Call: 866-499-1588

We recognize that setting up and using your CPAP or Bi-level (BiPAP) device may be challenging at first, but it’s well worth the time and effort it requires. Remember, your treatment will help you avoid more serious apnea-related complications such as excessive daytime sleepiness, heart disease, and more.

In order to get up to speed quickly we recommend that you work closely with your physician and Feeling Great’s CPAP and BiPAP professionals, who will help you overcome some of the most common obstacles. With our help, and a bit of patience and time, your treatment will be effective, sustainable, and stress-free.

Below are some tips for troubleshooting some of the most common challenges that you may encounter when you first start your CPAP therapy.

Mask Discomfort

This problem usually arises because either the patient adjusts the headgear too tight or because the mask does not fit properly. A CPAP mask should fit the face snugly to avoid air leaks but not so tight that is feels uncomfortable or causes pain. If you must pull your mask tightly to prevent leaks, it does not fit you correctly. Please notify your physician or our equipment professionals if your mask is causing you any discomfort or pain.

  • In order to avoid discomfort or pain, we recommend mask liners. They help eliminate annoying micro-leaks that can result in facial irritations.
  • If you are experiencing minor skin irritations or small cuts (i.e. on the bridge of your nose) we suggest that after you loosen your mask, you also cover it with zinc oxide, a band-aid, or skin tape.
  • Unfortunately, our faces are designed differently, and no mask will seal 100% of the time, so if you feel like your mask is leaking, make sure that it’s adjusted properly and before using your equipment make sure your face is clean and free from moisturizers, make up, or creams.
  • If you wake up with water in you mask / tubing, your humidifier is set too high. Start at the 1st setting (1) and gradually increase as necessary each night.
  • If your machine is making loud noises and /or there’s a lot of air blowing from your mask, it usually means that your mask is not fitted correctly or your seal is wearing out and needs to be replaced.

Nasal Congestion, Irritation, Runny Nose, or Sneezing

Your nose is your airway’s humidifier. It warms and humidifies the air that you breathe. If the CPAP begins to dry your nose, your body will increase the production of mucus in the nose to add more moisture to the inhaled air.

Unfortunately, this may cause nasal congestion and a runny nose. In some cases the dryness will cause irritation, burning, and sneezing. These symptoms can be alleviated by the use of a humidifier with your CPAP.

Some sleep specialists order a pass-over (cold water) humidifier with the initial CPAP order. If you already have a humidifier and still experience these symptoms, you may need a heated humidifier. This is a water pan that sits on a heating unit and is attached to CPAP just like the pass-over humidifier.

Heating the air and the water will allow the air to carry more moisture as it travels to your nose (just like the summer air is more humid than winter air). In almost all cases, this resolves nasal congestion and irritation if it is caused by CPAP.

If you’re sneezing you may be experiencing an allergic reaction to the cleaner you are using, so it’s a good idea to try alternate cleaners. Also, if you are using humidity, try using distilled water. You may also be allergic to the materials in your CPAP mask.

Difficulty Breathing Through Your Nose

If you have allergies, chronic sinus problems, or a deviated septum, or you regularly breathe through your mouth, you may experience more difficulties getting use to your CPAP therapy.

  • If you have allergies, it’s best to speak with your doctor about options such as a nasal steroid spray or other allergy medications that may help you.
  • If you have a deviated septum, you should also consult with your physician who may refer you to an ear, nose and throat specialist.
  • Additionally, you may find relief with one of the “full-face masks” – a quick, non-invasive, and extremely affordable solution - that will fit over both your nose and mouth.

Headaches or Ear Pressure

Although treating sleep apnea usually eliminates morning headaches, some CPAP users develop headaches or experience pain or pressure in their ears. These symptoms are generally caused by underlying sinus congestion due to allergies or the CPAP device.

The pain and pressure are similar to traveling on a plane with nasal congestion. The congestion can block the ear canals and this change in pressure can cause pain when air is trapped.

It is best to avoid using CPAP when you have a cold or sinus infection. Sometimes the congestion remains in the ears and sinuses after the acute cold symptoms are gone. If you develop headaches or ear pain on CPAP, speak with your sleep specialist or physician, who may prescribe a decongestant or antihistamine.

Dry Mouth

Waking up with a dry mouth is one of the most common side effects of CPAP therapy. Adding a chinstrap to your headgear is often helpful under these circumstances, because it will prevent you from keeping your mouth open and having more moisture evaporate.


If you feel claustrophobic, try the following:

  • Practice by holding the mask up to your face without any of the other parts.
  • Once you're comfortable with that, try wearing the mask with the straps. Hold the mask and hose (without the straps) with the hose attached to the CPAP machine at a low pressure setting (turn the ramp feature on). Wear the mask with the straps and with the air pressure machine turned on while awake. After you're comfortable with that, try sleeping with it on.

Difficulties Tolerating the Machine

Although most of our patients tolerate their CPAP machines well, there are some who experience difficulties at first.

If you feel like you’re not making sufficient progress, please contact your sleep specialist or physician, to ensure that your pressure settings are correct and that you’re using it properly. If there are other issues with your sleep, your physician may also prescribe medications that can help.

Trouble Falling Asleep

Although it is normal and usually temporary, some of our patients have trouble falling asleep when they begin treatment. If this is your situation, you should ...

  • Use your machine’s “ramp” feature to gradually increase air pressure over time.
  • Avoid caffeine and alcohol before bedtime.
  • Exercise regularly.
  • Take a warm bath before bedtime.
  • Avoid going to bed until you’re tired.

Contact Details

Durham: 919-477-1588
Toll Free: 866-499-1588

Fax Durham: 919-477-1688
Fax Toll Free: 866-499-1288

Sleep Medical Center Locations: Durham, Burlington, Jacksonville, North Carolina
Feeling Great Respiratory Equipment: Oxygen, CPAP / BiPAP, Nebulizers

Call 866 499 1588

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