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Figure wearing moon covered pajamas holding two different style sleep face masks.

The Sleep Machine

I was recently diagnosed with severe obstructive sleep apnea after having a sleep study test. This condition means that my airway closes while I am sleeping, which causes me to choke or not breathe during sleep and can damage the heart over the long-term.

Sleep apnea can also severely hamper quality of sleep, contributing to increased tiredness during the day and general feeling of fatigue. While I have struggled for many years with fatigue, I always attributed it to my rheumatoid arthritis. It seems that there was a second culprit as well!

Using an AutoPAP for sleep apnea

Admittedly, I was neither excited about having another condition added to my plate nor the current common treatment of using a CPAP machine while sleeping. I was convinced by the severity of my condition and the negative health effects that I should give the “sleep machine” (as I call it) a try.

AutoPAP vs traditional CPAP

Following the sleep study, the physician prescribed me an AutoPAP machine. This is different than the traditional CPAP, which is sending continuous airflow through a mask to make sure that your airways stay open. The Auto-PAP is a machine that ramps up the air gradually, senses when your breathing stops or gets too shallow, and then increases the airflow to open the airway. It is supposed to adjust to the individual’s condition and treatment needs, where a CPAP needs to be set in a sleep lab and checked to make sure it is delivering the right amount of air during sleep.

My experience using an Auto-PAP machine

After a couple weeks I received my machine via mail delivery. It came with a nose piece that had different sizes, hose, and machine with a humidifier. It also came with a lot of direction booklets! At first, I was really overwhelmed, but my husband patiently put it together (after soaking and drying the components), helped me pick the right nose piece size, and set it up.

The first night was really difficult because it felt uncomfortable in multiple ways: it felt claustrophobic around my face, too tight on my nose, and also like I couldn’t breathe because the air pressure was so strong. I kept trying it for a week and gradually became more accustomed to the feel of the mask. Sometimes I just had to take it off in the middle of the night because I couldn’t fall asleep or kept waking up feeling uncomfortable.

Helpful tools and information

Thankfully part of the process was a follow-up call with the sleep machine equipment provider to talk through my experience and see what adjustments could be made. The night before my scheduled call, I noticed a sticker on the machine that said I could download an app on my phone and get data on my sleep. For me, this sounded very helpful. The app would tell me the length of time wearing the mask, the level of air leakage from the mask, the number of sleep apnea incidents on average per hour, and if I took my mask on/off multiple times. Then an overall score of this information could tell me how it was going.

Making adjustments that work for me

On the call with the equipment provider, I explained how I was feeling uncomfortable with the nose mask. Once I put it on, speaking became difficult because opening my mouth altered the air pressure coming in through my nose. Additionally, I tend to breathe through my mouth some when sleeping. Whenever my mouth opened during sleep I would wake up with an air blast coming at my nose through the mask. It even woke my husband on multiple occasions!

Assistance from the sleep equipment provider

The provider suggested I try a full face mask that would cover both my mouth and nose. It arrived a few days later and I have been using it ever since. It is much more comfortable for my night time breathing and surprisingly feels less claustrophobic to me than the one strapped to my nose (which I think just gripped too tightly and near my eyes to be comfortable). With this change, my sleep phone app results also improved, as I haven’t had to remove the mask during the night and could keep it on longer.

Although I know I’ve just begun the journey, I am hopeful that the sleep machine is improving the quality of my sleep. I believe my fatigue may be getting better, although it can take a few months for that to be truly revealed. In any case, I’m going to continue working with it towards the goal of improving my health for the long term.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Mafalda
    7 months ago

    I was diagnosed with severe sleep apnea about 9 years ago. I stop breathing an average of 63 times an hour (as of Nov. 2018). I was overweight at the time of my diagnosis and slimming down to 134 lbs. didn’t make any difference, since my apnea is described as 50% obstructive, 50% central. And that’s why I use a CPAP instead of an Auto-PAP, I need a constant flow of pressured air.
    My diagnosis of RA, Fibro and other related conditions didn’t happen until 4 1/2 years ago, so I can safely say that treating my apnea hasn’t had any effects on these conditions, as the pain/fatigue has been increasing over time.
    I used to be a mouth breather and a snorer, but the pressurized air allows me to keep my mouth closed all night. No more snoring.
    Using my quiet CPAP with warmed air flow and a comfortable nasal pillow gives me the assurance that I won’t wake up -constantly- gasping for air, that I will be able to reach the much needed REM state, and that my vital organs won’t be deprived of precious oxigen.

  • Kelly Mack moderator author
    5 months ago

    Thanks Mafalda! Really appreciate your sharing and find it encouraging. I’m hanging in there and finding it helpful! Best, Kelly ( Team)

  • Frazzled
    7 months ago

    Hey Kelly,

    I also was diagnosed with severe sleep apnea (my AHI was around 55 when I was tested). I was given the nose pillow version of the autoPAP like you have, and I can’t even thinking about lying down without putting it on. Yes, talking is difficult, and I used to breathe out of my mouth, but I was able to make it work. I found the full-face mask to be way to claustrophobic. Guess we can be glad that they make different masks for different people.

    That said…I am not sure my fatigue has gotten any better, and I still struggle with getting to sleep. But I have had intractable insomnia for 25 year, which I attribute to my RA as well. I hope it works better for you than it does for me, but even if you don’t see a reduction in fatigue, the knowledge that you are not choking in the middle of the night, waking up with headaches, and all of the other potential side effects of apnea (especially on the heart) is worth it.


  • Kelly Mack moderator author
    5 months ago

    Thanks so much for the encouragement Mike! I think it is helping. Hope you get some rest and relief from fatigue. Best, Kelly ( Team)

  • verites
    8 months ago

    That could have been me writing that! It’s been a real struggle but after a month I am beginning to adjust to my mask…and I don’t wake up feeling totally drained and exhausted anymore. Still getting fatigue and needing to rest in the day but that is from my RA I think and not lack of sleep. My relationship with my CPAP machine has moved from intense hatred to respect.

  • Kelly Mack moderator author
    5 months ago

    Glad it is helping verites! Sounds like progress. I have used mine for about 6 months and can say my overall exhaustion has greatly improved. This is good! Keep at it! Best, Kelly ( Team)

  • Djpatters
    8 months ago

    Hi Kelly,

    I have had severe obstructive sleep apnea for the last 17 years and have successfully sleep all but a very few nights using a CPAP machine with full face mask. I also am a mouth breather and tried both the nasal and nose only masks at first with little success. I only use the humidifier in the winter when it’s dry outside as I don’t find it necessary in the summer. You will find a comfortable fit and before your husband knows it he won’t even hear your machine anymore.

    I was just diagnosed with Sero-negative inflammatory arthritis along with osteoarthritis last August so my journey with this disease has just begun. I am currently on plaquenil and methotrexate and seem to be doing good with no flares. Go for ultrasound on hands in August and look forward to finding out what is going on.

    Take care and sleep well.

  • Kelly Mack moderator author
    5 months ago

    Thanks for the encouraging comment Djpatters! I have been adjusting and find the full face mask good as I am also a mouth breather. Sorry to hear about your diagnosis, but glad it sounds you’re on stable treatment. Hang in there! Best, Kelly ( Team)

  • Lawrence 'rick' Phillips moderator
    8 months ago

    Oh I hope you like it. I have been using mine for over 20 years and I came to it kicking and screaming. Today i would not want to give it up because I rely on it to get to sleep.

  • Kelly Mack moderator author
    5 months ago

    Thanks Rick! I have adjusted pretty well. Wouldn’t say I love it, but it definitely helps. 🙂 Best, Kelly ( Team)

  • Gidgxx
    8 months ago

    I was diagnosed with mild sleep apnea and also insomnia two years ago after going for a sleep study. So far I haven’t needed the CPAP machine.

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