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9 Tips For Sleeping Better in a CPAP Mask

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Sleep apnea is kind of a big deal. But what happens when you get diagnosed and suddenly find yourself trying to sleep with a Darth Vader mask strapped to your face? Will sleep ever be normal again?

Living with CPAP can be frustrating. The very thing that is supposed to improve your sleep can also make falling asleep nearly impossible. Unfortunately, not complying with treatment can have some serious consequences for your health.

In this guide, we’ll go over what CPAP therapy is, how the equipment works, and give you nine tips for sleeping better in your mask (plus some alternatives if it’s not working out).

Sleep Apnea

Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing. The problem is that many people don’t even know they have it. In many cases, a partner identifies the issue, or a person may seek answers to their daytime fatigue and stumble across some info on OSA.

The telltale symptoms include loud snoring with pauses in breathing multiple times throughout the night. This pause is kind of like a yawn or holding your breath momentarily before a sneeze, only it lasts for 10 seconds or longer. When this happens, the levels of oxygen in the blood drop, and microarousals from sleep occur.

In most cases, OSA happens because muscles in the throat become relaxed during the night, collapsing or blocking the airway. Kind of like a hose that becomes kinked, airflow stops and the person may temporarily wake up or snort and return to sleep. This can go on all night with as many as 100 episodes or more.

Having trouble with sleep apnea? Best Mattress for Sleep Apnea.

How Many Are Diagnosed?

An estimated 22 million Americans have sleep apnea according to the National Sleep Apnea Association1. Alarmingly, 80 percent of the moderate and severe cases remain undiagnosed. 

While people of all ages and ethnicities can develop OSA, it’s most commonly seen in males over 40 and those who are overweight or obese. If you have type 2 diabetes or depression, you also are more likely to suffer from OSA.

Get More Info: How and Why is Sleep Apnea Misdiagnosed?

How Many People Receive Sleep Apnea Treatment?

Compliance is a term that you may have heard your doctor or respirologist mention before. Being ‘compliant’ means that you are using your CPAP machine as prescribed. ‘Noncompliance’ is when you are not following your therapy recommendations, either not wearing your mask regularly or not for long enough.

Most people fall into a pattern of either compliance or noncompliance within the first week of therapy. If you’ve ever had to sleep with a mask forcing air into your nose or mouth, you know that it’s not an easy task. Unfortunately, sticking with CPAP treatment is a problem that many people face.

If you struggle to wear your mask every night, you’re not alone. Up to 35 percent of patients prescribed CPAP therapy aren’t complying with treatment, according to over 20 years of data2. In some cases, they only use their machine for a few hours each night, and in other cases, they stop using it altogether.

People struggle with compliance for various reasons. The mask doesn’t fit right, the tubes get blocked when they sleep on their sides, or they struggle to fall asleep with the forced air. Some people seek help and try a different mask or adjust the settings, but many just give up on therapy entirely.

Dangers of Leaving OSA Untreated

The consequences of sleep apnea go far beyond the loud snoring and feeling exhausted despite getting a “good night’s rest.” If you struggle with complying with your CPAP therapy, you may want to think twice before driving. The ongoing sleep deprivation from microarousals at night can lead to serious accidents in the workplace or on the road. Drivers with obstructive sleep apnea are at least twice as likely3 to be involved in motor vehicle accidents as those without the condition.

Left untreated, OSA can place a significant strain on the heart and other organs in the body, increasing the risk of health complications4 like heart failure, stroke, or an abnormal heartbeat.

Additionally, research has found a link between the repeated drops of oxygen levels in the blood from sleep apnea and early or premature death. In a study5 that tracked 1,500 adults over 18 years, the risk of death for those with untreated sleep apnea was 3.8 times greater.

Are You Sleeping with Sleep Apnea?

Sleep Apnea Survey
Do you know what sleep apnea is?
Do you know someone with sleep apnea?
Do you think you have sleep apnea?
Have you taken a sleep apnea test?
Have you been diagnosed with sleep apnea by a medical professional?
Do you sleep with a CPAP machine?
Does someone you know sleep with a CPAP machine?
Have you sought treatment (other than a CPAP machine)for sleep apnea?

What Is a CPAP?

CPAP therapy is the most common treatment for obstructive sleep apnea and is usually the first thing your doctor will recommend. CPAP stands for continuous positive airway pressure and involves gently blowing air into the nose and/or mouth to keep the airways open.

Once your doctor has performed a sleep study evaluation to confirm a diagnosis of OSA, the next step is to choose a CPAP machine. Depending on your doctor and the degree of your apnea, your physician may refer you to a respirologist or a medical supply store that specializes in fitting masks.

CPAP therapy is covered by most insurance providers as long as you are compliant with therapy. Some workplaces may require that you show proof of CPAP compliance if you have a job that requires a high degree of alertness. Air pilots, truck drivers, and heavy machine operators are some of the examples that may request proof of treatment.03

How Does a CPAP Machine Work?

A CPAP machine is a small electronic box that connects to a mask with a hose. Most machines have built-in humidifiers that help to moisten the air before delivery. This can help to prevent a dry or stuffy nose.

Your doctor will determine the pressure settings that you need, and these can be programmed into the machine. Some machines come with features like ‘ramp’ which can start you off at a lower setting and gradually increase to keep you more comfortable. Many people prefer this because it gives you a chance to fall asleep before the maximum pressure is reached. 

Blowing pressurized air through the nose or mouth helps to prevent the muscles in the throat from collapsing and forces the airways to remain open. CPAP therapy uses regular room air, but it filters, humidifies, and pressurizes this air before delivery. While this type of therapy isn’t a ‘cure’ for OSA, using CPAP as prescribed can effectively treat the condition and help prevent many of the complications of sleep apnea.

View Our Guide: Top Rated CPAP Machines

Understanding Different CPAP Mask Types

While you may not be excited about the thought of having to fall asleep with a mask strapped to your face, you’ll be happy to know that there are many options to choose from, and CPAP masks have come a long way since their initial designs.

Modern masks are much smaller and more lightweight with soft padding and cushions to enhance comfort. Masks may fit over both the mouth and nose, which is an ideal option for mouth breathers. Or, some masks are small enough to sit right over or under nasal passages alone.

Most masks are designed to attach to the headgear that wraps around the back of the head. Getting the right fit is important to keep you comfortable and to prevent leaks that can minimize the effectiveness of therapy and irritate the eyes.

Masks come in many shapes and sizes, and some are even specifically designed for females. Certain nasal masks are available for mouth breathers and come with chin straps that help to keep the mouth closed.

Choosing the right mask for you can make all the difference in complying with therapy. Certain factors to consider are what type of sleeper you are, how easy it is to disconnect your mask if you need to get up at night, and whether you need to be able to see for reading or watching television in bed.

Visit Our Guide: Highest-Rated CPAP Masks

Tips for Sleeping with a CPAP Mask

Getting used to sleeping with a mask and forced air is going to take time and initially may make it harder to sleep at night. You’ll want to start by wearing your mask around the house and getting used to the feel, then slowly adding in pressurized air while you have some sort of distraction like watching a movie. Starting with smaller goals and gradually adding longer increments of time will help you to adjust and work your way up to a full night of therapy.

Ensure the Right Fit

Your doctor, sleep technologist, or CPAP supplier are the best people to turn to when it comes to fitting your mask. 

Once you’ve chosen a mask, the next step is to schedule a fitting where you’ll choose the right size and adjust the headgear according to the shape of your head and face. If the mask is too tight, you’ll be uncomfortable and wake up with lines on your cheeks where the straps were. If the mask is too loose, you won’t have a proper seal and air will leak out around the mask, irritating the skin and eyes.


If you find yourself struggling to tolerate the forced air, starting at a lower pressure setting may help. Many machines have a built-in feature called ‘ramp’ that allows you to fall asleep at the lowest pressure and automatically increases to the pressure prescribed by your physician.

If your machine doesn’t have a ‘ramp’ setting, it may be worth looking into switching to a machine that does. Over time, many people adjust to therapy enough that they no longer need to use ‘ramp.’ However, in the beginning, it can be very helpful.

Use Nasal Spray or a Humidifier

Your CPAP machine pulls air from your bedroom, so if you have the air conditioner on or the heat running during the winter months, the hot or cold air could be uncomfortable and irritating to the airways.

If you find yourself suddenly waking with a runny nose or even the occasional nosebleed, using humidified air may help. Likewise, using a nasal saline spray before bedtime may help to prevent the nostrils from overdrying.

Adjustable base beds

Similar to sleeping with a wedge pillow, an adjustable base bed elevates the head of the bed, which may help to minimize snoring. Sleeping at an incline can improve some of the symptoms of mild sleep apnea, but may also be a great option for those using a CPAP therapy.

By helping to maintain open airways, an adjustable bed could mean your pressure settings can be lowered. This may help you to be more comfortable with therapy and increase your likelihood of sticking with it. Another positive of an adjustable bed is it gets you a little closer to your machine, giving you a little extra room on your hose for moving around.

Anxiety Treatment

If small rooms and tight spaces have always bothered you, wearing a CPAP mask could be equally challenging. For some people, having a tight-fitted mask over the airways causes feelings of claustrophobia and anxiety. On top of it all, the hurricane-like wind blowing into the mouth or nose causes some people to experience a choking sensation or to panic and hold their breath.

If you are prone to anxiety, start by wearing the mask around the house without any pressure. Gradually add in the air at the lowest setting, using some form of distraction. Visualization and positive self-talk may also help, but if you still find yourself panicking every time you put your mask on, it may be worth seeking treatment for your anxiety.

Speak to your doctor about what options may be available to help you work through your feelings around CPAP therapy. They may recommend seeing a therapist who can teach you certain techniques to calm your anxiety or help you explore CPAP alternatives.

Learn More: Anxiety and Sleep

Expiratory Pressure Relief

Similar to the ‘ramp’ feature, expiratory pressure relief (also known as CFLEX) is another optional setting that may increase your comfort. While most CPAP machines deliver airflow at a steady pressure rate, expiratory pressure relief lowers pressure while you exhale, helping to alleviate feelings of breathlessness.

Most machines will reduce the pressure by 1, 2, or 3 settings during exhalation, making it easier to release your breath. Some even have advanced features that adjust automatically based on each user’s own breathing cycles. Expiratory pressure relief is a setting that may increase compliance for patients who struggle with adjusting to forced air.

Change Your Sleep Position

Your sleep position is an important factor in treating OSA. Sleeping on the back can make symptoms worse, because this position allows the tongue to fall back, blocking the airways.

Certain masks work best for back sleepers, and others are ideal for side sleepers. Keep in mind that sleeping on your side could kink your tubing, reducing the airflow and pressure through your mask. Thankfully, many masks are designed for side sleeping and have features that prevent the tube from becoming kinked.

Learning to sleep on your side may also help to decrease some of the symptoms of sleep apnea, decreasing your required pressure settings. While this may not mean you can stop therapy right away, it could be one positive step towards eventually no longer requiring CPAP.

Another bonus of side sleeping is being able to use a nasal mask instead of a full face mask. Nasal masks are smaller and usually more comfortable to wear, but many users who sleep on their backs require the highest pressure settings that can only be delivered using a full-face design.

If you are a side sleeper, take a look at our list of best mattresses for side sleepers.

Bumper Belts

If you are a die-hard back sleeper and find it hard to transition to sleeping on your side, a bumper belt may help. The belts are designed to comfortably hold you on your side. Most have an adjustable strap that goes around the waist or upper body with little pockets for the inflatable bumpers.

If you frequently fall asleep on your side only to wake up and find yourself on your back again, sleeping with a bumper belt may help. When you try and roll over onto your back during sleep, these bumpers make it uncomfortable for you and could help to gradually train yourself to sleep on your side.

Elbow Hoses

Once you’ve finally gotten used to CPAP therapy and can fall asleep at night, another problem you may encounter is waking to your machine’s alarm signaling that airflow is blocked. The most common cause of this is a kink in the hose. Adding an elbow adapter angles the CPAP hose in a better direction so you aren’t fighting with your tubing all night long.

Elbow hoses are designed to work with most CPAP machines and prevent crinkling or torsion during sleep. These L-shaped adaptors create a 90-degree angle, providing better airflow and allowing you to sleep more comfortably while connected to your machine.

Possible CPAP Alternatives

If you just can’t get your head wrapped around wearing a mask to bed each night or have tried CPAP therapy for months but are still struggling to adjust, there are some alternatives worth considering.

Lifestyle Changes

Along with changing your sleeping position, other lifestyle changes could help with your sleep apnea symptoms.

  • Cut back on alcoholAlcohol and certain medications act as sedatives, which may make symptoms of snoring and sleep apnea worse. These substances relax the muscles of the upper airways allowing them to collapse during sleep. If you do plan on drinking, try to avoid consuming alcohol for a few hours before bedtime.
  • Quit smoking – Smoking causes the upper airways to swell, reducing space in the upper airways. Research has found that smokers are more likely to develop OSA6 and tend to have more severe forms of the disorder.
  • Weight loss – Losing weight could help with your sleep apnea. This is because most people carry excess weight around the neck and have fatty deposits at the base of the tongue, which narrows the airway and makes it more prone to collapse. 

Read More: Obesity and Sleep

Oral Appliances

Oral appliances are specialty dental devices that are designed to correct anatomical problems that may be contributing to sleep apnea. 

For example, a short or recessed jaw20 might be contributing to your sleep apnea. Using a device that shifts the jaw forward may help keep the airways open21. Other devices may hold the tongue in place to prevent it from falling back and blocking the throat during sleep.21


In some cases, when all other treatment options have been exhausted, your doctor may recommend surgical options22. During surgery, some of the tissue in the back of the throat or at the base of the tongue is removed to create more space for airflow.22 In many cases, the surgeon also brings the tongue forward and may even insert a nerve stimulator that is designed to keep the airways open.22

For sleep apnea in children, one of the most common forms of surgery is the removal of the tonsils and adenoids. This is usually the first treatment doctors recommend for children and is often enough to stop snoring and apneic episodes in kids altogether.3

Check Out Our Guide: Top 10 CPAP Alternatives to Relieve Sleep Apnea

Questions For Your Doctor

Is anxiety medication right for me?

In some cases, a prescription for low-dose anti-anxiety pills could be enough to calm your body and mind so you are more likely to stick with treatment. That said, seeing a counselor who can help you develop coping skills to manage your anxiety may also be an option.

Are the alternatives to CPAP possible for me?

CPAP therapy is often the first treatment your doctor will recommend, but if you are worried about adjusting to sleeping with a mask on your face, it may be worth exploring other options. 

Ask your doctor about which CPAP alternatives may work best for you. Depending on the severity of your apnea, lifestyle changes like sleeping on your side or losing weight may be enough to improve your symptoms.

Check Out Our Guide: Top CPAP Alternatives to Relieve Sleep Apnea

Frequently Asked Questions

Why is it so hard to sleep with a CPAP?

There are different reasons why people may experience difficulty sleeping with their CPAP device. Some of the common complaints about CPAPs7 include mask discomfort, dry mouth, pressure intolerance, disruptive noise, and inadvertently removing the mask. 

If you’re having trouble sleeping with your CPAP, you should check with your healthcare provider as they can help solve the issue. For example, they may prescribe sleep medications or cognitive behavioral therapy, have you try another mask, or adjust the pressure on your current one.7

How do I sleep through the night with my CPAP?

To help you sleep better with your CPAP, ensure that you have the right fit because discomfort from an ill-fitting mask can disrupt your sleep. 

Sleepers who are having a hard time adjusting to the forced air that is pushed into their airways can check to see if their device has a built-in feature called “ramp”. This feature allows you to start the night at the lowest pressure and then gradually increase it to your prescribed amount. If your machine doesn’t have this, you can check with your doctor about getting one that does. 

Other ways to help you sleep better with a CPAP include humidifiers or nasal sprays, getting an adjustable base bed, and changing your sleep position. 

Is it good to sleep with a CPAP machine?

Yes, if your healthprovider has prescribed CPAP therapy to treat your sleep apnea, then it is good to consistently sleep with it. CPAPs are crucial in preventing complications8 from OSA, which can include cardiovascular problems and daytime fatigue. 

Although you may find aspects of CPAP therapy, such as sleeping in a mask or headgear, difficult at first, it is important that you stick with using your machine every night. If you are having difficulty with your CPAP device, tell your doctor so that the two of you can figure out the issue and remedy it.

What is the best position to sleep with a CPAP?

As mentioned, sleeping on the back can make sleep apnea worse. However, this is also the position least likely to give you issues with your CPAP mask and tubing since your face doesn’t come into contact with your pillow. 

Sleeping on your side9 is better for keeping the airways open, but you will need to make sure that your CPAP mask is conducive to this position. Nasal pillow masks are often a good fit for side sleepers. 


If you’ve been diagnosed with sleep apnea, chances are you’ll be faced with using CPAP therapy at some point along your journey. It may not be the sexiest looking thing and it definitely will take some time getting used to, but it might just save your life. The dangers of leaving sleep apnea untreated are real, which is why treatment is so vital.

Thankfully, there are many options to help you increase your comfort while using CPAP, or even alternatives if you just can’t make it work. The important thing to remember is that the adjustment period takes time. If you’re uncomfortable or struggling with compliance, speak to your doctor about options to adjust your therapy and to help you stick with it.

Raina Cordell

Raina Cordell

RN, RHN, Certified Health Coach

About Author

Raina Cordell is a Registered Nurse, Registered Holistic Nutritionist, and Certified Health Coach, but her true passion in life is helping others live well through her website, Her holistic approach focuses on the whole person, honing the physical body and spiritual and emotional well-being.

Combination Sleeper


  • 1. Ikpeze, Tochukwu. “Treatment for Obstructive Sleep Apnea”. Last modified September 25, 2024.
  • 2. Rotenberg, Brian W., Murariu, Dorian., Pang, Kenny P. “Trends in CPAP adherence over twenty years of data collection: a flattened curve”. Journal of Otolaryngology – Head & Neck Surgery. 2016.
  • 3. Karimi PhD, Mahssa., et al. “Sleep Apnea Related Risk of Motor Vehicle Accidents is Reduced by Continuous Positive Airway Pressure: Swedish Traffic Accident Registry Data”. Sleep. 2015.
  • 4. “Obstructive Sleep Apnea”. Johns Hopkins Medicine. Webpage accessed November 7, 2024.
  • 5. Young PhD, Terry., et al. “Sleep Disordered Breathing and Mortality: Eighteen-Year Follow-up of the Wisconsin Sleep Cohort”. Sleep. 2008.
  • 6. Bielicki, Piotr., Trojnar, Anna., Sobieraj, Piotr. “The impact of smoking status on obstructive sleep apnea (OSA) severity”. European Respiratory Journal. 2018.
  • 7. “I can’t tolerate CPAP, what can I do?”. Harvard Medical School. 2020.
  • 8. “CPAP machines: Tips for avoiding 10 common problems”. Mayo Clinic. Last modified November 29, 2024.
  • 9. “Choosing the Best Sleep Position”. Johns Hopkins Medicine.Webpage accessed November 8, 2024.