Getting started
Adjusting to CPAP: The First 30 Days
Most people need a few weeks to get used to CPAP. Use it every night and for naps, practice while awake, use comfort settings like ramp and humidity, and fix mask problems early. Call your clinician if you are not improving, since insurers often check your usage within the first 90 days.
Week one: practice and patience
Wear the mask with the air on for 20 to 30 minutes while reading or watching TV in the evening. Getting used to the feeling while awake makes it easier to fall asleep with it.
Aim for the whole night, but if you take it off at 3 a.m., put it back on when you notice. The AASM guideline strongly recommends education before starting PAP and suggests troubleshooting support during the early period because those steps improve how much people use it.
Common early problems and fixes
Dry mouth or nose: raise humidity or tube temperature, consider a chinstrap or full face mask for mouth breathing. Water in the hose (rainout): lower humidity, raise tube temperature or use heated tubing. Red marks or sore nose bridge: loosen the straps, check the cushion size, try mask liners.
Air leaking into your eyes: the cushion is usually too large or set too high. Feeling of not getting enough air or too much air: try ramp and exhale relief first, and if it persists, tell your clinician.
Bloating and swallowed air
Some people swallow air at night (aerophagia) and wake with a bloated stomach or burping. It can ease as you settle in.
If bloating does not improve after a few weeks, tell your clinician. Pressure is sometimes the cause, and only your prescriber should change pressure settings.
Watch your data, but do not obsess
Your machine or app shows hours used, leak and events per hour (AHI). Use it to spot patterns: lots of leak after you roll over, or short nights on weekends.
Medicare requires use of 4 hours or more per night on 70% of nights during a consecutive 30 day period within the first 3 months, and many private plans use similar rules. That works out to at least 21 nights out of 30, and the DreamStation 2 even tracks this as a 21 good nights goal.
When to call your clinician
Call if you still feel very sleepy after a few weeks of regular use, if your AHI stays high, if the machine reports many central apneas, if you have persistent bloating, skin breakdown, nosebleeds or sinus pain, or if you simply cannot tolerate it.
Struggling is common and fixable. Mask changes, settings reviews and in some cases different therapy are all options, and none of them start until you speak up.
Checklist
- Practice with the mask on for 20 to 30 minutes while awake.
- Use CPAP for every sleep, including naps.
- Check your hours and leak each morning for the first two weeks.
- Track how many nights out of 30 you reach 4 hours.
- Book or confirm your follow-up visit between day 31 and day 91 if you are on Medicare.
Supplies that can help
A soft strap that supports the jaw to help keep the mouth closed, used mainly with nasal and nasal pillow masks to reduce mouth leaks.
Soft fabric liners that sit between your skin and the mask cushion to reduce skin irritation, red marks and the noisy leaks some people get from …
Tubing with a built-in heating wire that keeps humidified air warm all the way to the mask, which is the main fix for rainout (water droplets …
Salt water spray that moistens and clears the nose, a simple aid for the congestion and dryness some people get on CPAP.
A pillow with cutouts or a contoured edge so a mask and hose are not pushed out of place when you sleep on your side.
A water-based or saline gel applied inside or around the nostrils to soothe dryness and soreness from CPAP airflow.
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Frequently asked questions
How long does it take to get used to CPAP?
It varies. Many people adjust within a few weeks of nightly use, and some take longer. Practicing while awake and fixing mask problems early speeds it up.
What if I can only use CPAP for a few hours?
A few hours is better than none, so keep going and add time each week. To meet Medicare's rule you need 4 hours or more on at least 70% of nights in a 30 day stretch within the first 3 months.
Is it normal to feel worse at first?
Some people sleep lightly for a few nights while they adjust. If you feel worse after a couple of weeks, or have chest pain, shortness of breath or palpitations, contact your clinician; chest pain needs emergency care.
Should I stop CPAP if I get a cold?
Not automatically. Higher humidity and saline spray can help with congestion, and a full face mask can help if your nose is blocked. See our guide on CPAP when you are sick.
Sources
Last reviewed October 11, 2026. How we research · Report an error