Starting CPAP is a lot like breaking in a new pair of shoes. It feels strange at first, and then, for most people, it gets easier. The first week is usually the hardest, and many people need a couple of weeks before sleeping with the mask feels natural. Here is what is common, what usually helps, and when to ask for help.

It is normal for it to feel odd

In the first few nights, many people notice:

  • The feeling of air being pushed in, and of breathing out against it
  • Being very aware of the mask and straps
  • Trouble falling asleep with the mask on
  • Waking up and finding the mask off, sometimes without remembering taking it off

These things usually ease as your body adjusts. That does not mean you have to put up with a mask that hurts or leaks. Most problems have a fix.

Common first-week problems and what usually helps

  • The air feels too strong, or it is hard to breathe out. Many machines have a ramp feature that starts at a lower pressure and rises as you fall asleep, and a comfort setting for breathing out. Please do not change your prescribed pressure on your own. If the pressure feels wrong, tell your provider. Your doctor sets it for you.
  • Dry mouth or nose, or a stuffy nose. A heated humidifier can help, and the humidity level can be adjusted. If your mouth falls open at night, tell us. A different style of mask may fit the way you breathe better.
  • Air leaks, or the mask feels too tight. Tighter is not better. Overtightening can make a mask leak and leave marks. Try adjusting the mask while lying in your usual sleep position, and ask us to look at the fit. Our guide to CPAP mask noise, leaks, and discomfort has more.
  • Feeling closed in. Practice helps (see below). So does trying a smaller or lighter mask style.
  • Red marks or sore spots. This usually points to a fit, size, or cushion problem. It is worth fixing early.

Tips that make the first week easier

  • Wear it while you are awake first. Put the mask on, with the machine running, for 15 to 30 minutes while you read or watch TV. Do this for a few days before you ask it to get you through a whole night.
  • Use it every night, and for naps. The benefits build with steady use, and the habit matters.
  • Keep a short note. Jot down what bothered you and when. It helps us and your doctor pinpoint the problem quickly.
  • Keep it clean. Daily and weekly cleaning keeps the mask sealing well and helps it last. See our CPAP cleaning guidelines.
  • Keep your follow-up appointments with your sleep doctor, including the re-evaluation your insurance requires in your first 90 days. See our guide, CPAP and Medicare: The First 90 Days.

When to ask for help

Please do not just tough it out in silence. Call us or your provider if you have pain or sores from the mask, leaks that will not go away, trouble sleeping with the mask after several nights, or a machine that is not working properly.

If you have trouble breathing that does not pass, chest pain, or other symptoms that worry you, contact your doctor right away.

How we help

Once your doctor’s office has sent us your order and sleep study, we will contact you to schedule your setup appointment with one of our PAP specialists. At that visit we help install and set up your CPAP, walk you through how it works, show you how to care for and clean it, and answer your questions about getting the most from your therapy.

Questions after setup? Call us at 800-442-6704 and we will schedule time with a PAP specialist at our La Grange or Bastrop office.

This article is general information, not medical advice. Always follow your doctor’s instructions for your therapy.