CPAP and PAP Adherence Therapy in Austin, TX
Telehealth for all of Texas
Behavioral approach for sleep apnea treatment barriers, CPAP intolerance, and insomnia
Struggling to adjust to CPAP or PAP therapy? You’re not alone - and you’re not failing.
For many people, the process goes something like this: You complete a sleep study. You’re told, “You have sleep apnea. Use CPAP.” And that’s where the support ends.
No one takes the time to fully explain:
What sleep apnea actually is
What happens in your body during an apnea
Why treatment matters
Why PAP therapy can feel so difficult at first
What to do when using the device feels uncomfortable, frustrating, or impossible
That’s where behavioral sleep medicine can help.
PAP therapy is a major adjustment, not a simple behavior change.
PAP therapy asks you to make a significant physical and behavioral adjustment, often with very little guidance.
Some people have a claustrophobic or suffocation reaction to the mask.
Some people also have insomnia, which makes PAP use significantly harder.
Some people never found a mask that actually fit comfortably.
Some people don’t fully understand why treatment matters, so motivation naturally drops over time.
Many people feel embarrassed or discouraged about needing “one of those machines.”
Meanwhile, untreated sleep apnea can leave you feeling exhausted, foggy, irritable, and physically depleted.
You may be:
falling asleep unintentionally during the day
struggling with concentration or memory
Waking feeling completely unrefreshed
Relying heavily on caffeine just to function
Anxious about your health
Frustrated that your sleep still feels broken
When your breathing repeatedly stops during sleep, your body experiences stress over and over throughout the night. That takes a real toll.
The first step is figuring out what’s actually getting in the way.
Most people don’t need more shame, pressure, or lectures about compliance. They need the right treatment for the specific barrier interfering with PAP use.
My approach starts with understanding why PAP therapy has been difficult for you.
Together we may:
review your sleep study in plain language so you fully understand what it means
identify the specific barriers interfering with PAP use
address insomnia or other sleep disorders that are making treatment harder
use research-backed desensitization strategies for claustrophobia or mask anxiety
troubleshoot mask issues and advocate for a better fit
discuss the medical and quality of life impact of untreated sleep apnea
build a step-by-step adjustment plan that feels realistic and sustainable
You deserve to make an informed decision about your treatment, not simply be told what to do.
When insomnia and sleep apnea happen together
Many people with sleep apnea also have insomnia.
In fact, it’s common enough that it gets its own acronym: COMISA (COMorbid Insomnia and Sleep Apnea.) Go here to read a blog I wrote about COMISA.
There’s probably no worse treatment for insomnia than: “put this unfamiliar thing on your face and try to sleep.”
Sleep apnea and insomnia are separate conditions that require separate treatment approaches. Treating one does not automatically resolve the other.
If insomnia, nightmares, or circadian rhythm issues are also present, I integrate evidence-based behavioral sleep treatments alongside PAP adherence work.
What starts to change when treatment works
When PAP treatment becomes more manageable and consistent, people often notice improvements in both daily functioning and long-term health.
Clients often report:
more energy during the day
clearer thinking and better concentration
improved sustained attention and memory
less anxiety about sleep
fewer unintentional naps or daytime sleep episodes
feeling more alert while driving, working, or traveling
improved mood and patience
reduced strain in relationships affected by snoring or exhaustion
sleeping through the night more consistently
Consistent treatment can also reduce strain on the body and support broader health goals, including:
cardiovascular health
blood pressure management
reduced stroke and heart attack risk
diabetes management
About Jessica
I’m Jessica Fink, LCSW-S, a behavioral sleep medicine specialist providing telehealth therapy throughout Texas.
I help adults address insomnia, PAP adherence difficulties, nightmares, hypersomnia, and circadian rhythm disorders using structured, evidence-based approaches.
My style is direct, educational, and practical. Clients often tell me they leave sessions understanding their sleep problems more clearly and feeling equipped with concrete tools to address them.
Frequently Asked Questions about PAP Adherence Therapy
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This is extremely common, and it does not mean you’re lazy, unmotivated, or “noncompliant.”
There are many different reasons people struggle with PAP therapy, including claustrophobia, untreated insomnia, discomfort with the mask, anxiety about sleep, low motivation, or simply not understanding why treatment matters.
The first step is identifying the actual barrier. Once we understand what’s getting in the way, we can use targeted, evidence-based strategies to address it.
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Untreated sleep apnea can affect both quality of life and long-term health.
People often experience:
excessive daytime sleepiness
poor concentration and memory
irritability or low mood
unrefreshing sleep
fatigue severe enough to affect work, driving, and relationships
Over time, untreated sleep apnea can also increase strain on the body and contribute to health concerns such as high blood pressure, cardiovascular disease, stroke risk, and difficulty managing diabetes.
Many people seek treatment because they are simply tired of feeling exhausted all the time.
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Yes. Behavioral sleep medicine includes research-backed approaches specifically designed to help people adjust to PAP therapy.
Treatment is not about forcing yourself to “just deal with it.” It’s about understanding the barriers interfering with use and addressing them systematically.
Depending on your needs, treatment may include:
education about sleep apnea and PAP therapy
behavioral strategies to improve adjustment
desensitization for claustrophobia or mask anxiety
insomnia treatment
troubleshooting routines and habits
motivation and decision-making support
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Absolutely.
Many people have both obstructive sleep apnea and insomnia, and the insomnia often goes untreated.
Trying to sleep with a mask on while you are already struggling to fall asleep can make the experience significantly more frustrating and stressful. Sleep apnea and insomnia are separate conditions, and treating one does not automatically resolve the other.
If insomnia is part of the picture, it’s important to address it directly rather than assuming PAP therapy alone will fix the problem.
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Claustrophobic or suffocation reactions to PAP masks are more common than many people realize.
Fortunately, there are structured, evidence-based approaches that can help. Rather than forcing yourself to tolerate the mask all at once, treatment involves a gradual, step-by-step desensitization process that helps your brain and body adapt over time.
Many people who initially believed they would “never be able to wear it” are eventually able to adjust successfully with the right support.
You do not have to figure this out alone.
PAP therapy can feel overwhelming at first—especially if nobody has taken the time to explain the process or address the barriers standing in your way.
With the right education, troubleshooting, and behavioral support, many people are able to adjust successfully and finally start feeling rested again.
If you’re struggling with PAP therapy, insomnia, or another sleep disorder, I’d be glad to help.