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A diagnosis forsleep apnea, a condition that causes breathing to temporarily stop and restart while a person is sleeping, generally means getting a prescription for aCPAP machine. CPAP stands for continuous positive airway pressure, and the basic function of the machine is to deliver a continuous flow of air to the wearer to keep their airways open.
When someone is first presented with the idea of using a CPAP, it’s a pretty common response to shudder and think,No way. It’s a small, boxy device slightly bigger than a loaf of bread with tubing that connects to a mask worn over your mouth and/or nose. Pharmacist and CPAP userDr. Alisha Reedput it to me frankly: “It’s not sexy. You’re getting ready for bed and it’s like, ‘I have my skin-care routine, I have my cute comfy pajamas on, and then I have to put this CPAP machine on.’” Sleeping comfortably with a mask that blows air into your facedefinitely takes some getting used to. But, beyond affecting sleep quality, untreated sleep apnea can increase the risk of conditions like heart disease, high blood pressure, and diabetes.
According to theAmerican Medical Association, about 6 million Americans are currently diagnosed with sleep apnea (though the AMA estimates that is likely an undercount of how many people actually have the condition). Despite being a relatively common sleep disorder, it is not the first thing people tend to assume is wrong when they’re dealing with symptoms like extreme tiredness, major snoring, or high blood pressure. And because sleep apnea isn’t something people often discuss in public, it can feel isolating. “You get the diagnosis, you get the machine, and then it can feel like you’re on your own,” says Kristen Cascio, a social worker andcontent creator.
That’s why Reed, Cascio, and so many other people who use CPAP machines find it important to talk about. “I am very heavily involved with the American Heart Association, and when I found out about the correlation and the connection between sleep apnea and heart disease, it was another reason for me to say, ‘Let’s talk about this. Let’s normalize it,’” Reed says. So I spoke to several CPAP users to learn all their tips, tricks, and habits that make adjusting to life with a CPAP easier until you get to the point where you can’t imagine sleeping without it.
Try different masks to get the right fit
Because a CPAP is a medical device prescribed by a doctor, it will generally be covered to some extent by insurance, if you have it. You’ll likely want to visit a durable-medical-equipment supplier, or DME, Cascio says. Though you may also be able to do an online consultation and have the machine shipped to you.
You should also prepare yourself for a marathon, not a sprint. “It’s not unusual that somebody would have to try three, four, or five different types of masks before they find one that’s good for them,” Cascio says. “Don’t give up if you don’t like the first mask.” Several CPAP users I spoke to mentioned this experience. The first mask that content creatorSamantha Paultried covered bother her mouth and nose, but she found it uncomfortable and switched to a nasal mask. Author and podcasterKate Spenceralso started with a full mouth-and-nose mask but ultimatelyswitched to a nasal maskpaired with a chin strap to keep her mouth closed. (Read more aboutSpencer’s full sleep setup, including her CPAP machine, here.)
Cascio was the opposite and started with the nasal mask because it felt less invasive. But because she was breathing through her mouth while the mask was over her nose, she wasn’t experiencing the full benefit of using the CPAP, so she switched to a full mask, which she now prefers. Finding the right fit can be a lengthy process, she warns, especially because insurance typically covers a new mask only every few months — but she also emphasizes that making the effort is worth it.
If you are breathing through your mouth, a chin strap or mouth tape may help
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A common refrain I heard from CPAP users was that they didn’t realize they were breathing through their mouth until they started using their machine. For some, like Cascio, switching to the full face mask may do the trick. For others, an accessory like a chin strap or mouth tape can help solve the problem. Spencer uses a chin strap, in conjunction with her nasal mask, to gently keep her mouth closed withoutforcingit closed. Paul uses mouth tape and recommends choosing an X-shape tape that’s made of a breathable material.
Read more:How I Stopped Mouth Breathing and Finally Got Some Sleep
If you’re struggling to adjust to the mask, practice wearing itbeforeyou go to sleep
Cascio suggests getting accustomed to the feeling of the mask by wearing it for a while before you actually go to bed to desensitize yourself to the feeling of it on your face. Reed used this trick when she was a new CPAP user — she’d put on her mask while reading or watching TV to ease her transition into wearing it all night long.
Virginia Sole-Smith, author of the anti-diet, body-liberation newsletterBurnt Toast, received her sleep-apnea diagnosis and starting using a CPAP machine more recently; she’s also wearing her mask for some extra time before bed and pairing it with simple breathing exercises. “I do some deliberate slow, deep breathing when I first put it on to get in the rhythm, and then I basically forget it’s there,” she says.
Use the “ramp time” setting to adjust to the pressure
When a doctor prescribes a CPAP machine, they’ll also prescribe a specific air-pressure setting. But the full “dose” can feel intense initially, Cascio says. She recommends relying on your machine’s “ramp time” feature to acclimate to the feeling of the air pressure. “You can usually set it up to 45 minutes and over that time your machine, instead of just starting at the recommended pressure that your doctor puts it at, will gradually build up to that,” Cascio explains. Since it takes most people ten to 15 minutes to fall asleep, Cascio advises setting the ramp time for slightly longer than that so by the time you’re fully asleep, it will reach the full pressure your doctor prescribed.
Keep your mask clean to prevent breakouts
“Most CPAP masks are a thin silicone that goes right up against your face. But I have really sensitive skin and I would get a lot of redness and breakouts from it,” says Cascio. She started using CPAP mask liners, which are made of fabric and serve as a barrier between the mask and your face, to prevent irritation and acne. You can get both reusable and disposable mask liners — just be sure to match the liner to the type of mask you have.
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Reed also struggled with breakouts when she first started wearing her CPAP mask and recommends using CPAP-specific wipes to clean your mask daily. Since they’re designed for CPAP devices, they are generally alcohol- and latex-free and won’t degrade the silicone.
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Cascio also does aweekly deep cleanof her CPAP parts by washing them with Dawn dish soap and letting them soak, then letting them air dry. “Some people say you should do that every day, but there’s no way I’m going to keep up with that,” she says, “so I do it weekly.”
If the sound of your CPAP machine disturbs you or your partner, get a sound machine
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“People are worried that it’s really noisy,” Cascio says. “It does not make a lot of noise, but you can hear your breathing in and out a little bit.” To keep the noise from bothering her and her husband, Cascio uses asound machine, which she says easily drowns out any sound from the CPAP.
Teeth hurting? You may need a mouth guard.
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Sole-Smith started experiencing some tooth pain after about a month of using her CPAP machine. After talking to her dentist, she learned there is an association between CPAP use and jaw clenching, so now she’s getting amouth guardtoo.
Traveling with a CPAP is easier than you might think — but plan ahead for power and water
Every CPAP user I spoke to assured me that traveling with their machine was simple. Because airlines allow you to bring medical equipment onboard without counting it toward your baggage allowance, you don’t need to worry about squeezing your CPAP into yourcarry-on. Most CPAP machines come with their own case, sort of like a messenger bag. Most are black and fairly nondescript, though ResMed does make aLuxe travel totefor CPAPs. They generally have padding to protect the machine, much like a camera case, and help quickly identify the bag as medical equipment. Cascio noted that it’s typically best to keep the CPAP separate from your other luggage and to always carry it on, so you don’t have to worry about losing it if your bag gets gate checked.
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Cascio has taken her full-size CPAP machine to 14 countries without any issues, but if you’d prefer to travel with something smaller, many CPAP manufacturers also make travel-size machines. These can be especially convenient if you’re managing other people’s luggage in addition to your own; after taking her regular machine on a recent trip to Jamaica, Sole-Smith has ordered a smaller one for her next trip. “When I’mtraveling with kidsand have more stuff to schlep, I don’t relish having to cart the CPAP around the airport with us,” she says.
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A CPAP requires distilled water, so you’ll need to do some research and make a plan before you leave — will it be easier to bring it with you or buy it at your destination? Reed went on a cruise and was able to get distilled water onboard — she simply checked with the company ahead of time. Spencer has flown with bottles of distilled water while on a family trip and said it was easy enough; TSA had to do a quick additional screening. Cascio also prefers to bring her own distilled water; she recommends buying a multipack of bottles that are labeled for medical use and always brings a few with her when she travels.
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For international travel, Cascio says you likely won’t need a full-on power converter, just an adapter. However, she suggests confirming that your CPAP machine is dual voltage and making sure you understand what range it can handle. While most modern CPAP machines are designed to work internationally with an adapter, this is a “better safe than sorry” scenario: Frying your hair dryer is unfortunate, but you can live with it. You definitely don’t want to fry your CPAP.
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Sole-Smith packed a travel adapter with an extension cord for a recent trip, just in case the outlets at her hotel room weren’t close to the bed. Turns out she made the right call, and the extension cord allowed her to use her CPAP without any issues.
For long-haul flights during which she needs to sleep, Cascio uses her CPAP machine on the plane. Some airlines will let you plug the machine into the seat’s outlets, but you have to check in advance, Cascio says. She recommends searching the airline’s website for a page about medical devices or assistive devices, which should give you a clear answer. If you can’t plug in on the plane or want to be extra prepared, you may also want to get a portable battery. They’re basically like a portable phone charger, and they can be expensive, Cascio says, but for frequent travelers it’s a worthwhile purchase.
Don’t be afraid to ask for help
Everyone I spoke with stressed the importance of being patient and giving yourself grace as you adjust to sleeping with a CPAP. Talk to your doctor if you’re struggling with your mask or pressure settings or are experiencing any other hurdles. Paul’s doctor was able to prescribe her a temporary anti-anxiety medication to help with the transition period. Sole-Smith thought she needed a new mask until she did a consultation with a tech from her DME, who showed her the proper way to wear it. It’s not always easy, but it’s important to make the CPAP work well for you — not only for your health but because you’ll generally need to show compliance for a certain number of days for your insurance to cover the costs.
I also heard the same piece of advice over and over: Don’t hesitate to ask more experienced CPAP users for help. If you don’t already have someone in your life who also uses a CPAP machine, you can almost certainly find a community online. Cascio relies on the CPAP community on social media for recommendations and volunteers with the nonprofit Project Sleep, which runs a program calledSleep Apnea Squadto provide resources to people with the condition. Sole-Smith is now documenting her experiences in a series called theSleep Apnea Diariesand told me there’s a dedicated sleep-apnea chat forBurnt Toastsubscribers where she’s already picked up some great tips.
More From Sleep Better Week
- Welcome to Sleep Better Week
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- If You Don’t Know What Kind of Mattress You Want, Try a Medium-Firm Hybrid
- Unisom Was the Only Thing That Helped My Pregnancy Insomnia
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