Getting used to CPAP
CPAP First Week Tips: Getting Through the First Nights
The first week on CPAP is often the hardest, and the habits you form now tend to predict how well you do long term. Practice with the mask while awake, use the ramp, fit the mask while lying down with the air on, and wear it every night, including naps. Call your provider early about problems instead of giving up.
Signs
- Trouble falling asleep with the mask on
- Taking the mask off without realizing
- Feeling like you cannot breathe out against the air
- Dry mouth or nose
- Mask leaks or marks
Common causes
- New sensation
- Wearing a mask and breathing pressurized air takes getting used to.
- Mask fit not dialed in
- Many early problems such as leaks, marks and dry mouth come from fit.
- Pressure feels strong at first
- The air can feel like a lot before you are used to it.
- Early use pattern matters
- Researchers report that the pattern of CPAP use is established within the first week and predicts long term use.
Fixes to try, easiest first
Practice while awake
Wear the mask for short periods while watching TV or reading. NHLBI and the Sleep Foundation both recommend this, starting with the mask alone and then with the air on.
Use the ramp
Ramp starts the air at a low pressure and builds to your prescribed level as you fall asleep. On the AirSense 11 you can set ramp time to off, 5 to 45 minutes or Auto from the comfort menu.
Fit the mask lying down with the air on
NHLBI recommends adjusting the mask every night while lying down with the machine on.
Try exhale relief
If breathing out feels hard, comfort features such as EPR on ResMed machines or Flex on Philips lower the pressure slightly as you exhale. If you are not sure how to turn it on, ask your equipment provider.
Use humidification
If your nose or mouth gets dry, turn up humidity one step at a time.
Wear it for all sleep
Use CPAP every night, all night, and for naps. Putting the mask back on when you wake up builds the habit.
Skip naps if bedtime is a struggle
ResMed suggests that new users who struggle may find falling asleep with CPAP easier if they skip daytime naps, so they are tired at bedtime. If you do nap, wear your CPAP.
Call your provider about problems with your clinician
Do not wait weeks. If leaks, claustrophobia or discomfort are keeping you from using it, your provider can change your mask, check your settings or help with comfort features.
Call your sleep doctor or equipment provider if you cannot sleep with the mask after a few nights, if it is not getting easier after about a week, or if you feel claustrophobic or panicky. Call promptly for stomach pain or bloating, nosebleeds that will not stop, ear pain, or skin sores. Seek urgent care for chest pain or severe shortness of breath.
Supplies that can help
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.
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 …
Distilled water is what most CPAP humidifier chambers are meant to be filled with, because it leaves little or no mineral scale behind.
Salt water spray that moistens and clears the nose, a simple aid for the congestion and dryness some people get on CPAP.
Retailer links are affiliate links. We may earn a commission at no cost to you.
Mask types this applies to
Frequently asked questions
How many hours should I use CPAP the first week?
Aim to use it every time you sleep, all night. If you cannot manage a full night at first, keep putting it back on when you wake. Insurers commonly look for at least 4 hours a night.
Is it normal to take my CPAP mask off in my sleep the first week?
Yes, it is common early on. Put it back on when you notice, and tell your provider if it keeps happening, since it often points to a fit or comfort issue.
Should I nap during my first week on CPAP?
ResMed suggests new users who struggle at bedtime may do better avoiding naps so they are tired at night. If you do nap, use your CPAP.
What if the air pressure feels too strong?
Use the ramp and exhale relief features, and give yourself a few nights to adjust. If it still feels too strong, talk to your doctor. Do not change your prescribed pressure yourself.
Sources
Last reviewed October 11, 2026. How we research · Report an error