CPAP for Beginners: Week-to-Week Survival Guide to Your First 90 Days

Request a prescription for an auto-CPAP machine

What to try: Ask your doctor if you can use an APAP machine that automatically adjusts pressure based on your breathing.

When to try it: Bring this up when you're first discussing therapy options with your doctor. If you already have a fixed-pressure CPAP prescription, check in with your doctor before buying a machine.

Why it helps: APAPs provide just enough pressure to keep your airway open at all times, mimicking a natural breathing pattern and making it easier to breathe comfortably.

Turn on expiratory pressure relief (EPR) for easier breathing

What to try: Enable exploratory pressure relief in your CPAP settings and choose a comfort level (usually 1–3) based on how much you want the pressure to decrease when you breathe out.

When to try it: You can use EPR all the time, but it’s especially important to turn it on before your first therapy session.

Why it helps: EPR reduces your CPAP pressure when you exhale, making it easier to breathe out and easing the feeling of “choking on air.” 

Try a V-Com device to make exhaling feel easier

What to try: Add a V-Com comfort adapter to your CPAP setup. This small, lightweight accessory attaches between your mask and hose to soften the airflow, especially during exhalation.

When to try it: If you’re feeling overwhelmed by pressure, try using the V-com starting on your first night of therapy. If you continue to struggle, you can keep using this device for long term.

Why it helps: The V-Com reduces the force of incoming air when you exhale, making it easier to breathe naturally. A clinical trial found that people who were just starting CPAP therapy and used the V-Com were more likely to meet their 90-day compliance goals.

Talk to your doctor about adjusting your pressure if you’re struggling

What to try: If your CPAP feels too strong and you’re still struggling to adjust after weeks of practice, ask your provider about lowering your pressure setting.

When to try it: Consider this if you’ve been trying to adjust to therapy for a few weeks and the pressure is still so uncomfortable that you're thinking about quitting CPAP altogether.

Why it helps: A slightly lower  CPAP pressure can ease your discomfort without compromising the benefits of your therapy. A small change in air pressure is better than not doing therapy at all. Your doctor may not agree to lower your therapy pressure, but it’s worth bringing up your concerns.

Choose a low-profile mask with fewer pressure points

What to try: Start with a nasal pillow mask, nasal cradle mask, or under-the-nose full face mask that seals under the nostrils instead of covering your whole nose or face.

When to try it: Right from the beginning if you’re worried about comfort or feeling claustrophobic.

Why it helps: Low-profile masks touch less of your face and cause less pressure, making them easier to adjust to—especially for sensitive or first-time users.

Find CPAP gear that works for your sleep style

What to try: Match your mask to your sleeping habits—like nasal pillow masks for side sleepers, masks with a shallow profile for stomach sleepers, or top-of-head hose masks for active sleepers. Add accessories like a CPAP pillow or hose hanger to reduce mask movement.

When to try it: If you toss and turn or feel like your mask keeps slipping out of place overnight.

Why it helps: Gear designed for your sleep style helps your mask stay in place and reduces frustrating leaks and pressure shifts that interrupt sleep.

Don’t hesitate to try a new mask if your current one isn’t working

What to try: Buy your mask from a seller with a 30-day Mask Fit Guarantee so you can try different styles risk-free.

When to try it: If you’ve been struggling for at least a week and other solutions and adjustments aren’t helping.

Why it helps: Mask comfort can make or break your CPAP success. Swap sooner rather than later to find a mask that fits you, not just your prescription.

Start by wearing your mask for short periods during the day

What to try: Wear your CPAP mask for 15-30 minutes, a couple times a day, while reading a book, watching TV, or doing some other activity you enjoy. 

When to try it: Start this on day 1 and keep doing it at least throughout the first couple of weeks or anytime you're struggling to adjust to a new mask.

Why it helps: Wearing the mask daily helps you get used to the feeling of having something on your face. Distracting yourself with fun daily tasks can take your mind off of feeling anxious or claustrophobic, and creates a positive association with CPAP thera.

Introduce your CPAP mask during naps before transitioning to nighttime

What to try: Take short naps with your CPAP mask on and your machine turned off. Once you’re getting comfortable with this, add your machine while you nap.

When to try it: Start this within the first 1-2 days of using your CPAP mask. Continue doing it until you’re able to fall asleep easily with your CPAP mask on.

Why it helps: People can get very anxious about their CPAP mask, keeping them awake and making them miss out on too much sleep. It creates a cycle where you want to go to sleep, but you can’t relax enough to drift off. Practicing during naptime is easier because missing out on a quick nap is a lot less stressful, so it’s easier to relax and actually enjoy some rest.

Wear your mask while you’re relaxing before bed

What to try: Wear your CPAP mask by itself for at least 30 minutes before going to sleep, ideally while you’re scrolling through your phone, watching TV, reading a book, or meditating.

When to try it: Start this on the first night after getting your CPAP mask. Continue doing it even after you start falling asleep with your mask on.

Why it helps: Wearing the mask while you’re relaxing before bed helps you adjust to the feeling of wearing something on your face and trains your brain to associate your CPAP mask with your nightly routine.

Sleep with your mask by itself before adding your CPAP machine

What to try: Try sleeping with your mask on for the first 1-2 hours of the night. Once you can do that, extend that time by another hour. Continue this until you can comfortably fall asleep and stay asleep for at least 3-4 hours.

When to try it: You should start wearing your CPAP mask to bed by night 2 or 3. This slow and steady method may be unnecessary for some people, but it can be very helpful if you’re struggling.

Why it helps: The biggest hurdle for CPAP beginners is usually getting used to the mask. Creating realistic goals and taking time to acclimate to your mask, while still carving out some time to sleep without it, can help you avoid feeling frustrated. 

Add your CPAP machine to naptime to adjust to the feeling of PAP therapy

What to try: Start adding your CPAP machine into your routine by sleeping with it during short naps for 30-60 minutes. 

When to try it: If you’re adjusting well to your CPAP mask, add your machine by day 3 or 4. If you need more time to adjust, wait until day 5 or 6. 

Why it helps: This is a great way to bridge the gap between acclimating to your CPAP mask and transitioning into CPAP therapy. This is a low-stakes way to get comfortable with therapy, without missing out on too much sleep if it doesn’t go well. 

Slowly work your way up to sleeping with your CPAP full time

What to try: Make a goal to use your CPAP machine for the first 1-2 hours each night. Then take it off if you need to and sleep normally. Once you can do that, start adding another 30 minutes of therapy until you’ve worked up to a full night of CPAP.

When to try it: If you’re adjusting well to your CPAP mask, add your machine by night 3 or 4. If you need more time to adjust, wait until night 5 or 6.

Why it helps: Going from zero to a full night of therapy too quickly is a recipe for quitting. Gradually introducing CPAP therapy gives your body and mind time to adapt, so you can build sustainable sleep habits without getting burnt out.

 Consider taking a short break if you feel overwhelmed

What to try: Take a night off from CPAP if you’re feeling so frustrated that you’re ready to give up altogether. Skipping one night of CPAP won’t undo your progress—but it’s important to avoid skipping multiple days in a row.

When to try it: Use this approach when you're feeling emotionally or physically overwhelmed and need a break to reset your mindset.

Why it helps: Taking a planned break can give you space to breathe (pun intended) and help prevent burnout. For some people, the ability to step back makes it easier to stick with therapy long-term

Aim for consistency, not perfection

What to try: Focus on building a habit of regular CPAP use, even if it’s not perfect. If you miss a night, just pick it back up the next day.

When to try it: After you’ve gotten through the first week or two of therapy and have started to develop a steady CPAP routine.

Why it helps: Research shows that users who are consistent by weeks 2–3 are far more likely to succeed long-term. Skipping too many nights early on can make it harder to feel the benefits or stick with the routine.

Use your humidifier to stop dryness and sore throat

What to try: Set your CPAP humidifier to level 3 and gradually increase the humidity until you no longer feel dry or congested. If the air still feels dry, add a heated hose to boost moisture and prevent condensation buildup and gurgling from your CPAP machine (aka “CPAP rainout”).

When to try it: Right away—humidification should always be part of your CPAP routine from night one.

Why it helps: Heated humidifiers add moisture to the air, helping to soothe dry throat, reduce nasal irritation, and make therapy feel more natural. A heated hose helps maintain consistent humidity and temperature throughout the night, especially in cooler rooms or drier climates

Add padded mask accessories to reduce skin irritation

What to try: Use mask liners, strap covers, or gel pads to create a soft barrier between your skin and your CPAP equipment. These are especially helpful if you’re waking up with red marks, sore spots, or discomfort on your cheeks or nose bridge.

When to try it: As soon as you notice skin irritation or pressure marks, especially within the first couple of weeks of therapy.

Why it helps: Soft-touch padding reduces friction and pressure that can lead to skin breakdown. It also makes your mask more comfortable, especially while your skin adjusts to nightly wear.

Keep your mask clean to prevent breakouts and rashes

What to try: Clean your mask daily using CPAP wipes or mild soap and warm water. Give it a deep clean once a week using a gentle detergent. Be sure to rinse thoroughly and let it dry completely before the next use.

When to try it: Every single day—especially if you have oily or sensitive skin.

Why it helps: Skin oils, sweat, and bacteria can build up quickly and irritate your skin or clog your pores. A clean mask helps prevent breakouts, rashes, and even mask leaks by keeping the seal clean and intact.

Stop air leaks to prevent dry mouth

What to try: Use your machine's Mask Fit Test to check your CPAP mask for air leaks before going to bed. After you wake up, you can check your nightly therapy data on your machine or companion app for your leak rate. If you are leaking more than 20 liters per minute, you’re leaking too much air out of your mouth or mask. 

When to try it: You should check your therapy data for air leaks after every therapy session. Run the Mask Fit Test if you've adjusted your mask fit, changed your mask parts, or are noticing signs of an air leak, like a dry mouth, sore throat, extra noises coming from the mask seal, etc.            

Why it helps: Skin oils, sweat, and bacteria can build up quickly and irritate your skin or clog your pores. A clean mask helps prevent mask leaks, breakouts, rashes, and even mask leaks by keeping the seal clean and intact.

Check daily for air leakage above 20 LPM

What to try: Use your CPAP machine’s built-in mask fit feature to check for air leaks before you go to sleep. Review your nightly therapy data each morning via your machine display or companion app. Specifically look for anything over 20 LPM.

When to try it: You can check for mask leaks every night when putting on your mask, especially if you’re new to therapy or trying out a new mask or cushion size. And check your leak rate after every therapy session.

Why it helps: Sometimes you can tell your mask is leaking air by the noise it produces or the feeling it creates by having air flowing toward your eyes, around your nose, or across your cheeks. But sometimes those signs aren’t as obvious, and you don’t know you have a problem until the leaks begin to affect your therapy results. Checking for air leaks daily helps you identify and fix problems before they affect your sleep health. 

Keep your mouth closed when using a nasal mask

What to try: Use a chinstrap or CPAP mouth tape to prevent air from escaping through your mouth while you’re using a nasal mask. If leaks continue, consider switching to a full face mask.

When to try it: If your therapy report shows a leak rate over 20 LPM, or if you wake up with a dry mouth despite using a humidifier.

Why it helps: Mouth leaks allow air (and moisture) to escape, drying out your throat and reducing the effectiveness of therapy. Keeping your mouth closed ensures proper pressure and hydration.

Try to adjust your headgear to create a stronger seal

What to try: Try repositioning your CPAP cushion and refitting your mask straps to improve your seal stability. Avoid overtightening your mask, as this can cause air leaks as well.

When to try it: Try this if you’re waking up with dryness or sore throat and your therapy data shows signs of air leaks over 20 LPM.

Why it helps: When air leaks out from under your seal, it limits the effectiveness of your therapy and allows moisture to escape, drying out your mouth and nose. A proper seal keeps your pressure and humidity levels right where they need to be.

Try a different cushion size to stop air leak discomfort

What to try: Switch out your current CPAP cushion for a different size. Be sure to check out your mask’s sizing guide and test out all of your options for cushion sizing. 

When to try it: Do this if adjusting your mask fit has not stopped the air leaks.

Why it helps: When air leaks out from under your seal, it limits the effectiveness of your therapy and allow moisture to escape, drying out your mouth and nose. A proper seal keeps your pressure and humidity levels right where they need to be. 

Invest in comfort accessories to accommodate your sleeping preferences

What to try: Choose comfort add-ons like CPAP pillows or hose holders based on how you sleep. Side sleepers will enjoy using a CPAP pillow with cutouts to prevent mask shifting. If you’re an active sleeper, a hose hanger may reduce tugging and pulling on your mask each time you move.

When to try it: Start exploring accessories once you’ve identified what’s disrupting your comfort, whether it’s mask shifting, pressure, or noise.

Why it helps: These small upgrades make therapy feel more natural and less disruptive. Tailoring your setup to your personal sleep style can reduce irritation, leaks, and nighttime wakeups.

Start therapy off with a consistent bedtime routine

What to try: Build a calming nighttime routine. Wash your face, preheat your humidifier water with warm-up mode, and turn on your CPAP machine for at least at 15 minutes before bed. Spend some time unwinding by reading, watching TV, journaling, meditating, or listening to calming music. If you can, wear your mask as you do this.

When to try it: Every night, starting from your first night wearing your CPAP mask.

Why it helps: Our brains respond well to consistency. A bedtime routine helps signal to your body that it’s time for rest, which can ease the transition into CPAP and make therapy part of your nightly rhythm.

Use sound therapy to distract from noise and anxiety

What to try: Play soothing or distracting sounds like white noise, nature sounds, calming music, audiobooks, or guided meditations to help you relax before and during therapy. You can also use a sleep app, such as SleepSpace, to wind down and track your routines. 

When to try it: Start sound therapy on night 1, as part of your wind-down routine, and continue it as you fall asleep with your CPAP running.

Why it helps: While most modern CPAP machines are quiet, the airflow can still feel loud if you’re a light sleeper or anxious. Adding comforting audio helps drown out CPAP sounds and can shift your focus away from discomfort or restlessness.

Set Ramp to at least 15 minutes to help you drift off to sleep

What to try: Use your CPAP machine’s Ramp feature to start therapy at a lower pressure. If your machine supports AutoRamp, enable it so pressure only increases after you’ve fallen asleep. Otherwise, set a manual Ramp time for up to 45 minutes, depending on how long it takes to fall asleep.

When to try it: Set this up before your very first night of using your machine, and adjust as needed.

Why it helps: The Ramp feature makes it easier to fall asleep by gradually increasing pressure instead of delivering full airflow right away. It gives your body time to relax into sleep before therapy fully kicks in.

Avoid masks that are easy to take off

What to try: Choose a mask that doesn't use magnetic clips or stretchy headbands that come off too easily. Some brands offer optional clip replacements if your mask came with magnets.

When to try it: If you keep removing your mask in the middle of the night and aren’t sure why.

Why it helps: Quick-release features are convenient, but they also make it way too easy to remove your mask in your sleep without even waking up. Choosing something a little less user-friendly will, at the very least, make you work for it a little more when you make a midnight jailbreak from your CPAP mask. 

Wearing soft gloves can reduce your finger dexterity needed to release your headgear

What to try: Try sleeping with soft gloves or light mittens to make it harder to undo your headgear straps or clips during the night.

When to try it: If you regularly wake up without your mask and don’t remember taking it off.

Why it helps: Adding mild friction makes it harder for your subconscious brain to remove the mask, helping retrain your body to keep it on.

Choose a minimalist mask that doesn't feel like it confines you

What to try: Go for a lightweight mask with a low-profile design—like nasal pillows or under-the-nose masks—that have fewer facial touchpoints.

When to try it: If you find your current mask uncomfortable or irritating during sleep.

Why it helps: The more natural your mask feels, the less likely it is to trigger discomfort or frustration that causes you to pull it off without realizing.

Keep your CPAP equipment clean to limit wear

What to try: Wipe your mask cushion daily with a CPAP wipe or a damp cloth and mild soap. Once a week, wash your mask, headgear, and tubing in warm water with fragrance-free soap, then let everything air dry completely. 

When to try it: Clean your gear daily and deep-clean weekly, starting from your first night.

Why it helps: Clean equipment is less likely to cause discomfort, lasts longer, and seals better. Dirt and oil buildup can break down your mask seal, cause rubbing and irritation, and even lead to air leaks that reduce your therapy effectiveness.

Use your machine’s companion app

What to try: Set up your CPAP machine and then download the machine’s companion app—like myAir (Resmed machines) or DreamMapper (React Health machines)—and follow the steps to connect it to your device.

When to try it: Set it up on day one of therapy, before you use your machine for the first time, so you can begin tracking your progress right away.

Why it helps: Companion apps help you monitor important metrics like usage hours, AHI (Apnea-Hypopnea Index), and mask fit. They also offer coaching, reminders, and reports you can share with your doctor. Seeing your results in real time can boost motivation and help catch issues early

Stay up-to-date on your therapy progress to stay motivated and catch issues before they affect your sleep health

What to try: Monitor both your machine’s data and your sleep apnea symptoms, then compare that information to how you were feeling before and after starting CPAP therapy. 

When to try it: Do a quick self-evaluation every week to see if you feel like you're seeing improvements in your sleep apnea symptoms. This is especially important when you're trying to survive the first 90 days of therapy. 

Why it helps: Consistent progress means your therapy is working. If your numbers or symptoms aren’t improving, it might be time to revisit your mask fit, pressure settings, or comfort features with your doctor or equipment supplier.

Use alternative sleep apnea solutions if you need to take a CPAP break

What to try: If you take a night off from CPAP, try sleeping on your side or at a slight incline. Use a wedge pillow or adjustable bed to raise your head 30 to 45 degrees. Avoid sleeping flat on your back, which increases the chance of airway collapse.

When to try it: Do this on nights when you feel too overwhelmed to use your CPAP,  need a short break to reset your routine, or even if you're traveling and left your CPAP machine at home.

Why it helps: While nothing replaces CPAP, positional therapy can reduce apnea events for some people, especially with mild OSA. These strategies minimize the effect that gravity has on your obstructive sleep apnea, and offer a safer alternative when you’re off your machine.

Be open to making changes to your therapy as time goes on

What to try: If something doesn’t feel right—like mask discomfort, noisy airflow, or condensation in your tubing—look for solutions, like comfort accessories, alternate mask styles, or new machine features that better fit your needs.

When to try it: As soon as something starts to affect your sleep or comfort, even if you’ve already been using CPAP for a while.

Why it helps: Therapy isn’t one-size-fits-all. The sooner you make small adjustments, the less likely you are to get discouraged. Being flexible and proactive keeps you moving forward on your path to better sleep.

Stay on top of your CPAP replacement schedule

What to try: Follow a regular replacement schedule—mask cushions every 1–3 months, headgear every 6 months, and tubing every 3–6 months. Watch for signs of wear like reduced pressure, noisy airflow, or a loose seal.

When to try it: Set reminders based on your equipment age, or replace parts as soon as you notice performance changes.

Why it helps: Worn parts can reduce comfort, increase air leaks, or interfere with pressure delivery. Replacing them on schedule keeps your therapy working as it should and prevents bigger issues down the road

Breathing Style

Nose breathing: Most nose breathers can wear any mask, but nasal pillows are a great place to start. If your mouth tends to fall open during sleep, a chinstrap can help prevent air leaks. 

Mouth breathing: People who breathe through the mouth need a full face mask that covers the mouth and nose. Start by looking for a low-profile shape like a hybrid mask that seals under the nose.

Sleeping Habits

Sleeping Position: Back sleepers can use any mask. Side and stomach sleepers should try an under-the-nose cushion and soft, thin, flexible headgear. Belly sleeping is easier with a slimmer hose connection and an adaptive, full swivel hose connection that you can easily reposition. 

Activity Level: Active sleepers need an adaptive, flexible seal that moves with you. Look for a 360° top of head hose connection to eliminate hose tangling. If you prefer a traditional hose connection, look for a compact mask with a short tube to create a little extra room for movement.

Sensitivity to Noise: Modern CPAP masks all feature sound muffling technology, but some are better than others. If you or your partner are light sleepers, consider a nasal pillow mask, as those are often the quietest of all the mask types.

Bedtime Routine: If you like to read, watch TV, or wear glasses in bed, go for a mask with a small footprint and a clear line of sight. For glasses, look for designs that sit low on the face and don’t press on your cheeks or the spot just over your ears.

Special Considerations

Claustrophobia & Anxiety: If CPAP makes you feel anxious or claustrophobic, find a mask that covers as little of your face as possible, such as a nasal pillow or under-the-nose full face mask.

Skin Sensitivity: Our CPAP masks are latex-free, but if silicone irritates your skin, try cushions made from memory foam, gel, or soft cloth. Also, keep an eye out for masks with a fabric-wrapped frame.

Dexterity Limitations: If you have limited movement in your hands or arms due to arthritis, injury, or other conditions, look for a mask that’s easy to put on, take off, assemble, and reassemble. Avoid masks that require reaching above or behind your head or assembling small pieces.

Physical Features: Facial hair can make it hard to get a good seal around your mouth. If you have a beard or mustache, a nasal pillow or hybrid mask may fit better. People with long hair may prefer headgear that allows them to pull their hair through the back for a more comfortable fit.

Upkeep

Maintenance Requirements: Masks with fewer pieces are often easier and cheaper to maintain, but sometimes these minimal masks have unique designs that require a little extra effort while cleaning or reassembling.

Skin Sensitivity: Our CPAP masks are latex-free, but if silicone irritates your skin, try cushions made from memory foam, gel, or soft cloth. Also, keep an eye out for masks with a fabric-wrapped frame.

Purchasing Options

Sizing Needs: Many masks offer headgear, cushions, and sometimes even frames in sizes small to large. If you’re unsure of your cushion size, try a fit pack that includes multiple sizes. Some masks also offer smaller “For Her” sizes, which may include extra-small options.

Cost: Mask price depends on materials and replacement schedules. Higher quality masks last longer, but cost more. This also differs depending on mask type—nasal pillows are replaced every 2-4 weeks, while a traditional over-the-nose cushion can last over 3 months.