A treatment approach for overcoming anxiety about using CPAP
(1) As a preliminary step, I recommend you learn and practice relaxation exercises, specifically diaphragmatic breathing and progressive muscle relaxation. The idea would be to use these for 5-10 minutes prior to engaging in the exercises described below. Instructions for these exercises can be found here.
(2) When you practice wearing the mask, start with an interval of time you feel you are willing to tolerate. It is better to start small (e.g. somewhere between 1 to 5 minutes) and work up gradually from there. While you are wearing the mask, see if you can relax and adopt an attitude of allowing and accepting the sensations of wearing the mask. You can also engage in other sedentary activities, such reading, browsing the internet, or watching TV.
(3) You can use a rating system called Subjective Units of Discomfort (SUD) to rate the amount of anxiety you experience during and at the end of a practice session. Imagine a scale going from 0 to 10, with 10 being the highest level of anxiety you can imagine. For any practice session, you can rate the peak anxiety level and the level at the end of the session.
(4) I would repeat practice sessions until your SUDs ratings fall to a 3 or lower at the end of an session before increasing the amount of time spent during the session. For example, repeat a 5 minute session as many times as is needed for this to happen. You will want to allow a break between sessions (e.g., 15 minutes), and also limit the number on any given day (e.g., perhaps up to 3 sessions).
(5) Once your SUDs rating is a 3 or lower, decide on what increase of time you are willing to do. It is better to gradually increase the amount of time (e.g., from 5 minutes, to 7 minutes, to 10 minutes, to 15 minutes, etc.).
(6) In one study on using this method, they had patients work up to spending 1 hour with the mask on while awake. Then they had people practice while taking timed naps. I’d suggest starting small (e.g., set a timer for 15 minutes). Then, they had people wearing the CPAP at night for the first 3-4 hours of nocturnal sleep. Finally, they had people wear it for a whole night.