Continuous Positive Air Pressure (CPAP) therapy is an effective treatment for obstructive sleep apnea. It uses a machine to deliver a continuous stream of pressurized air through a mask, keeping the airway open during sleep. Understanding what to expect on the first night can reduce anxiety and help you begin your journey toward restorative sleep. The initial experience is often the most challenging as your body adjusts to the new sensation of air pressure and wearing a mask.
Preparing for First Use
Place your CPAP machine on a stable surface near your bed, ensuring the tubing can reach without strain. If your machine includes a humidifier, fill the water chamber with distilled water to ensure the air delivered is comfortably moist. Complete a practice run before bedtime to confirm the mask fit. Adjust the headgear straps so the cushion creates a secure seal that is snug but not overly tight. Overtightening is a common mistake that causes leaks and discomfort, so aim for a fit that allows one or two fingers to slip beneath the strap.
Sit up and wear the mask with the machine running for a few minutes while you are awake. This allows you to become accustomed to the feel of the pressurized air and the quiet sound of the machine. Practicing your breathing with the mask on can help minimize the feeling of restriction when you finally attempt to sleep.
Immediate Sensations and Adjustments
The most notable sensation is the feeling of air pressure being delivered through the mask. This consistent flow prevents airway collapse, but it may initially feel unusual or slightly uncomfortable. Many modern CPAP machines feature a “Ramp” setting, which is useful for first-time users.
The ramp function starts the air flow at a lower, more tolerable pressure and gradually increases it over a set time period. This allows you to fall asleep comfortably before the machine reaches your prescribed therapeutic pressure setting. If your machine has an AutoRamp feature, it may wait until you fall asleep before increasing the pressure.
You will likely notice resistance when exhaling against the incoming air. Some machines have pressure relief technologies, such as EPR or C-Flex, that slightly reduce the pressure during your breath out to make the sensation feel more natural. Concentrate on breathing normally and evenly, rather than fighting the machine’s rhythm.
Troubleshooting Common Discomforts
Air leaks are a frequent problem, often caused by a poorly seated mask or a shift in sleeping position. Instead of pulling the straps tighter, try repositioning the mask or gently pulling the mask straight out to reset the seal.
Dry mouth or nasal irritation can occur because the continuous air stream may dry out the nasal passages. This is often solved by using the heated humidifier feature to add moisture to the air you are breathing. Using a saline nasal spray before bed can also help keep your nasal passages clear.
Some individuals feel claustrophobic when wearing the mask for the first time. If this occurs, try removing the mask and practicing relaxation techniques before attempting to reapply it. If the feeling persists, practicing wearing the mask while awake during the day for short periods, such as while reading, can help you acclimate.
Measuring Success and Next Steps
Set realistic expectations for your first night of CPAP therapy. A successful first night does not mean sleeping soundly for eight straight hours; wearing the mask for even a few hours is a positive accomplishment. Consistency is far more important than duration in the beginning, and adapting to the machine typically takes days to a couple of weeks.
When you wake up, check your machine’s data or sleep report for basic usage statistics. This information will confirm the duration you wore the mask and may show initial metrics.
If you experience persistent pain, extreme discomfort, or are completely unable to tolerate the air pressure after multiple attempts, contact your equipment provider or physician. They can check your machine settings, such as the ramp time, or suggest a different mask style that may better suit your needs.