The Stanford Center for Sleep Sciences and Medicine

Adjusting to PAP Therapy

Try not to get frustrated. PAP is an invasive device and it takes most people several weeks to get comfortable with the therapy.

Wait Until the Mask is on Before Starting the Air

During your adjustment period to PAP therapy, be sure to secure your mask before turning on the air pressure. A well sealed mask is much more comfortable than a leaking mask.

Getting Used to the Air Pressure

New PAP users often find it strange to exhale against the positive pressure. Do your best to relax and just breath normally. If you’re having trouble adjusting, try reading a magazine or watching TV while wearing your PAP mask. You may find that with some distraction, you forget all about the mask.

Another technique is to use the ramp feature which starts the pressure at a lower level and slowly increases it to the therapeutic pressure over a period of time.

Getting the Right Mask

Using a PAP machine with an ill-fitting mask in nearly impossible. There are many different mask styles available to fit all shapes and sizes. If you are consistently having trouble getting your mask to seal properly, contact your Durable Medical Equipment (DME) company – you may need a different size or style.


While you may be tempted to take a night off while you’re adjusting to your PAP machine, the more consistently you use the machine, the faster you’ll get used to the therapy, so do your best to keep the mask on all night, every night.

Permission to Take a Break

During the night if you find yourself battling with your mask or fighting to breath against the pressure then take a break. Take the mask off and get up for a glass of water or to use the restroom before trying again.

If you’re extremely frustrated and unable to get comfortable even after taking after a break, it’s okay to take the mask off for the rest of the night. Remember, removing the mask should be a last resort since the more often you do this, the longer it will take you to adjust to the therapy.

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