New to CPAP? What to Expect in the First 30 Days

August 17, 2026

A woman in bed wearing a sleep apnea oxygen mask and CPAP device

Continuous positive airway pressure (CPAP) is one of the most effective treatments for sleep apnea, but sleeping with a mask and pressurized air takes some getting used to, says Kuei-Mei Wang, MSN, APRN, AGNP-C, a board-certified nurse practitioner in the Division of Sleep Medicine at University Hospitals.

“Most people who stop using CPAP discontinue it because small issues aren’t addressed early,” says Wang. “But even minor adjustments can make a big difference.” Knowing what to expect and how to handle common challenges can help you adjust to CPAP faster and start experiencing the benefits sooner.

How Does CPAP Help With Sleep Apnea

Sleep apnea is a common but serious condition that causes your airways to narrow or collapse, resulting in pauses in breathing that disrupt sleep. Sleep apnea can lead to complications like:

A CPAP system pumps a powerful stream of air through a tube and into a mask that covers your nose and/or mouth. The air goes into your airways to help keep them open, so your breathing stays steadier while you sleep.

Common CPAP Challenges and How to Handle Them

Even if the CPAP machine or mask feels uncomfortable at first, it doesn’t mean the therapy isn’t a good option for you. Small changes to how you’re managing your machine, mask or bedtime routine can improve comfort.

Wang recommends using your CPAP machine anytime you go to sleep, including when you nap (unless your healthcare provider advises you otherwise). She adds that putting the mask on before you get too sleepy can also give you time to relax and get comfortable wearing it, which may help you ease into sleep better.

For many new CPAP therapy patients, the mask is the biggest hurdle. Common challenges run the gamut from difficulty getting the mask to fit right to feeling claustrophobic when wearing it. But most mask problems can be solved with a little troubleshooting and some minor adjustments.

Wang shares six of the most common mask challenges her patients encounter and her tips for solving them:

Mask leaks: “Refit the mask to your face while lying down and keep the straps snug,” she says. You may need to try different mask sizes, styles or liners. The headgear may also need to be replaced, especially if the straps don’t fit properly.
Dry mouth: “Check the humidifier settings and mask seal,” says Wang. Increasing the humidity level, using a chin strap to keep your mouth closed or switching to a full-face mask can help reduce dryness.
Nasal dryness or congestion: Wang recommends using the CPAP’s heated humidifier to help relieve a dry or stuffy nose. Boosting the humidity level or using a saline nasal product at bedtime may also help. She notes that it’s important to keep the equipment clean too, since that can prevent irritation that might make symptoms worse.
Pressure intolerance: “If the air pressure feels uncomfortable, whether it seems too strong or not quite right, contact your sleep health provider,” says Wang. “Pressure settings can often be adjusted to improve comfort and make therapy easier to tolerate.” If you don't like the sensation of pressurized air through the mask, try using your CPAP machine's ramp feature, which starts at a lower pressure and gradually increases as you fall asleep. Wang also recommends wearing the mask while awake, such as while watching TV or reading a book, to help you become more comfortable with the sensation.
Skin irritation: Keeping your mask clean, making sure it’s not too tight and using a mask liner or cushion can help prevent irritation and skin infections, says Wang. You may also need to try a different mask, since a poor fit or air leak can irritate the skin.
Anxiety or claustrophobia: Gradual exposure to the mask can help make you feel less anxious or claustrophobic about wearing it. Try putting it on for short periods while you’re awake and breathing calmly, suggests Wang. You might start with the machine off to get used to the feel of the mask, or turn it on and distract yourself by listening to a podcast or playing a game on your phone. If these desensitization techniques don’t help, a smaller mask that covers less of your face may feel less confining.

If your CPAP machine or mask isn’t working for you, let a member of your sleep team know. Addressing problems early can make it easier to stick with CPAP therapy and get the full benefits of the treatment.

Early Signs CPAP Therapy Is Starting to Work

By the end of the first month, most patients get used to sleeping with the CPAP machine and mask, says Wang. Early signs that the therapy is working may include:

More restful sleep.
Better focus, memory and mood.
Less snoring.
More daytime energy.
Fewer or no morning headaches.

“Don’t aim for perfection,” says Wang. “You don’t have to be perfect at using your CPAP right away.” It’s better to focus on steady progress. “Each night you use your CPAP you’ll move closer to better sleep, more daytime energy, and improvements in your long-term health.”