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How to Use a CPAP Machine for Sleep Apnea

A continuous positive airway pressure (CPAP) machine is a device used for the treatment of sleep apnea. It’s estimated that around 30 million adults1 in the U.S. have obstructive sleep apnea1, which is a sleep disorder that prevents your body from breathing properly, causing frequent awakenings throughout the night due to oxygen deprivation. 

A CPAP machine delivers a continuous flow of filtered, pressurized air into your airway, via a hose and mask to facilitate better breathing. If your doctor suspects you have sleep apnea, they’ll likely refer you to a sleep clinic for testing, after which a CPAP therapy may be prescribed. 

If you’re new to CPAP therapy, using these devices might feel overwhelming. We’ll go through how to set up your machine, how to get the most out of it, and highlight any potential pitfalls.


How to Set Up Your CPAP Device

This is a general, informative guide2 for setting up your CPAP machine for first use. However, always consult the manufacturer’s handbook for specific instructions regarding your particular device.

  1. Ensure you have the correct parts – Remove everything from the box and make sure you have all the necessary parts and accessories, which should include the device itself, a power cable, a hose, a facial or nasal mask, and an air filter (which may already be inside the machine). Many machines also include a humidifier reservoir.
  2. Read the manual – Read the setup instructions before starting to familiarize yourself with the process.
  3. Find a secure place for your CPAP machine – Place your CPAP device somewhere stable, close to your bed, and within reach of a power socket. A bedside table is usually a good choice as it gives you easy access to the controls.
  4. Attach the power cord – Attach the power cord to the device, ensuring the cable won’t be pulling on the machine once it’s plugged into the outlet. Do not plug it into the outlet yet.
  5. Insert the filter – CPAP machines rely on filters that prevent dirt from entering the machine. If your filter isn’t already in place, insert it – refer to your machine’s manual if you’re unsure where this goes.
  6. Fill the humidifier tank – If your machine has a built-in humidifier reservoir, clean it with warm, soapy water and rinse well before filling it with distilled water. Make sure you don’t fill past the ‘maximum’ line.
  7. Connect the hose – Attach the hose securely to the CPAP machine, using the provided attachment.
  8. Prepare the mask – Check the CPAP mask to make sure it’s clean before attaching any straps or cushioning.
  9. Connect the mask – Attach the other end of the hose to the mask. 
  10. Check the hose – Stretch the hose out to make sure it comfortably reaches your bed from the machine without being tugged or pinched. 
  11. Plug the machine in – Plug the device into an electrical outlet, making sure the cable is tucked away so you won’t trip over it. 
  12. Turn on the device – Consult your user manual to find out how to turn on the device. The machine’s settings should have already been programmed by your healthcare provider. 
  13. Put your mask on –  Check that air is flowing through the mask before putting it on. The mask should have a snug fit against your face, to prevent air leaks, which will stop the device from working properly. You can check for air leaks by moving your head around – if you feel or hear any air escaping, adjust the mask to make it tighter. 

BiPAP and APAP Machines

BiPAP and APAP machines look similar to CPAP machines and are set up in much the same way. 

BiPAP stands for bilevel positive airway pressure, which delivers airflow at two different pressures; one for when you inhale, and one for when you exhale3. A CPAP machine delivers air at the same pressure regardless of whether you’re breathing in or out. BiPAP machines are used to treat sleep apnea, as well as chronic obstructive pulmonary disease, heart failure, and hypercapnic respiratory failure.3 

Learn More: BiPAP vs CPAP

An APAP machine automatically adjusts pressure4 while you sleep, and this is within a set parameter that’s determined by your doctor. This pressure stays the same for the inhale and exhale, but it will automatically increase air pressure if it detects obstruction or snoring, and decrease pressure if it senses that you’re breathing more naturally. APAP machines are also used in the treatment of sleep apnea.

Learn More: APAP vs CPAP

What Is the Proper Way to Use a CPAP Machine?

CPAP machines must be used consistently5 to reap the benefits, which means using them all night, every night, and during naps. It’s important to follow any instructions given by your physician. Also, you must ensure that your mask fits you properly and doesn’t have any leaks as this will prevent the device from delivering the required air pressure. 

Other Tips for First-Time CPAP Users

The American Academy of Sleep Medicine recommends the following advice for patients who are new to CPAP therapy.5

  • Start by using your CPAP during the day – It can initially feel strange having a mask on your face, so try wearing it while watching TV to get used to the feel.
  • Make CPAP part of your bedtime routine – It takes time to form a new habit, so try setting a reminder on your phone that nudges you to turn on and use your CPAP machine. There are proven health benefits6 of using your device consistently, such as a reduced risk of cardiovascular disease and a lower mortality rate.
  • Take time to adjust your mask – An ill-fitting mask can stop the device from working properly, but it can also cause discomfort, which can affect your sleep quality. Place the mask on your face and adjust any straps or headgear so that it’s both snug and comfortable. 
  • Clean your equipment regularly – It’s advised to clean your hose, mask, and headgear weekly. Write this on your calendar or schedule a phone reminder so you don’t forget. Read more on how to clean a CPAP here.
  • Buy a saline nasal spray – Have a saline nasal spray if you’re experiencing any mild sinus or nasal congestion, which is a common reason7 that patients stop using their machines. Speak to your doctor if nasal congestion is severe before discontinuing the use of your CPAP.
  • Don’t struggle in silence – If you’re struggling with your CPAP machine, speak to your healthcare provider. They may be able to offer a solution, such as trying a new mask style or adjusting the air pressure of your machine.

CPAP Machine Side Effects

Older CPAP machines were noisy, but modern machines are relatively silent, emitting a noise that’s about as quiet as a whisper8. However, those sensitive to noise may still feel disturbed, in which case earplugs are advised. 

Some patients complain of general discomfort and claustrophobia while wearing a mask9, and nasal congestion, nosebleeds, and skin irritation are also common complaints. Some users are also susceptible to aerophagia10, which is when you swallow too much air; this can lead to bloating, flatulence, and burping.

Frequently Asked Questions

How many hours a night should I use my CPAP?

If you have a CPAP machine via Medicare, you’re required to use it for at least four hours per night, on 70 percent of nights, to remain eligible for coverage11. This compliance period begins 31 days after receiving the device. Private insurers may have similar requirements.
Research12 shows that health benefits begin after using a CPAP machine for two to three hours per night, increasing each hour up to seven hours. As such, it makes sense to use your device for the entire night for the best results.

When using a CPAP, do you breathe through the nose or the mouth?

Experts advise always breathing through the nose13, whether you use a CPAP or not. The lungs function better with warm, moist air, which nose breathing provides. Conversely, breath taken in through the mouth is cooler and dryer, and mouth breathing can also increase the likelihood of sleep apnea.13

However, mouth breathing can be a hard habit to break; using a nasal mask with a chin strap may help to keep your mouth closed while you sleep. Additionally, a CPAP that has a humidifier may also help keep air moist15. However, your physician may recommend a CPAP mask that covers the nose and mouth to ensure you get adequate air pressure for those times when you breathe through your mouth.

How do I keep my mouth shut with my CPAP machine?

As mentioned above, you can try using a mask with a chinstrap to help keep your mouth closed while sleeping. Another option is mouth taping, though there’s limited scientific evidence to prove that mouth taping is safe and beneficial. It’s best to speak to your doctor before using anything that keeps your mouth closed while sleeping.

If you’re mouth breathing because of nasal congestion, you can try a decongestant or room humidifier. Additionally, sleeping on an incline could help drain your sinuses when you lie down.

Lisa Bowman

Lisa Bowman

Writer

About Author

Lisa is a content writer for Sleep Advisor, which combines two of her greatest passions – writing and sleeping. She can also be found writing about fitness, sustainability and vegan food.

Combination Sleeper

    Resources

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  • 2. “How Do I Set Up My CPAP Machine for the First Time?” RespShop. 2022.
  • 3. “BiPAP”. Cleveland Clinic. Last modified May 10, 2024.
  • 4. Girouard, Ayla. “CPAP vs. BiPAP vs. APAP: What’s the Difference?” National Council on Aging. 2024.
  • 5. “CPAP”. American Academy of Sleep Medicine. 2020.
  • 6. “Treatment for dangerous snoring prevents deaths from heart disease. A small patient trial also suggests CPAP may be more effective than a weight-loss drug in tackling clogged arteries”. European Respiratory Society. 2024.
  • 7. Inoue, Akiko., et al. “Nasal function and CPAP compliance”. Auris Nasus Larynx. 2019.
  • 8. “CPAP Machine”. Cleveland Clinic. Last modified November 9, 2021.
  • 9. Pogach, Melanie. “I can’t tolerate CPAP, what can I do?” Harvard Health Publishing. 2020.
  • 10. Mehra MD, Reena. “Sleep apnea ABCs: Airway, breathing, circulation”. Cleveland Clinic Journal of Medicine. 2014.
  • 11. Riva, Miranda M. “A Guide to Medicare Coverage of CPAP Machines and Supplies in 2024”. National Council on Aging. 2024.
  • 12. Malhotra, A., et al. “Dose Response Relationship Between Positive Airway Pressure Adherence and Clinically Important Outcomes in Patients with Obstructive Sleep Apnea”. American Thoracic Society. 2022.
  • 13. “Mouth Breathing”. Cleveland Clinic. Last modified April 11, 2022.
  • 14. “CPAP machines: Tips for avoiding 10 common problems”. Mayo Clinic. Last modified November 29, 2024.