How-to guide
How to Get Started With CPAP
Quick answer: CPAP gently blows air through a mask to keep your airway open while you sleep. A medical equipment (DME) company delivers your machine, fits your mask and teaches you to use it. Use it every night, all night, including naps: the more hours, the better you will feel. Medicare and many insurers require use at least 4 hours a night on at least 70% of nights in a 30-day stretch during your first 3 months, and we see you 1 to 3 months after you start. Wipe the mask daily, wash the mask, tubing and water chamber weekly, use distilled water in the humidifier, and call if something makes CPAP hard to use.
What is CPAP?
CPAP (continuous positive airway pressure) is a small bedside machine that blows a gentle, steady stream of air through a hose and mask. The air holds your airway open so your breathing does not stop during sleep. Many machines adjust the pressure automatically (often called APAP). Our CPAP page explains how it works and the different types of machines.
Who sets up my machine?
- A durable medical equipment (DME) company delivers your machine, fits your mask, shows you how to use and clean it, and supplies replacement parts.
- Save their name and phone number in your phone. Call them first for problems with the machine, the mask fit or supplies.
- Your machine records how many hours you use it each night. That information is shared with us and your insurance to check how therapy is going.
- If you have an older machine, ask your DME company whether it is under a recall. The FDA lists medical device recalls on its website.
How do I get used to it?
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Practice while awake
For the first few days, wear the mask with the machine on for 20 to 30 minutes while you watch TV or read. It gets you used to the feel of the mask and air before you need to fall asleep with it.
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Use it every night and every nap
Put it on every time you sleep, from the first night. Making it part of your bedtime routine helps it become a habit.
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Use the ramp if the air feels strong
Most machines have a ramp setting that starts at a low pressure and slowly raises it while you fall asleep.
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Put it back on if you take it off
If you wake up and it is off, put it back on before you go back to sleep.
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Give the mask a fair try, then ask
Masks come in several styles: nasal pillows, nasal masks and full-face masks. If yours leaks or bothers you after a week or two, ask your DME company to try another style or size.
How much do I need to use it?
Use it all night, every night. The more hours you use it, the better you are likely to feel: daytime sleepiness and how well you function keep improving with longer use, at least up to 6 to 7 hours a night.
- Insurance rule: Medicare and many insurers require you to use CPAP at least 4 hours a night on at least 70% of nights (21 of 30) during a 30-day stretch within your first 3 months. If you do not, they may stop paying for the machine.
- Short of 4 hours? Keep going. The 4-hour mark is an insurance rule, not the point where CPAP starts to help. Keep using it every night and call us for help rather than stopping.
- Follow-up visit: we see you 1 to 3 months after you start, to check how it is going and review your machine’s data. Your insurance may also require this visit to keep paying for the machine. Bring your mask and questions.
How do I keep it clean?
- Every day: wipe the mask cushion with a damp cloth and mild soap or an unscented CPAP wipe, empty the water chamber, and let parts air-dry.
- Every week: wash the mask, tubing and water chamber in warm water with a little mild dish soap, rinse well, and air-dry out of direct sunlight. Wash the headgear by hand when it gets dirty.
- Water: fill the humidifier with distilled water, not tap water.
- Skip ozone or UV “CPAP cleaners”: they are not needed, and the FDA has warned that ozone can irritate the lungs and damage equipment.
- Follow the cleaning instructions that came with your machine and mask.
Parts wear out. This is how often insurance usually covers replacements; your DME company can set up automatic refills:
| Part | Replace about |
|---|---|
| Nasal pillows or nasal mask cushion | 2 a month |
| Full-face mask cushion | 1 a month |
| Mask frame | Every 3 months |
| Tubing | Every 3 months |
| Disposable filters | 2 a month |
| Reusable filter, headgear, chin strap, water chamber | Every 6 months |
What if something bothers me?
| Problem | What helps |
|---|---|
| Air leaks or red marks on the face | Readjust the mask while lying down with the machine on. Do not overtighten the straps. If it still leaks, ask your DME company for another size or style. |
| Dry nose or mouth | Turn up the humidifier or use heated tubing. A saline nasal spray before bed helps a dry nose. If you breathe through your mouth, a full-face mask or chin strap often helps more than turning up the humidifier. |
| Stuffy nose | Use saline spray, and a steroid nasal spray if we recommend one. Tell us if your nose is often blocked: treating it can make CPAP much easier. |
| The air feels too strong | Use the ramp setting, and ask us about the exhale relief setting or a pressure change. |
| Swallowing air, bloating or burping | Tell us. A pressure change often helps. |
| Trouble falling asleep with it on | Keep practicing while awake. If trouble sleeping is a long-standing problem, see our guide on insomnia with sleep apnea. |
What if I have surgery or travel?
- Tell your surgeon and anesthesia team that you use CPAP. After nasal or sinus surgery, keep using it starting the night of surgery, unless your surgeon tells you otherwise.
- Take your machine when you travel, and pack it in your carry-on bag. A travel adapter or extension cord can help in hotels.
When should I call?
Call us for
- You cannot use it most nights after 2 to 3 weeks of trying
- Mask problems that your DME company has not been able to fix
- You still feel sleepy during the day, or your snoring comes back, even with regular use
- You nearly fall asleep while driving. Do not drive while you feel that sleepy.
- Morning headaches, nosebleeds or sinus pain that start with CPAP
- A big change in your weight, up or down, since your pressure was set
Call 911 or go to the ER for
Chest pain or trouble breathing.
Austin 512-339-4040 · Lakeway 512-682-4798 · Marble Falls 830-992-2830
Questions patients ask
All night, every night, including naps. Benefits keep improving with longer use, at least up to 6 to 7 hours a night. Medicare and many insurers require at least 4 hours a night on 70% of nights in a 30-day stretch during the first 3 months. If you fall short of that, keep using it and call us for help rather than stopping.
Wear it with the machine on for 20 to 30 minutes while awake for the first few days, use the ramp setting, and use it every time you sleep. If the mask leaks or bothers you after a week or two, ask your DME company to try another style or size.
Wipe the mask cushion and empty the water chamber every day. Wash the mask, tubing and water chamber in warm, mildly soapy water every week and air-dry them. Use distilled water in the humidifier.
Ozone and UV CPAP cleaners are not needed. The FDA has warned that ozone can irritate the lungs and damage equipment. Soap and water work.
Insurance usually covers nasal pillows or nasal cushions twice a month, full-face cushions monthly, the mask frame and tubing every 3 months, and headgear, reusable filters and the water chamber every 6 months.
This guide is for educational purposes only and does not replace an in-person evaluation. If we gave you different instructions, follow ours.
Full guide: capitalent.com/cpap-getting-started.html
Sources
- Patil SP, Ayappa IA, Caples SM, et al. Treatment of adult obstructive sleep apnea with positive airway pressure: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2019. PubMed
- Weaver TE, Maislin G, Dinges DF, et al. Relationship between hours of CPAP use and achieving normal levels of sleepiness and daily functioning. Sleep. 2007. PubMed
- Martins De Araújo MT, Vieira SB, Vasquez EC, Fleury B. Heated humidification or face mask to prevent upper airway dryness during continuous positive airway pressure therapy. Chest. 2000. PubMed
- Centers for Medicare & Medicaid Services. Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea, Local Coverage Determination L33718.
- U.S. Food and Drug Administration. Safety communication: Potential risks associated with the use of ozone and ultraviolet (UV) light products for cleaning CPAP machines. 2020.