Abstract Background and purpose Compliance with continuous positive airway pressure (CPAP) treatment in obstructive sleep apnoea syndrome (OSAS) may be difficult. Patient education is important but strategies and their outcomes are not clear. Patients and methods We studied the effects of four education strategies on compliance and quality of life changes with CPAP treatment in seven centres in the French ANTADIR homecare network. Patients received from prescribers either a simple oral explanation (SP) or an oral and written explanation (RP) of CPAP use. In addition, they received from homecare technicians either a single home visit (SH) at CPAP onset or repeated home visits at CPAP onset and at 1 week, 1 month and 3 months after (RH). Compliance and quality of life were evaluated at CPAP onset, and at 3, 6 and 12 months after initiation of treatment. Results One hundred twelve patients with severe OSAS (mean age 58 ± 11 year, apnoea–hypopnoea index 58 ± 25/h) were allocated randomly to groups (SP + SH; SP + RH; RP + SH; RP + RH) with no initial differences. Quality of life, evaluated by the generic SF-36 questionnaire, improved in the combined emotional domains. Compliance was over 5 h in all four education groups. These effects were sustained over 12 months and were not different between the four groups. We conclude that standard education strategies for CPAP induction in France are sufficient for good compliance and improved quality of life with CPAP. Education with reinforced input should be focussed on identified subgroups prone to problems.