[Skip to Content]

New to Sleep Apnea: What to Expect

What to Expect When First Starting PAP (Positive Airway Pressure) Therapy

Starting therapy can be overwhelming sometimes for some people.

  • “How do I get my equipment?"
  • “What mask would work best for me?”
  • “What if I can’t get used to wearing PAP?”
  • “Who do I call if I have more questions about things?”

Following a diagnosis of sleep apnea, your provider will write a prescription for PAP therapy, just like a prescription for a new medication.

Whether you had a sleep study in the sleep center and will have CPAP (one, continuous set pressure) or you had a home sleep test and will have APAP (various pressures) the prescription will include the pressure or pressure range, a list of the supplies needed for CPAP and a request for status reports on CPAP usage.

Instead of being sent to a pharmacy like a usual prescription, PAP prescriptions are sent to home care companies that provide durable medical equipment (or DME) or You, the patient, get to select which home care company you’d like to use in order to receive your PAP equipment and supplies.

Once the home care company receives the prescription or order it is sent to the insurance company for approval for the equipment.

Following insurance approval, the home care company will contact you in order to set up a day for equipment delivery and education on how the machine works and what mask will work best for you.

What will I receive when I get my equipment?

  • PAP (Positive Airway Pressure) machine with a humidifier that can detach for refilling
  • Hose which connects to the machine and the mask
  • PAP  (Positive Airway Pressure) mask
    • Nasal pillows: Silicone pieces fit into the nostrils
      • Good for people who have claustrophobia or sleep on their sides
      • Minimal mask to face contact
    • Nasal mask: Mask that covers the nose only
      • Good for people who cannot tolerate nasal pillows
      • Good for people who sleep on their sides
      • Small mask to face contact
    • Full Face mask: Mask that covers both the nose and mouth
      • Good for people who are “mouth breathers” and have frequent complaints of dry mouth
      • Medium-Large mask to face contact

Common Issues When Starting PAP Therapy

Expand all

Mask Fitting Issues

  • Claustrophobia
    • Solution: Try wearing your mask for short time periods. Wear the mask only during commercial breaks and gradually increase the amount of time you can keep the mask on. 
    • Solution: Try a smaller mask
  • Leaks
    • Solution: Make sure the mask is the right size and not too big or too small
    • Solution: When adjusting the mask do so equally: adjust both sides at the same time so they mask stays centered on the face
    • Solution: Do not over tighten the mask: PAP masks are designed to create a good seal to the face. Put the mask on firmly but leave it a little loose to let the pressure from the machine push the mask to your face.


Pressure Issues

  • Too much pressure
    • Solution: Try to use the ramp feature of the machine. The ramp will start the machine off at a low setting and slowly increase pressure over a set amount of time to allow you to fall asleep without a high pressure.
    • Solution: If you have an Auto machine check to see if there is a big leak. Sometimes the machine thinks a leak is an apnea so it will keep increasing the pressure.
  • Too little pressure
    • Solution: If the ramp feature is on, turn it off so the pressure starts off higher in the beginning
    • Solution: Check for leaks. Large leaks can decrease how much pressure is actually going through the mask.

Physiological Issues

  • Dry nose
    • Solution: Increase the humidity level on the machine
    • Solution: Try an over the counter normal saline nose spray
  • Dry mouth/throat
    • Solution: Increase the humidity level on the machine
    • Solution: If using a nasal mask try switching to a full face make
    • Solution: Try using a chin strap if you notice your open your mouth while sleeping with a nasal mask
    • Stay hydrated!


Skin irritation/sores

  • Solution: Do not use soaps or lotions before putting on the mask
  • Solution: Wipe down the mask each morning with warm water and mild soap and let air dry
  • Solution: Loosen the mask
  • Solution: Try a different style mask
  • Solution: Try an over the counter healing ointment during the daytime



  • Machine issues
    • Home care company where the equipment is from
  • Other (return of symptoms, usage issues)
    • Physician or provider who prescribed the PAP
    • Sleep Center