It says to wash it prior to use on the box it comes in.

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No, you don’t need to wash it prior to first use.

put big towels under u. don’t use over night

As you use it more and you can use a little less since it becomes saturated

How often you wash will be personal preference, I wash once a month if I use it several nights a week. You will need to replace it at some point. To start out I would cycle it. I wouldn’t start by wearing it overnight. I would wear it for an hour or two and work up to overnight. Yes, you add 1 tablespoon before each use.