Sometimes removing the mask while sleeping can be remedied by the use of Bilevel PAP instead of CPAP. Bilevel PAP lets you breathe easier on exhalation and keeps the blood CO2 level lower (a good thing.) Respironics has a new pseudo-Bilevel CPAP machine out now called CPAP with C-Flex technology. It is really CPAP with a variable exhalation pressure let-down setting you can adjust for comfort. However it is not quite Bilevel PAP.

ResMed has a great Bilevel PAP machine named the "VPAP II." It has clinician adjustable settings for inspiratory rise time, IPAP max and IPAP min. All those technical terms really mean the machine can be adjusted for maximum comfort and effectiveness, helping to prevent you from arousing during slow-wave sleep and removing the interface.

Another reason for removing the interface at night is if the pressure setting is incorrect. Studies done by incompetent staff and/or interpreted by non ABSM Diplomates can easily result in a prescription for an incorrect and ineffective pressure that cannot be tolerated. (Not every physician who interprets sleep studies has studied sleep medicine!)

Autotitrating CPAP machines are not the answer either. They cannot detect nor understand your internal physiological response to air pressure which is something highly trained sleep medicine personnel routinely do during an attended sleep study.

You might speak with a real sleep physician because even if treated for OSA, there might be an additional medical issue needing to be treated. There is more than one sleep disorder and many people have several at once.