Still Tired After CPAP: Why Do I Feel Worse After Using My CPAP Equipment?

💡 Key Takeaways

• Initial Fatigue is Common: It's not unusual to feel more tired after starting CPAP therapy. Consistency and patience are key to seeing improvements.
• Adjustment Period: Getting used to the mask and the machine takes time. Initially, you might experience issues like mask leaks, claustrophobia, or dry mouth, which sabotage your therapy.
• Compliance Matters: Many people quit CPAP therapy due to initial discomfort. To get the most out of your treatment, practice wearing your mask and keep your equipment clean.
• Try CPAP Accessories: Sometimes, the secret to getting the most out of therapy is a mask liner, heated hose, fabric frame wraps, or a good CPAP pillow.
• Focus on Long-Term Benefits: Despite the initial challenges, many users report renewed energy and focus once they've adjusted to their CPAP machine.

If you’re not used to sleeping with CPAP equipment, adding new devices to your sleep routine can be a big adjustment—and you may be surprised that you feel more tired after starting CPAP treatment. Even if you’re no longer experiencing classic sleep apnea symptoms after starting sleep therapy, you may be, much to your disappointment, still tired after CPAP.

It might be encouraging to know, though, that it’s common for people with sleep apnea to feel the same (or even worse) right after starting CPAP therapy. You may be wondering, “How long does CPAP take to work?” The short answer is that you are more likely to see results (such as feeling less fatigued) when you prioritize consistency and patience, but it’s different for everyone.

Some of the most important things you can do to ensure successful CPAP treatment is being consistent, building a good support system, and ensuring you like and trust your physician or sleep specialist. It may take a few months, but the good news is that when your CPAP treatment does start working for you, you will feel less tired and better than you have in awhile.

One study showed it can take three weeks for daytime sleepiness to improve, but some may still feel tired after CPAP for months. When we say CPAP therapy takes time, we don’t just mean a few days or weeks, so make your best effort to adjust to sleep therapy.

When beginning CPAP treatment, you may need to become accustomed to:

• The feeling of pressure on your face and throat
• Changing your sleep position to accommodate the mask
• The new noise in the room, stemming from the CPAP equipment
• Refraining from taking the CPAP mask off overnight

Of all of these, many agree the most difficult to overcome is removing the mask while sleeping. Obviously, if the mask isn’t on, it can’t make a difference in how you feel—and you may even feel worse.

Other people may feel worse after using their CPAP equipment due to:

• CPAP mask leaks
• Claustrophobia
• Waking up with a dry mouth, nose, or gas from swallowed air (this is a normal occurrence called aerophagia)
• Issues with CPAP air pressure, which can lead to a high apnea-hypopnea index (AHI)

You may be asking yourself, “Is it normal to be tired after starting CPAP?” Yes, and many new users find that it takes months to start feeling the benefits of uninterrupted sleep. If your sleep schedule has been off for a long time, sleeping well isn’t something you can change overnight (no pun intended).

On the other hand, if your sleep quality wasn’t poor before beginning CPAP treatment, you may not notice a big difference once you start sleep therapy. Keep in mind that some people with sleep apnea may wake up 15 to 20 times per hour while others may only wake up a few times per hour. If you have a very mild form of sleep apnea and have been largely asymptomatic, you may not notice any improvement throughout treatment. However, leaving your sleep apnea untreated can lead to severe cardiovascular and metabolic conditions as well as other symptoms like daytime sleepiness, frequent overnight urination, teeth grinding, short-term memory issues, and poor focus or concentration.

There’s no denying that sleep apnea treatment can cause a person to experience certain side effects, and chances are, it’s not going to be comfortable in the beginning—your body may simply need time to adjust to CPAP treatment.

One study shows between one-third to over 50 percent of CPAP wearers either quit sleep therapy or never even fill their prescription (partially because they're still tired after CPAP), but there are several things you can do to make your CPAP experience more comfortable, including:

• Practice wearing your mask during the day
• Limit your evening naps, which may interfere with nighttime sleep
• Lower your caffeine intake
• Use a decongestant for nasal relief
• Routinely clean your CPAP equipment

As with most health conditions, sleep apnea doesn’t resolve itself without treatment, and also like most health conditions, sleep apnea conditions can get worse without treatment.

One way to get the most out of your therapy is to set goals for yourself. To start, aim to wear your mask for a certain amount of hours, incrementally increasing the length of time it’s worn each night. Though it may help to slowly acclimate to wearing your CPAP mask, it’s critical to work your way up to wearing it all night long, since you won’t reap the benefits of the last stage of sleep, rapid eye movement (or REM), if you’ve prematurely removed your mask.

As time goes on, you will discover which sleeping positions feel most comfortable, and though getting used to your CPAP therapy may seem like a challenge at first, don’t give up: CPAP is proven to work.

Consider joining an in-person or online support group, or even engaging in comments on blog posts on CPAP.com. (We have a free sleep apnea forum, too, where you can ask questions, get insight, and meet other people with sleep apnea.) It can also help to talk to your partner about sleep apnea, as they can be a helpful source of encouragement and support.

Reminding yourself of the big picture and your “why” for continuing CPAP therapy is a great way to stay encouraged; surrounding yourself with a strong support system matters: studies suggest that some who started CPAP therapy eventually reported symptoms of depression, causing them to give up on CPAP.

If you feel depressed after starting CPAP, share your symptoms with your physician to determine if you could benefit from working with a therapist, as well. A therapist may not only help stave off the symptoms of depression but also help you maintain a more positive outlook on life, increasing the likelihood of sleep therapy compliance.

To achieve continuous CPAP compliance, here are a few ways you can practice getting used to your CPAP machine and mask:

• If you’re having a hard time getting used to the mask, try wearing it while you’re awake
• If you’re just watching TV or reading, put on your mask and turn the machine on. The more you experience the air pressure in the CPAP mask, the faster you’ll get used to it
• Always make sure your machine is switched on while wearing your mask
• Try the ramp feature (available on many devices), which gradually increases pressurized air instead of starting your night at full pressure

Getting used to sleeping with CPAP therapy can be difficult, but it does get easier with time. If you're still tired after CPAP therapy, it's worth investigating solutions that may help. There are plenty of products designed specifically for providing comfort for CPAP users, which can help you limit or eliminate CPAP fatigue. If you don’t know which comfort items could serve you best, we can help you identify nearly-personalized products depending on the type of CPAP issue you’re experiencing.

Top CPAP comfort items—specifically for those who feel worse after starting CPAP treatment—that can enhance your CPAP experience include:

• CPAP Pillow With Specialized Cut-Outs
• Sound Machine (Includes 10 Settings)
• Gravity-Weighted Sleep Mask
• Aromatherapy Starter Pack
• All-In-One Saline Spray

Each of these items are designed to help you fall asleep and stay asleep, giving your body the rest it needs so you can wake up feeling refreshed. Be aware that you may experience some minor CPAP side effects when starting therapy, which is normal and may require adjustments to your mask size or pressure settings, the use of nasal congestion products, or the addition of comfort items like a heated humidifier. Never adjust your CPAP settings or cease sleep therapy without consulting your sleep care physician first.

Open communication with your doctor about your CPAP therapy experience is so important, especially when you first start out. Each individual is different, so be sure to let your doctor know how your experience is going and don’t hesitate to communicate any issues or concerns you have.

Some issues—including mask leaks, incorrect air pressure, and mask discomfort—can have relatively simple solutions. Open communication with your physician could be the difference between feeling better sooner rather than later.

Research indicates that the more you actively participate in your treatment, the better your outcomes will be. CPAP therapy is unique in that it requires you, the CPAP wearer, to actively participate in your own treatment which can indirectly control your health outcome and help prevent you from being still tired after CPAP.

Some surgical interventions mean you’re symptom-free after the initial postoperative recovery, but CPAP treatment requires you to utilize your CPAP equipment right after diagnosis and to keep at it every night. Many say that after becoming adjusted to their CPAP machine, the renewed energy and invigorating focus they have far outweighs any minor discomfort they experienced.

If you’re still tired after CPAP, implementing these solutions and products into your sleep care routine can make all the difference.

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1. Weaver, Terri E. et al. Relationship Between Hours of CPAP Use and Achieving Normal Levels of Sleepiness and Daily Functioning Published in the medical journal Sleep in 2007: 711–719. Accessed on October 18, 2018..