP) or a variable positive airway pressure (VPAP) machine. These devices automatically reduce the air pressure as you exhale, making it easier to breathe with the mask on.

Stuffy or dry nose, dry mouth

Use a CPAP machine with a heated humidifier to help with a dry or stuffy nose. You may also want to use a nasal saline spray before bedtime to cope with this problem. A leaky mask can cause a dry nose, so make sure your mask fits well. If the problem persists, your therapist may prescribe a nasal steroid spray.

CPAP users who breathe through their mouth at night may wake up with a dry mouth. Using a chin strap with a nasal mask can help to keep your mouth closed through the night. A full-face mask that covers both the nose and the mouth can also prevent the mouth from drying out.

Skin or eye irritation due to a leaky mask

A leaky mask can lead to skin irritation. If the air is leaking towards your eyes, it can cause them to become dry or teary, and will inhibit successful CPAP therapy. Sometimes simply repositioning the mask or adjusting the straps on the headgear to get a better fit can solve this problem. The mask cushion should not sit too high on the bridge of your nose, as this can direct the air into your eyes. If you cannot fix the leak with these adjustments, you may need to ask your CPAP supplier for a different size or style of mask, such as a nasal pillows or a mask with an inflatable cushion.

Pressure sores

A proper-fitting mask should not leave marks on your skin that last for longer than an hour. However, some masks can cause pressure sores, especially on the bridge of the nose. Make sure your straps are not too tight and try using extra padding or a bandage over problem spots. If simple adjustments to the mask and headgear do not help, you may need a different mask that better fits you. Masks with soft silicone padding are available and should help prevent the development of pressure sores.


Most modern CPAP machines and masks are designed to be almost completely silent. If your device is noisy, check that it is set up correctly, the filter is clean, and the machine’s air intake is unobstructed. You may want your CPAP supplier to check that your machine is working properly. If there are no problems with your equipment but the noise continues to be bothersome, try wearing earplugs or masking the sound of the machine with relaxing ambient noise.

Removing the mask at night

Sometimes you may wake up and realize that you are no longer wearing the mask. You may have removed it by accident while moving in your sleep. Using a chin-strap with your mask can help secure it on your face throughout the night. Switching to a full-face mask can also help overcome this problem.

In other cases, you may be removing the mask in your sleep due to a stuffy nose. Make sure your mask fits properly and use a CPAP machine with a heated humidifier to prevent this. If you still find yourself removing the mask during the night, you may want to consider setting an alarm for sometime during the night so that you can wake up and re-secure your mask.

Better sleep equals better life

Poor sleep negatively affects health, brain function and overall quality of life. Assistive sleeping devices help to provide a positive outlook and allow the body to naturally heal during sleep.
If you are suffering with poor sleep or your CPAP therapy is inadequate, we are here to help.

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