Starting CPAP treatment marks the beginning of your journey towards better sleep and improved health. While the prospect of sleeping with a machine might feel overwhelming, understanding what to expect during your first month of CPAP therapy helps you prepare for the adjustment period ahead. Most new CPAP users experience a mix of challenges and encouraging improvements as their bodies adapt to this sleep apnoea treatment. This comprehensive guide walks you through each week of your CPAP adjustment period, covering everything from initial setup struggles to building sustainable habits that support long-term success.
Week 1: Getting comfortable with your CPAP machine
Your CPAP therapy adaptation begins the moment you unpack your equipment. The initial setup and first few nights present several common experiences that nearly all new users encounter:
- Equipment familiarisation challenges – Connecting tubing, adjusting your mask, and learning basic machine functions can feel overwhelming initially
- Unusual breathing sensations – The constant air pressure flowing through your mask creates an unfamiliar feeling that requires mental adjustment
- Unconscious mask removal – Many people remove their masks during sleep without realising it as their brain adapts to the new breathing pattern
- Frequent wake-ups – Waking multiple times to adjust mask position or airflow settings is typical during the first week
- Facial pressure discomfort – Some pressure from the mask seal is normal as you learn proper fitting techniques
These initial challenges represent your body’s natural adaptation process rather than treatment failure. Most people notice gradual improvement by night five or six as they develop familiarity with their equipment. To accelerate this adjustment, practise wearing your mask while awake for short periods during the day, starting with 15-minute sessions and gradually increasing duration as comfort improves.
What side effects should you expect during CPAP adjustment?
CPAP side effects during the first month are common and typically temporary. Understanding these effects helps you manage them effectively while your body adapts to treatment:
- Dry mouth and throat – The most frequent complaint caused by continuous airflow drying oral and nasal passages, particularly with mouth breathing or mask leaks
- Nasal congestion – Your nasal passages respond to pressurised air with temporary congestion that typically peaks during week one
- Mask pressure marks – Red marks that fade within an hour indicate normal use, while persistent marks suggest fitting adjustments are needed
- Claustrophobic sensations – Affects roughly 10% of new users but usually diminishes significantly after the second week
- Sleep disruption – Initial sleep quality may temporarily decrease as your body learns to sleep with the equipment
These side effects typically resolve within two to three weeks as your body completes its adjustment to therapy. Using a heated humidifier attachment effectively addresses dry mouth issues, while gradual exposure therapy and relaxation techniques help overcome anxiety-related symptoms. However, persistent or worsening symptoms after three weeks warrant consultation with your sleep specialist to ensure optimal treatment outcomes.
Weeks 2–3: Building your CPAP routine and troubleshooting issues
The second and third weeks focus on establishing consistent nightly use and addressing ongoing comfort issues. This critical period determines whether you’ll achieve the four-hour minimum nightly usage required for CPAP compliance success.
Building a sustainable routine starts with creating positive associations with your CPAP therapy. Set up your equipment in the same location each night, ensure your mask and tubing are clean and ready, and establish a consistent bedtime schedule that allows adequate sleep time.
Common troubleshooting during this period includes addressing mask leaks, which create whistling sounds and reduce therapy effectiveness. Check your mask positioning and headgear tension, ensuring the mask sits snugly without being overly tight. Small adjustments often eliminate leaks completely.
Experiment with different sleeping positions if comfort remains challenging. Many new users find that sleeping on their back initially works better than side sleeping, though you can gradually return to your preferred position as adaptation progresses. Track your usage hours during this period, aiming to increase nightly wear time gradually by adding 30–60 minutes each night until you’re wearing your mask for your entire sleep period.
How to track your progress and sleep improvements
Monitoring your progress during CPAP therapy helps maintain motivation and identifies areas needing adjustment. Your tracking approach should include both objective machine data and subjective daily improvements:
- Machine-generated metrics – Modern CPAP devices track usage hours, mask seal quality, and apnoea events per hour through smartphone apps
- AHI reduction monitoring – Effective therapy typically reduces your apnoea–hypopnoea index to fewer than five events per hour
- Morning alertness improvements – Most people notice increased wake-up energy within the first two weeks of consistent use
- Daytime energy tracking – Improved concentration and reduced afternoon fatigue become apparent as sleep quality improves
- Mood and irritability changes – Better sleep often leads to improved emotional regulation and reduced stress responses
Maintaining a simple sleep diary that notes morning feelings, daily energy levels, and persistent symptoms provides valuable information for follow-up appointments with your sleep specialist. This combination of objective data and personal observations creates a comprehensive picture of your treatment progress, helping identify successful strategies and areas requiring adjustment for optimal long-term outcomes.
Week 4 and beyond: Maintaining long-term CPAP success
Successfully completing your first month of CPAP therapy represents a significant milestone, but long-term success requires ongoing attention to equipment maintenance and personal motivation.
Establish a regular cleaning schedule to maintain your equipment’s effectiveness and longevity. Clean your mask and tubing weekly with mild soap and water, replace disposable filters monthly, and change your mask cushions every three to six months depending on wear patterns.
Equipment replacement timelines vary by component. Masks typically need replacement every six to twelve months, tubing annually, and the machine itself every five to seven years. Following these schedules ensures optimal therapy delivery and prevents equipment failures.
Maintaining motivation becomes important as the novelty of treatment wears off. Remember the symptoms that led you to seek treatment and celebrate the improvements you’ve achieved. Many successful long-term users find that tracking their progress and sharing experiences with support groups helps maintain their commitment to therapy.
Regular follow-up appointments with your sleep specialist help address emerging issues and optimise your treatment settings. These appointments typically occur at three months, six months, and annually thereafter, though more frequent visits may be necessary if problems arise.
Your first month of CPAP therapy lays the foundation for years of improved sleep and better health. While the adjustment period presents challenges, most people find that the benefits far outweigh the initial inconveniences. At Dream Sleep Respiratory, we provide comprehensive support throughout your CPAP journey, from initial sleep apnoea testing through ongoing therapy management, ensuring you achieve the best possible outcomes from your treatment.
If you would like to learn more, contact our team of experts today.