Why Your CPAP Therapy Is Not Working (And How to Fix It)

You started CPAP therapy expecting better sleep, more energy, and improved health.

But instead…You’re still tired. Still struggling. Maybe even considering giving up.

If that sounds familiar — you’re not alone.

The truth is: most CPAP problems are fixable. And in almost every case, it’s not the machine — it’s the setup, monitoring, or optimisation.

Let’s break down the real reasons your CPAP therapy might not be working — and exactly how to fix them.

1. Mask Leak: The Silent Therapy Killer

Even a small leak can completely reduce the effectiveness of your therapy.

Signs you have a mask leak:

• Dry mouth in the morning

• Whistling or air blowing into your eyes

• High leak warnings on your machine

• Your partner complaining about noise

  
  

How to fix it:

• Refit your mask properly (not too tight!)

• Replace worn cushions (every 1–3 months)

• Ensure correct mask size

• Consider switching mask type (see point 5)

👉 Key insight: Many patients overtighten masks, making leaks worse — not better.

2. Incorrect Pressure Settings (Most Important)

This is one of the BIGGEST reasons CPAP therapy fails.

Too low → airway still collapses

Too high → discomfort, aerophagia, poor sleep

Signs your pressure is wrong:

• Feeling like you’re “not getting enough air”

• Waking up bloated (air swallowing)

• Persistent apneas despite using the machine

• Removing mask during the night

  
  

How to fix it:

• Use AutoSet (APAP) instead of fixed pressure when possible

• Adjust minimum pressure (critical setting!)

• Review therapy data — not guesswork

👉 Important: Without proper titration or monitoring, pressure settings are often wrong.

3. No Monitoring or Follow-Up

Imagine taking medication without ever checking if it works.

That’s what most CPAP users are doing.

The problem:

• No one checks your AHI

• No one reviews leak rates

• No one adjusts your settings

  
  

The result:

👉 You stay tired — even while using CPAP.

The solution:

• Use remote monitoring (like AirView)

• Track:

  • AHI (apnea events)

  • Leak rate

  • Usage hours

• Adjust therapy based on real data

  
  

👉 This is where real CPAP success happens.

4. Old or Worn-Out Equipment

CPAP equipment doesn’t last forever.

Over time:

• Masks lose their seal

• Tubing develops micro-leaks

• Filters clog airflow

  
  

Signs your equipment is too old:

• Mask feels loose even when tight

• Therapy feels weaker

• Increased noise or leaks

  
  

Replacement guidelines:

• Mask cushion: every 1–3 months

• Mask frame: every 6–12 months

• Tubing: every 6–12 months

• Filters: monthly

👉 Old equipment = poor therapy (even with a good machine)

5. Wrong Mask Type for Your Breathing Style

Not all masks work for all patients.

Choosing the wrong type can ruin your therapy.

Common mistake:

Using a nasal mask while breathing through your mouth → therapy fails.

Mask guide:

• Nasal mask (e.g., N20): Best for nose breathers

• Full face mask (e.g., F20 / F40): Best for mouth breathers

• Nasal pillows (e.g., P10): Minimal, but not for high pressures

  
  

Fix:

• Match mask to your breathing pattern

• Don’t force a mask that doesn’t suit you

  
  

The Real Problem Most People Don’t Realise

CPAP therapy is not plug-and-play.

It’s a medical treatment that needs adjustment, monitoring, and support.

Most failures happen because:

• The device was sold without proper setup

• No one followed up

• No one reviewed the data

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Final Thoughts: CPAP Should Work — When Done Right

If your CPAP therapy isn’t working, don’t give up.

You likely don’t need a new machine —You need proper optimisation.

Why Patients Across South Africa Choose CPAP Equip

• Sleep Lab–backed setup

• Remote monitoring via AirView

• Personalised pressure optimisation

• Nationwide delivery & support

• Expert guidance (not just a sale)

  
  

Ready to Fix Your CPAP Therapy?

If you're struggling with your CPAP:

👉 We’ll review your data

👉 Optimise your settings

👉 Help you find the right mask

👉 Get your therapy working properly

👉 Final Word

At CPAP Equip we don’t just sell machines — we monitor and optimise your therapy.

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Jean-Marie Claassens

Clinical Technologist (Pulmonology)

CPAP Equip