Patient guide
Getting used to CPAP: common problems and practical solutions
CPAP is the main treatment for moderate and severe obstructive sleep apnoea, and it works when used regularly. Many people find it awkward at first. Most problems are fixable with a better mask fit, humidification or pressure adjustment. This guide explains common difficulties, what helps and how to get support.
Last checked: 2026-10-03
Key facts
At a glance.
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Effective when used
CPAP keeps the airway open with gentle air pressure and is the standard treatment for moderate and severe OSA.
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Early difficulty is common
Many people have mask, comfort or noise issues in the first weeks, and early support improves long-term use.
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Adjustable
Masks, pressure ramps, humidifiers and pressure settings can all be changed.
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Use data
Machines record usage and leak, which clinicians can review to troubleshoot.
How CPAP works
A machine delivers air through a hose and mask, creating a gentle pressure that keeps the throat open during sleep. Some machines adjust pressure automatically within a range. Treatment prevents breathing pauses, reduces snoring and daytime sleepiness and may improve blood pressure. Effects depend on using it every night, for most of the night.
Common problems and what helps
| Problem | Things that may help |
|---|---|
| Mask leaks or discomfort | Refit with a different size or style; check straps are not too tight; replace worn cushions |
| Dry mouth or nose | Use the humidifier and heated tube; consider a chin strap or full face mask if mouth leaks |
| Blocked or runny nose | Increase humidification; treat allergies or congestion; discuss options with the service |
| Air pressure feels too strong | Use the ramp feature; ask the service to review pressure or change to an auto-adjusting machine |
| Claustrophobia or anxiety | Wear the mask for short periods while awake; try nasal pillows; ask about desensitisation support |
| Noise or bed partner disturbance | Check mask seals; place the machine below bed level; consider quieter models |
| Skin marks or pressure sores | Adjust fit; use mask liners; ask for a different style |
Building the habit
Start by wearing the mask while watching television or reading, to get used to the feel. Use CPAP for every sleep period, including naps, at first, so the brain adapts. Do not give up after one bad night. Aim for steady progress. Many services monitor usage over the first weeks and contact you if the numbers are low. Tell them about difficulties early, because the first month is the best predictor of long-term use.
Maintenance
Clean the mask and cushion daily, wash the hose and humidifier chamber regularly as instructed and replace filters, cushions and headgear as advised. Use distilled or cooled boiled water if recommended. Check for leaks and wear. Replacement parts may be supplied through the NHS or bought privately, depending on how your machine was obtained.
When to ask for help
Contact the sleep service if you are using the machine less than most nights, if symptoms persist despite use, if you develop chest discomfort or breathing difficulty on treatment or if you cannot tolerate the mask. They can review data, refit masks, adjust settings or consider alternatives such as a mandibular advancement device or positional therapy for suitable patients.
Travelling and equipment
CPAP machines can be taken on planes, often as hand luggage. Check airline policies and carry a letter. Use adaptors for different voltages if needed. If travelling for a long time, ask about portable machines and backup plans. Keep a record of your settings.
Frequently asked
Questions people ask.
Quick, plain-English answers to the questions we hear most.
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How long does it take to get used to CPAP?
Many people adapt within weeks, but some need adjustments and support.
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Should I use it every night?
Yes. Benefits depend on regular use, ideally throughout sleep.
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Can I use CPAP if I have a cold?
Often yes, with humidification. If you are very blocked, ask the service for advice.
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Can I buy my own machine?
Yes, but a clinician should set pressures and monitor use. Check how replacement parts and follow-up will work.
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What if I still feel sleepy?
Report it. Pressure, mask leaks or other sleep conditions may need review.
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Does CPAP cure sleep apnoea?
It controls it while in use. Weight loss and other measures may reduce the need in some people.
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Are there alternatives?
Mandibular advancement devices, positional therapy, weight management and surgery in selected cases.
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Does it need to be used for naps?
Using it for naps helps adaptation, particularly in the early weeks.
Where this comes from
Sources and checking.
This guide is for information, not medical advice.
Your GP or consultant knows your history and can tell you which parts apply to you. If your symptoms are severe, rapidly worsening, or come with red-flag features, seek urgent medical care. Figures and availability change, so treat them as a guide and confirm with the provider.
Published 2026-10-03, next review 2027-10-03.
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NICE guideline NG202, Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s (nice.org.uk)
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NHS website, Sleep apnoea and Insomnia pages (nhs.uk)
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DVLA, Assessing fitness to drive: a guide for medical professionals (gov.uk/dvla)
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General Medical Council, Good practice in prescribing and managing medicines and devices (gmc-uk.org)