CPAP Success for Sleep Apnea: What You Must Know

CPAP, or continuous positive airway pressure, is one of the first-line ways of treating obstructive sleep apnea. Gentle, positive air pressure is passed through a mask into the nose to keep your throat tissues open. For many people, CPAP works very well, but there are many others that have difficulty adjusting to CPAP and end up giving up. 


There are a number of proven, systematic steps that can be taken to improve CPAP usage, and I’ll cover each of these steps in future posts, but theres’s one important factor that determines whether or not you’ll ultimately benefit from CPAP even before you start. This is your mindset.


CPAP compliance, or the number of people who are able to use and ultimately benefit from CPAP, ranges anywhere from 29 to 83%. (Compliance is only a measure of how many hours patients actually use their machines. It doesn’t actually measure how well they are benefiting from CPAP treatment. You can be 100% complaint, but not sleep any better.) In the real world, compliance is  much less than 50%. We know that with intensive education, support, and follow-up, CPAP compliance rates can be very high, but in our fragmented health care system with multiple providers for each patients, results are much less than ideal.


However, over the past 11 years in clinical practice, I’ve noticed a few observations: Bus drivers and airline pilots accept CPAP therapy readily and are usually very successful in adapting to and benefiting from their CPAP machines. In addition, newly diagnosed sleep apnea patients who have either friends or relatives who have good experiences with CPAP also tend to do well. On the other hand, if they hear horror stories about CPAP, they tend not do do as well.


What this goes to show is that your mindset and motivation ultimately affects whether or not you end up accepting or rejecting CPAP. Pilots and bus drivers have their jobs on the line. Until they are treated and cleared by a medical doctor, they can’t return to work. A close friend or family member’s experience using CPAP is also a major factor in how well you’ll be able to tolerate and benefit from CPAP. Imagine having the proper mindset, as well as undergoing intensive education, counseling, support and follow-up. CPAP success rates are sure to go up.


What was your motivating factor in succeeding with CPAP? If you couldn’t tolerate CPAP, what was the main reason? Please enter your comments below.


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11 thoughts on “CPAP Success for Sleep Apnea: What You Must Know

  1. I’ve been on titration for two months. It was determined a setting of 12 was to be my standard. I complained about the pressure – air leaking into my eyes (even though mask was so tightly sealed that I woke up with a headache every day from the pressure of the straps on my neck. On Oct 14 I woke up totally deaf in my right ear. This lasted 4 hours and has re-occurred about 4 times since. High frequencies have been lost and now I have to ask my co-workers to repeat themselves. I stopped using cpap until I can get an opinion from an ear specialist.

    However, while I was using cpap, I was not waking up refreshed – in fact, I was getting more and more tired, fuzzy headed, confused and depressed as each day passed. My work declined to the point the I had to double and triple check each computer program I wrote before I could run even the simplest thing. I keep reading about how wonderful cpap is and how everybody is refreshed and enjoying the good life – but I’m just the opposite. I’ve used up half my holidays and numerous sick days rying to get established with cpap. Since I’ve been off it, everything has changed for the better. My doctor doesn’t seem to listen to my problem – it is like talking to the wall. so now I have ear damage

    Any suggestions to make cpap work for me or should I just pack it in???

  2. Sorry to hear about all your problems with CPAP. Before you give up on CPAP, make sure you have some sort of objective data from your machine that can tell you how effectively you’re using your machine.

    If your nose is stuffy, then this should be taken care of definitively first. Try talking with your DME vendor, and maybe even find another sleep doctor who listens to you.

    If you’re considering surgery, make sure you read my report on surgery (see top of sidebar on the right . There are lots of myths and misconceptions that even some sleep doctors continue to perpetuate.

  3. I have been attempting to adapt to my CPAP for the last few months and have had many ups and downs. I do know that I am tired of feeling guilty for not being able to adapt. The fact is the CPAP is invasive emtionally and terribly uncomfortable. I cannot understand how so much research could not improve on the design of the masks. With so much non compliance one would think the CPAP companies would come up with a comfortable mask. I do understand how important it is to treat sleep apnea, but it is terrible to be caught between worrying about damaging your health and dreading the nightly misery of the CPAP.

  4. I just started CPAP therapy. The third night (out of 3 total so far) I woke up totally panicked after a couple hours hooked up, which ironically is what started my journey to CPAP. Except this was different. I suspect I'm not breathing well against the airflow (machine set at 8, continuous flow except for 20 min rampup). I have a great attitude about this, because I have several arrhythmias include PVCs/PACs that were minimized/alleviated during a sleep study. (Thumbs waay up!)
    So I'm giving it that old college try. Not liking CPAP. Abandoned it completely last night. But, onward and upward.
    Emotionally invasive–so true!
    Weird thing: it seems to have brought my menstrual cycle back, though that's wild speculation on my part. Wasn't having my period (for 3 months–longest I've ever gone) until the sleep study/first use of CPAP. I know I'm eventually going to go through menopause (completely), but I wasn't quite ready for it this soon–so this is a good thing;-)

  5. To S Denton, I see it’s been a few months since that last post but just in case you read this: I once said to my doctor, “I guess I got my period back”. He said, “Oh no, you do not get your period back” and he started ordering tests. I had poylps bleeding from my cervix. So I wouldn’t assume that cpap brought back your period. Maybe you should check into it.

  6. I struggled with horrible masks,,, steel pushed against my cheeks. Since I finally got a good mask; soft and pliable, I’ve been comfortable. It’s even better with the hose holder. I can move in my sleep without waking up.

    Three months didn’t do it… I would have given up long ago if it weren’t for my son who kept trying something I could tolerate.

  7. The mask is hard to put on and get in place properly—I keep having to shift it around.
    It feels confining.
    The exhaust blows on my hand or face. I have to arrange the covers and my hands just so in order to avoid this. Then, while I’m asleep, they get out of place, and I’m awakened by air blowing on me.
    The mask keeps getting out of place while I’m sleeping or trying to sleep. I’ll hear air escaping and, in my drowsy state, try to fix the mask, but often it keeps leaking. Then I either take it off entirely, or turn on the light and readjust it. Then I’m wide awake.
    Sometimes when the mask gets out of place, it makes a loud noise like a balloon deflating. That wakes me up.
    I wake up every night at least once with my mouth very dry—my cheeks will be stuck to my teeth. Then I have to drink some water, and I’m wide awake.
    Sometimes I wake up and feel sweat under the edges of the mask. This produces a clammy feeling, which is uncomfortable and makes me want to take off the mask, which I sometimes do.
    Sometimes I wake up with the mask digging into my skin. This is uncomfortable and makes me want to take off the mask, which I sometimes do.

    In the six years I’ve had the machine, I have not once slept through the whole night with it.

  8. My dad and brother love their CPAPs. Even their wives rave about how much better life is now. That was really motivating. My husband hated his and couldn’t tolerate it. I wish I hadn’t seen him struggle as it almost psyched me out, but then I rallied. Of course I had to prove I could be better at it then him, right?! ;)

  9. Nine years using a CPAP. Thought it was the best think until I started to get the shakes. Finally decided the CPAP was the problem. Visited several MD, dentist and specialist with no help only commented that they never heard of such a think.
    presently using an oral appliance with limited success.

  10. Cpap use took about a month of trial and error. Tweaking little details based on information from the night before. I used hairclips to keep strap on the back, tried different masks (dreamwear by respironics is my pick)and i got used to washing my mask everyday in the shower. Why did I stick to it? Because I slept like never before with cpap. It was worth the trouble of that trial month. The quality of my sleep is much better. I cant sleep without it. Its been a year since I started cpap and people’s biggest mistake is giving up after a few days. Please give it more time.

  11. I was awakened about every 15 min prior to starting my cpap. When diagnosed, I had 60 events per hour
    Needless to say this scared the hell out of me. Now I am at about 2-4 events per hour. What a difference.
    Even with the buzzing in my ears, headaches, sinus pressure and ear fluid, I still would never stop. In fact, I’m wearing it now!
    Isn’t this supposed to be life sustaining.