Can’t Sleep with CPAP? Try These 7 Simple Fixes (2025)

CPAP (Continuous Positive Airway Pressure) therapy is a cornerstone treatment for obstructive sleep apnea (OSA), offering meaningful improvements in sleep quality, energy levels, and long-term health. However, some people find that even with nightly use, they’re still waking up throughout the night. If you’re wondering, “Why can’t I sleep through the night with my CPAP?” – you’re not alone. Many factors can contribute to this experience, but fortunately, most of them can be addressed with the right strategies and support.

Getting used to a CPAP machine doesn’t always happen overnight. The sensation of constant airflow can feel unnatural at first, and wearing a mask can be uncomfortable for some users. Even small air leaks or mask movement can be enough to disturb your rest. Mentally, the adjustment to sleeping with equipment on your face can take time, and physically, you may be dealing with settings or features that aren’t yet tailored to your needs.

A major reason for disturbed sleep while on CPAP is related to the mask itself. If the mask doesn’t fit well, it may cause air to escape or create pressure points on your face. This can lead to noisy leaks that interrupt sleep or skin irritation that makes it hard to get comfortable. Finding the right style such as nasal pillows, nasal masks, or full-face designs, and ensuring a proper fit are essential first steps in improving your sleep experience.

Another common issue is incorrect pressure settings. If the pressure feels too strong, it can be difficult to exhale, making it uncomfortable to fall or stay asleep. On the flip side, if the pressure is too low, it may not fully prevent airway collapse, and sleep apnea episodes can still occur. This can cause frequent awakenings and reduced treatment effectiveness. Your sleep specialist can help you adjust these settings or consider an auto-adjusting machine (APAP) for better comfort.

Dry air from your machine can lead to irritation in your nose, throat, or mouth. This is especially common if you don’t use a humidifier or if you live in a dry climate. In addition, nasal stuffiness can make it harder to breathe comfortably through your nose, especially with nasal-only masks. These issues can interrupt your sleep or make it difficult to fall asleep in the first place. Heated humidifiers and heated tubing are great tools to combat these symptoms and make breathing easier.

Some people experience aerophagia, or swallowing air, while using CPAP. This can cause gas, bloating, and abdominal discomfort that may wake you up during the night. Aerophagia is often related to high pressure settings or difficulty exhaling against the incoming airflow. Adjusting your pressure, using a machine with exhalation relief, or switching to a BiPAP may help alleviate this uncomfortable side effect.

Even quiet CPAP machines can produce enough noise to bother light sleepers. Beyond sound, the feeling of a mask on your face or tubing near your body can create a distracting sensation. These physical discomforts can interfere with sleep if not addressed. Try placing the machine on a padded surface to dampen vibrations, using a specially shaped CPAP pillow to support your mask, or wearing soft mask liners to reduce irritation.

Sometimes the issue isn’t the CPAP, it’s another condition. If you have restless legs syndrome (RLS), chronic insomnia, or frequent nighttime urination, these can break up your sleep regardless of how well your CPAP is working. It’s important to evaluate your overall sleep health to identify any contributing factors. A sleep specialist can help assess and treat coexisting issues to improve your overall sleep quality.

Struggling to stay asleep while using your CPAP doesn’t mean therapy isn’t working, it just means something needs to be adjusted. Whether it’s your mask, your pressure settings, your sleeping position, or coexisting conditions, there are ways to troubleshoot and improve your experience. With the right support and adjustments, CPAP can become a comfortable and essential part of your nightly routine. Don’t give up. The long-term benefits of CPAP, better sleep, more energy, and improved heart and brain health are well worth the initial adjustment period. Talk to your healthcare provider, stay consistent, and explore solutions that work for you.