How to Make CPAP Work: Setup, Titration and Troubleshooting at Respire, Hyderabad
Pulmonologist-Supervised CPAP Setup, Mask Fitting & 90-Day Follow-Up
Most CPAP machines in Hyderabad are not in active use. They are in cupboards. CPAP works when three things are true at once: the pressure is set correctly, the mask actually fits, and someone clinical is reachable when something goes wrong. Respire delivers all three as a supervised service, not as a delivery.
Medical disclaimer: This content is reviewed by Dr. Kunal Waghray, DM (Pulmonary Medicine), Interventional Pulmonologist. It is for informational purposes only and does not replace a medical consultation.
Last reviewed: 2026-05-10 by Dr. Kunal Waghray
Written and reviewed by Dr. Kunal Waghray, DM (Pulmonary Medicine), Interventional Pulmonologist (1,000+ bronchoscopies), Respire Airway Clinics. Co-reviewed by Dr. Pradyut Waghray, MBBS MD FRCP (London) FCCP FAMS, Founder, 35+ years in pulmonary and sleep medicine.
Patients tell us the same sentence almost word for word: “I tried CPAP for a week and threw it in the cupboard.” The mask leaked. The pressure felt like a hairdryer. Nobody picked up the phone when the dryness started. By day eight, the box was on top of the wardrobe.
If you are newly prescribed, this is how a setup should go. If your machine is already gathering dust, this is what a fix looks like. For broader context on the condition itself, see our page on sleep apnea treatment.
Why most CPAP failures are setup failures, not patient failures
If CPAP feels impossible, the problem is almost never you.
Most failed setups in our clinic share the same five faults: pressure set too low to splint the airway, pressure set too high so the patient fights the machine, a mask shape wrong for the face, no humidifier in a city where winter air dries the nose by 2 a.m., and no follow-up phone number. Add a sixth in Hyderabad: machines bought from a supplier with no clinical input, where the prescription is a piece of paper and nothing else.
You cannot patient your way out of a wrong pressure. Adjusting the mask straps tighter does not fix a leak caused by the wrong cushion size. These are clinical problems with clinical answers.
What CPAP actually does
CPAP is a splint made of air.
CPAP (continuous positive airway pressure: air gently splints the airway open) prevents the soft tissue at the back of the throat from collapsing during sleep. It is not oxygen. It is not a sedative. It does not cure sleep apnea; it treats it for as long as you wear the machine, in the same way that glasses correct vision only while you wear them.
When CPAP is prescribed
The American Academy of Sleep Medicine recommends positive airway pressure as first-line therapy for adults with moderate-to-severe obstructive sleep apnea, and as an option for mild OSA with daytime symptoms (AASM Clinical Practice Guideline, Patil et al., 2019). The trigger is your AHI (apnea-hypopnea index: pauses per hour while sleeping) on a sleep study, alongside symptoms and cardiovascular risk.
What CPAP is not
CPAP is not a snoring gadget you can buy off a shelf. It is a prescription device. If you also snore without diagnosed apnea, that is a separate conversation. See our page on snoring treatment.
CPAP vs APAP vs BiPAP: which one and why
The choice of machine is decided by the sleep study, not the patient.
CPAP
Delivers a single fixed pressure all night. Best when titration shows one pressure controls events across all sleep stages and positions.
APAP
A CPAP that adjusts pressure automatically through the night within a set range. Useful when pressure needs change with REM sleep or back-sleeping.
BiPAP
Delivers two pressures: one for breathing in, one for breathing out. Reserved for higher pressure requirements, CPAP intolerance, and conditions like obesity hypoventilation or coexisting lung disease.
A common mistake is buying APAP because it sounds smarter. Smarter is not always better. The right machine is the one your study points to.
Why titration matters more than the brand of machine
Pressure is a prescription, not a default setting.
Titration (the process of finding the right pressure for your airway) is how a pulmonologist converts your sleep study into a number you can actually sleep on. In some patients, an in-lab titration study is needed: pressures are adjusted manually while sleep stages are recorded. In others, an APAP-led titration over two to four weeks at home gives us the 90th-percentile pressure to fix into a CPAP. Either way, the number is reviewed at follow-up, not assumed at handover.
If your last setup skipped this step, you were given a machine, not a therapy. Patients arriving at Respire after a failed start almost always need a home sleep study review and a re-titration before anything else changes.
Masks: the part that decides whether you keep using CPAP
The right mask is the one you forget you are wearing.
Three families exist: nasal masks (cushion over the nose), full-face masks (covers nose and mouth, used for mouth-breathers and high pressures), and nasal pillows (small inserts at the nostrils, lightest option, often best for claustrophobia and side-sleepers). Beard, facial structure, deviated septum, and sleeping position all change the answer.
How a mask fitting works
In the clinic, we sample two or three mask types against the running machine, check seal at therapeutic pressure, and observe how the cushion behaves when the head turns. A fitting takes 30 to 45 minutes. It is not a guess based on a photograph.
Fixing leaks and pressure marks
A leak at the top of a nasal mask usually means the cushion is too large, not too small. Red marks on the bridge of the nose mean overtightened straps compensating for a wrong size. Both are refit problems, not patient problems.
Common side effects and how each one is fixed
Every common CPAP complaint has a clinical fix.
| Complaint | Likely cause | Fix |
|---|---|---|
| Dry mouth | Mouth leak, no humidity | Heated humidifier; chinstrap or full-face mask if mouth-breathing |
| Nasal congestion | Cold dry air, untreated rhinitis | Heated humidity; nasal steroid spray; ENT review |
| Aerophagia (swallowed air) | Pressure too high for inspiration | Pressure adjustment; switch to BiPAP if persistent |
| Claustrophobia | Mask too occlusive | Nasal pillows; graded desensitisation at home |
| Pressure marks on bridge | Strap overtightening, wrong size | Refit, different cushion family |
| "Hairdryer" sensation | Ramp off, pressure misset | Enable ramp; re-titrate |
If you are claustrophobic and have written off the mask entirely, nasal pillows often change that conversation in a single session.
How CPAP at Respire works
Your CPAP starts with a prescription and ends with a follow-up, not a delivery.
The path is straightforward. You see Dr. Kunal Waghray or Dr. Pradyut Waghray for a consultation and sleep study review. Machine type is chosen against your data. A mask is fitted in person. Titration is supervised, either in-lab or APAP-led. You then enter a 90-day follow-up window where pressures, masks, and humidity are adjusted until the therapy is invisible to your sleep.
In our clinic, we routinely refit masks and adjust pressures for patients who were handed a machine without follow-up elsewhere. Some bring boxes opened only once. The work is rarely complicated; it is just work that nobody did the first time.
Both clinics, Basheer Bagh and Jubilee Hills, run integrated ENT, pulmonology, and sleep medicine in one visit, which matters when nasal obstruction or septal anatomy is part of why a mask is failing.
Renting vs buying CPAP in Hyderabad
Rent if you are starting. Buy when you know it works for you.
A short rental during the first four to eight weeks lets you confirm the right machine type and mask before committing. If APAP data over that period shows stable pressures and good usage hours, purchase becomes straightforward. If the data shows the wrong machine or unresolved leaks, you have not bought a problem. Contact the clinic for current rental and purchase pricing in Hyderabad.
Frequently Asked Questions
What is the price of a CPAP machine in Hyderabad?
Prices vary by machine type (CPAP, APAP, BiPAP), brand, and whether a humidifier is included. We discuss machine cost openly at the consultation and do not push specific brands. Contact the clinic for current pricing.
Can I rent a CPAP machine in Hyderabad?
Yes. Respire arranges supervised rentals during the trial period so you can confirm machine type and mask fit before purchase. Rental data also informs the final pressure setting.
What is the difference between CPAP and BiPAP?
CPAP delivers one pressure for inhalation and exhalation. BiPAP delivers two: a higher inspiratory pressure and a lower expiratory pressure. BiPAP is used for higher pressure needs, certain lung conditions, and patients who cannot tolerate exhaling against fixed CPAP pressure.
How do I get a CPAP prescription in India?
A sleep study (home or in-lab) is required, followed by a prescription from a pulmonologist or sleep physician. CPAP is a prescription medical device; reputable suppliers will ask for both documents.
Does CPAP have side effects?
Most are minor and fixable: dry mouth, nasal congestion, mask marks, occasional aerophagia. Each has a specific clinical adjustment. Side effects that persist past two weeks usually mean a setting or mask needs review, not that CPAP is wrong for you.
How long does CPAP therapy take to work?
Many patients feel sharper within a week of consistent use. Full benefit on daytime alertness, blood pressure, and morning headaches is typically seen at four to eight weeks of nightly use.
I'm claustrophobic and can't wear the mask. What can be done?
Nasal pillows are far less occlusive than full-face masks and resolve claustrophobia for most patients in our clinic. We pair the switch with short daytime desensitisation sessions before night use.
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Already on CPAP and struggling?
Book a troubleshooting visit. Bring the machine and mask you have.
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