Can’t get used to CPAP? Here’s why so many fail to stick with it (and what you can do about it)

If you or someone you know has been diagnosed with sleep apnea, chances are a CPAP (continuous positive airway pressure) machine was prescribed as the primary treatment. However, many patients can’t get used to CPAP, and getting them to use it regularly is an ongoing challenge in the medical community. Many studies have reported this frustrating and discouraging news.

One such study, published in the Journal of Otolaryngology – Head and Neck Surgery in 2016, revealed a startling statistic: over a 20-year period, the percentage of individuals who used their CPAP machines for the recommended 7 hours per night remained at a dismal 34%! * That means nearly two-thirds of patients were not adhering to their prescribed therapy.

So, what’s behind this alarmingly low adherence rate? Let’s explore some of the common barriers that make it difficult for many people to stick with their CPAP treatment.

Reason #1 people can’t get used to CPAP: The Adjustment Period

Using a CPAP machine requires a significant lifestyle adjustment. Wearing a mask over your face all night and having air continuously forced into your airways can feel uncomfortable, claustrophobic, and even embarrassing, especially when sleeping with a partner. This initial discomfort often leads to inconsistent use or abandonment of the therapy altogether.

Reason #2: Lack of Immediate Results

CPAP therapy can take time to produce noticeable improvements in sleep quality and daytime energy levels. When the benefits aren’t immediate, it’s easy for patients to become discouraged, get it stuck in their heads that they simply “can’t get used to CPAP”, and stop using their machine regularly.

Reason #3: Nasal and Throat Irritation

The constant airflow from the CPAP machine can dry out and irritate the nasal passages and throat, leaving users feeling stuffed up and uncomfortable. This dryness is a common complaint that contributes to poor adherence.

Reason #4: Traveling Challenges

The need to pack and transport the CPAP equipment can be a hassle for frequent travelers, making it tempting to skip using the machine when away from home. Consistency is key, and taking breaks makes people think they can’t get used to CPAP, even though they would if they used it more regularly.

Despite these challenges, it’s crucial for patients to persist with their CPAP therapy. Untreated sleep apnea can lead to serious health consequences, including an increased risk of high blood pressure, heart disease, and stroke. With proper education, support, and adjustments, many of the barriers to CPAP adherence can be overcome.

Healthcare providers play a vital role in helping patients navigate the difficulties and find solutions that work for their individual needs. Regular follow-ups, troubleshooting, and encouragement can go a long way in improving adherence rates and ensuring patients receive the full benefits of this life-changing treatment.


*Rotenberg, B.W., Murariu, D. & Pang, K.P. Trends in CPAP adherence over twenty years of data. J Otolaryngol Head Neck Surg 45, 43 (2016).

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