It’s time to pull the ol’ CPAP out of the closet, dust it off and try using it again.

By Clinton Marquardt - Sleep & Fatigue Specialist

February 25, 2015

cpap, obstructive sleep apnea, OSA

CPAP Desensitization

If you just couldn’t get used to using CPAP, the way it was introduced to you could be to blame. Sleep clinics are overwhelmed by huge waiting lists of patients. To try and help as many people as possible, they move fast, really fast. If you were diagnosed with obstructive sleep apnea, this could mean that your introduction to CPAP was very quick. You likely showed up at the sleep clinic, were told you had to wear this contraption on your face all night, they slapped it on and told you to sleep. Not too fun.

For some people this unpleasant experience can sensitize you to CPAP. What this means is that your brain and body learned very quickly that the CPAP experience was a negative one. Now all it may take is a quick glance into the closet to look at your CPAP and you feel your neck muscles tighten up and your blood pressure increase as a wave of frustration rushes over you. You are sensitized to CPAP. So what do you do? You desensitize.

CPAP desensitization is a process that reprograms your brain and body to feel that CPAP isn’t that bad, in fact, if done right, the CPAP experience can become a very positive one. So much so that simply looking at your CPAP brings up images of a peaceful, restorative sleep.

Here are the CPAP Desensitization[1] Steps:

  1. CPAP DesensitizationStart by wearing your CPAP mask without the tubing for about 15 minutes each day while you are awake. Do this while you are doing a pleasant activity that will keep your mind off the CPAP. Some people watch TV, read or do dishes.
  2. When you can wear the CPAP mask without tubing for 15 minutes without any negative feelings like stress or anxiety, increase the time by 15 minutes. Slowly work your way up to wearing the mask for an hour each day. When you can wear the mask for an hour while awake without any negative feelings, move on to the next step.
  3. Attach the mask to the tubing and CPAP unit and switch it “on”. If you can adjust the pressure manually, keep it at a low setting. If you can’t adjust the pressure setting, let the unit ramp up to your prescribed pressure and continue with the desensitization process. Practice breathing with the the CPAP system and pressure on for 30 minutes. Do this while you are doing some pleasant activity that will keep your mind off the CPAP.
  4. Slowly work your way up to wearing the mask with the pressure on while awake for one hour each day.
  5. When you can use the CPAP system for an hour without any negative feelings, start increasing the pressure a little each day until you get to your prescribed pressure.
  6. The next step is the best part because you now have permission to nap! Schedule a 90 minute nap each day you are at home. Try to start your nap around 2 pm. Use the CPAP at your prescribed pressure or ramp settings while napping.
  7. Let yourself get used to napping with CPAP slowly. When you start to enjoy your afternoon naps, it’s time to phase CPAP into your nighttime sleep.
  8. Start by using CPAP for the first 3 to 4 hours of your nighttime sleep. Do this for 4 or 5 days and then slowly increase the duration by an hour every 4 or 5 days until you can wear CPAP for the whole night.


Remember not to speed through the process. Go slowly, even more slowly than suggested if you need to. Don’t move on to the next step until you can complete the step you are on without any negative feelings. If you start to feel anxious or stressed at any step, you can even go back a step. If you take it slowly and make sure that the whole process is fairly comfortable and positive, your CPAP will become your best friend and won’t collect any more closet dust bunnies.

If you would like to optimize your CPAP desensitization process, let Clinton know. He can point you to a sleep coach in your area who can walk you through the steps and give you more guidance and tips (like using relaxation exercises) to help you succeed.


[1] These steps are based on the pioneering work of Thomas K. Speer. For more information, see Speer, T., & Fayle, R. (1997). The effects of systematic desensitization and sensory awareness training on adherence to CPAP treatment. Sleep, 26, 216.


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