CPAP Therapy

Beginner’s Guide to Using CPAP: Surviving the First 90 Days

When I first began CPAP therapy in 2017, I had a lot of questions and few answers. I was struggling to adjust to a new routine—using a strange and bulky mask, adjusting to breathing highly pressurized air, and making it a full night without taking my mask off. 

After several months of adjustment, I adapted to my new routine and started to reap the benefits of CPAP therapy. I had more energy, less snoring, and I felt really good. I wanted to share some of my favorite tips that worked for me while I went through the first 90 days of CPAP therapy. 

Tips for Surviving the First 90 Days

Tip 1: Get used to wearing your mask, by wearing it even when you’re not trying to sleep.

Quite possibly, the hardest thing about CPAP therapy is the adjustment to the new mask. I found when I started, and I would rip the mask off every night around 3 AM because I felt like I was “choking on air,” and it was no longer comfortable. 

In this situation, my therapy pressure increased, mostly because of my sleeping position causing my mask to leak. So I would take it off. I was able to get past this by wearing my mask casually. I would wear it around the house, and this helped to normalize the newness of the CPAP mask for me. Ultimately, you’ll ease into therapy if you can find a way to make it seem like a normal part of your routine, and wearing the mask when you’re awake is a good way to start. 

Once you break it in, you’ll find you’re more comfortable wearing it at night, and your therapy will be more likely to be successful.

Tip 2: Make sure you don’t miss a night of therapy.

The only way this is going to work is if you keep up with your therapy every night. If you skip therapy sessions, it’s going to prolong the adjustment period, and it will take even longer to get used to your new equipment. It may be hard in the beginning to visualize the benefits you’ll get from your therapy, and you may be frustrated. I’ve been there. 

One way I kept myself going when things were tough in the beginning was by having written goals. I wrote down on a piece of paper why I was starting CPAP, and I taped it to my machine. So every time I would look at it, I would remind myself that I was trying to lower my blood pressure, trying to have more energy, and trying to keep myself healthy. You have to have a “why” when you’re starting CPAP therapy if you don’t have a “why,” you won’t have the motivation to push through when times get tough.

Tip 3: Make regular cleaning a part of your therapy.

If you don’t clean, you’re going to expose yourself to a bunch of nasty bacteria that will grow and fester in the ideal environment that is your CPAP equipment. Your mask, hose, and humidifier chamber are warm and have plenty of moisture. For germs, it’s an ideal environment.

That’s why you should clean your CPAP equipment every day. Personally, I use the CleanSmart Spray at home to clean my mask and hose. CleanSmart Spray uses a chemical found in white blood cells to disinfect on contact and can clean with minimal scrubbing. It uses mostly natural ingredients, and it breaks down to simple saline (saltwater) after disinfecting. It has the cleaning power of harsher chemicals while being safe to use with your CPAP therapy.

Tip 4: Know your likes, dislikes, and must-haves before you pick out your equipment.

So you’ve been diagnosed with sleep apnea, and your next step is treatment. Great! That’s the hardest part of the process. Your next step is going to be selecting the equipment you’ll use. Before you investigate and buy a CPAP machine, you need to know a few things about how you sleep.

  • First, are you easily bothered by noise? As an experiment, turn on your TV to a station that’s just white noise (or find a digital radio station on your phone that generates that sound). Turn the sound very low, but not completely off, and cover the TV with a blanket, so you won’t be bothered by the light. That white noise sound is similar to the sound your CPAP equipment will make. Try to sleep in that environment, and in the morning, ask yourself if it was easy or hard. If it was difficult, you’d need to make sure you got a quiet CPAP machine
  • You’ll also need to know if you change positions frequently in the night, as some machines are designed for more active sleepers.
  • Do you sleep on your side? Your back? A combination of the two? Your CPAP therapy will be more effective if you sleep on your side, and it’s something I’m actively training my body to adjust to. If you lay on your back, your machine will have to work a lot harder, and your therapy won’t be as effective. How you sleep can have a big impact on how you feel in the morning.

If you know the answers to these questions, you’ll have a better chance of picking out equipment that will work for you the first time around instead of going through a more painful adjustment process.

CPAP Masks: Surviving the First 90 Days 

How to get used to CPAP: When choosing your first mask, you need to choose a mask that matches your sleeping style. Do you sleep with your mouth open or closed? Can you breathe through the nose? Would you consider using a chinstrap to force you to breathe the nose? Before shopping for a mask, you should know the answers to these questions. Doing so will help you get used to your CPAP machine and make your therapy more effective.

Best CPAP Mask for Side Sleeper 

Recommended Products: AirFit P10 Nasal Pillow, DreamWear Nasal, AirFit F20 Full Face

Who it’s Best For: Both the P10 and the DreamWear Nasal are ideally suited for anyone who sleeps on the side, because of the minimal amount of bulk these masks have. You want a mask that’s not going to push up against the pillow. I chose the AirFit F20 as the full face mask because I’ve used it personally and I sleep on my side. It’s rugged enough to handle the pressure from the pillow and still maintain a good seal.

Here’s the Kicker: If you can successfully sleep on your side, you’ll snore less, your AHI will be lower, and your CPAP machine won’t have to work as hard. These are all good reasons why you should be trying to sleep on your side if you don’t already.

How to use it: Each of these masks are easy to use. Just put it on, secure it in place, and adjust to the desired tightness.

Recommendation: I was using the AifFit F30 at first, and it worked well. I really liked the low profile and open field of vision. When I tried to start side sleeping actively, it just wasn’t cutting it anymore. I started having near-constant mask leaks, and so I switched to the AirFit F20, which turned out to be rugged enough to keep up with my routine. 

I can’t speak to a personal experience with the P10 or DreamWear as I can’t breathe through my nose, but I’ve heard our customers really like these masks. They’re lightweight and a lot less bulky than most masks on the market today, and if you can breathe through the nose, they’re really the best option for side sleeping.

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Best CPAP Mask for a Stomach Sleeper

What is the product: DreamWisp Nasal, DreamWear Gel Nasal Pillow, DreamWear Full Face

Who it’s Best For: If you sleep on your stomach, you are pretty much locked into using a nasal or nasal pillow mask, but you could get away with using a full face mask if you used the DreamWear Full Face (because the hose connection is on the crown of the head). Because of how the tubes connect to CPAP masks, you can’t really have one that connects in the front. That’s just not gonna work if you sleep on your stomach.

Here’s the Kicker: Stomach sleeping is one of the most challenging positions for CPAP users. There’s no way around it. But if that’s how you sleep best, you’ll need to accommodate it, and the best way to do that is with a mask that minimizes bulk and connects to the hose anywhere but the front of the face.

How to use it: You’d connect the hose to the top of the head, and then adjust the cushions. You may want to make sure the straps are tight enough to withstand the pressure you’ll be putting on the cushion, but make sure you’re comfortable.

Recommendation: When researching the DreamWisp, the more I read, the more I liked it. While the cushion covers the bridge of the nose, it’s still less bulky and out-of-the-way. You can do so much with the DreamWisp. It’s extremely versatile, and it’s one of my favorite nasal masks. If I slept on my stomach, I would probably choose the DreamWear Full Face or the DreamWear Gel Nasal Pillow. All the masks mentioned here use a top-of-the-head hose connection, which is essential for a stomach sleeper. All of these masks are good options for anyone.

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Best CPAP Mask for Women

What is the product: AirFit P10 for Her

Who it’s Best For: The AirFit P10 for Her was designed with a woman’s unique features in mind. It’s available in smaller sizes, and the headgear is intended to be less messy for a person’s hair. The AirFit P10 is one of the best masks available, and the for Her version is one you wouldn’t want to pass up!

Here’s the Kicker: ResMed has a number of masks (and even makes a CPAP machine) intended for women exclusively. This attention to the needs of women is not common among its competitors, and it provides a good opportunity for women to find headgear in the correct size and a frame that’s designed for her.

How to use it: The P10 for Her uses the same simple headgear design as the regular P10. Slide the headgear over the head, and it creates enough tension to seal the mask in place—without needing velcro to do it.

Recommendation: With every CPAP purchase, you need to get a product that works for you. If you struggle to find a suitable mask in your size, trying the AirFit P10 for Her may be a good option (or consider shopping a for her version of other popular masks). If you get something that works and works well, you’ll be in a great situation heading into your therapy.

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Best CPAP Mask for Beards

What is the product: AirFit P30i, AirFit N30i 

Who it’s Best For: If you have facial hair, there are certain masks that just won’t work. Full face masks fall into that category. Full face masks occupy the same surface area that beards or goatees use and it can be almost impossible to get a good seal. For guys that have facial hair, you’ll really need to use a nasal pillow or nasal mask, and these two masks are good for that purpose. 

Both of these masks use the same frame and feature a hose connection on the crown of the head. This keeps the bulk away from your beard and can allow you to sleep comfortably in almost any position. 

Here’s the Kicker: Facial hair presents a lot of challenges to most people when it comes to CPAP therapy. In most cases, you may not have to shave your beard, if you’re able to make some adjustments (like using a chinstrap if you’re a mouth breather). 

How to use it: For facial hair, you may want to trim the mustache area down a little, as this will help you get a better seal with your nasal or nasal pillow mask. This is a good practice with any nasal pillow or nasal mask, regardless of brand or manufacturer. With your mustache trimmed you can position the pillows or nasal cushion in place and strap on the headgear.

Recommendation: At one point in time, I had a goatee, before I was diagnosed with sleep apnea. It was something I had for years, and it was really part of my identity. So I could totally see how a person wouldn’t want to shave for CPAP therapy. These masks should do the trick and make it possible to have a really full beard and not have to give it up.

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Find out how we ranked the top CPAP masks of 2019


CPAP Machines: Surviving the First 90 Days

How to use a CPAP machine: If you’re wondering how to use a CPAP machine, it’s actually pretty easy. You’d just need to fill the humidifier with distilled water, set the machine near the bedside, and turn it on. 

If you have an auto-adjusting machine, the machine will study your breathing and adjust the pressure throughout the night. If you have a standard single-pressure machine, it will be set at your prescribed pressure when you receive it, and you can take it from there. That’s really all there is to using a CPAP machine.   

Best CPAP Machine for Easing into Treatment

For easing into treatment, there’s one machine I’d recommend. It’s the machine I personally use, and it’s one I know a lot of sleep labs prefer. It’s called the DreamStation Auto. You could also try using the AirSense 10, that’s another machine I’d recommend if you’re just starting out with CPAP therapy.

What is the product: DreamStation Auto with Heated Humidifier, ResMed AirSense 10

Who it’s Best For: Both these machines are among our best sellers, and I like them because they’re easy to use. For the DreamStation Auto, all you’ll really need to do is press the start button, and it goes. It has smart technology that allows it to turn on with just your breathing, and it makes adjustments throughout the night. It’s a great starter machine, and it’s also very quiet, only registering at 25.8 decibels!

The AirSense 10 is quiet too, and also a good starter machine. It includes a built-in heated humidifier, which is nice because you won’t have to buy anything else to get the most out of your therapy. The AirSense 10 is one of the best machines on the market, and it’s easy to see why. Like the DreamStation Auto, the AirSense10 uses auto-adjusting technology to make pressure adjustments throughout the night.

Who it’s For: For new users, starting CPAP therapy is tough enough! You don’t need your equipment getting in the way of what could be successful therapy. These machines are great starter machines that are powerful, effective, and easy to operate—perfect for beginners.

How to use it: These machines are easy enough to operate. The DreamStation can start therapy with the cadence of your breathing. The AirSense 10 uses a start button. From there, therapy will begin. I flagged these machines as being helpful for beginners because they’re easy to use, and they both have automatic pressure adjustments. They’re also both very quiet. The DreamStation is 25.8 decibels, and the AirSense 10 is 26. These are considered whisper-quiet.

Recommendation: As a 2-year user of the DreamStation Auto, I can say I really like this device, and I’m glad I have it. It’s been a good sidekick as I’ve gone through my battle with sleep apnea. 

That being said, I’d really like to try the AirSense 10. It has a lot of really nice features, and the built-in humidifier is a nice touch. Many people have tried the AirSense 10 and find it works well for them, and it comes from a respected brand. In terms of comfort and features, both machines are roughly equivalent.

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Best CPAP Machine for High-Pressure Settings

If you have high-pressure settings, and you’re routinely pushing 17, 18, or even 19, you may want to ask your doctor if he or she thinks a BiPAP may be right for you. Unlike CPAP machines, a BiPAP machine can reach pressure settings as high as 25. If you’re close to maxing out your CPAP pressure settings, you may need to go higher later on in life. A pressure setting above 20 would mean you’d need a BiPAP machine.

What is the product: BiPAP / BiLevel Machine

Who it’s For: BiPAP Machines (BiLevel Machines) are for anyone who needs pressure settings above 20, or for people that suffer from Central Sleep Apnea or Complex Sleep Apnea, as BiPAP machines can prompt breathing in situations where someone has stopped breathing. BiPAPs aren’t just a “better APAP,” they’re prescribed devices that treat specific conditions.

Here’s the Kicker: You can’t take a CPAP prescription and purchase a BiPAP machine. In order to get one, you’d need to get the doctor to sign off on it. Your starting point for this device is going to be a visit to your physician and a sleep study.

How to use it: BiPAP Machines outwardly work the same way as a CPAP machine does. The only difference between the two is that instead of delivering one pressure or choosing a pressure from a range of pressures; a BiPAP uses two pressures, one for inhale, and one for exhale. Starting your therapy is no different than a CPAP machine, you put on the mask, press the start button, and the machine takes it from there.

Recommendation: If my doctor would be on-board, I’d love to try a BiPAP machine. I tend to use higher pressures as part of my therapy, so for me, it would be cool to see if I ever used a pressure setting higher than 20. But so far, my doctor thinks the APAP machine I use is good enough, so I’m sticking with it.

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Find out how we ranked the top CPAP machines of 2019


Final Thoughts

I think you’ll find that as you get into CPAP therapy, it will make a huge difference in how you feel. Go back to your goals. Remember the “why.” Your “why” is going to be the thing that motivates you through the difficult initial period after you first get your machine. You can do it, provided you stick with it, and never give up!

Simplify Getting Started

If you want a simple way to begin your therapy, consider our CPAP Starter Pack: a guided shopping experience that will get you up and running fast! Choose a mask and a machine, and head to the checkout to pay. It’s never been easier!

David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.

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