Solve Your CPAP Problems With These Tips

Continuous positive airway pressure (CPAP) is a treatment that applies continual air pressure to prevent upper airway collapse, as can occur with obstructive sleep apnea, or ease breathing in people with acute heart failure.

Despite the efficacy of the device, users frequently encounter problems that can complicate treatment. Here are 10 solutions that can help overcome these challenges and improve the overall treatment experience.

1

Breathing Against the Pressure

CPAP machines often have a ramp feature to allow the pressure to be lowered
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One of the most difficult adjustments to make when first starting to use CPAP is learning to breathe out against the pressure. You can better adapt by setting the machine at a lower pressure when you first put it on and gradually increase the pressure as you start to fall asleep (referred to as ramp function).

Some machines also have bi-level (BiPAP) or C-Flex settings that alternates between inhalation and exhalation pressure to mimic natural breathing.

If the problem persists and you still have difficulty breathing against the pressure, speak with your healthcare provider. It may be that the pressure setting is too high for you.

2

Swallowing Air

Swallowing air is a source of discomfort for some users of CPAP, leaving them feeling bloated and burping. This typically occurs if your pressure is set too high.

In order to correct this, it may be necessary to decrease the pressure, get a ramp pressure device, or undergo a new CPAP titration study to better identify what your appropriate pressure level is.

3

Overcoming Claustrophobia

If, after applying the mask to your face, you start to feel smothered, your heart and breathing rate increase, and you feel the irrational need to yank the mask off, you are likely experiencing claustrophobia.

Some people overcome this by getting a mask that does not enclose the nose, such as nasal pillows. Others use relaxation or distraction techniques, such as watching TV or listening to music, to gradually adjust to the sensation of wearing a mask.

If the claustrophobic feeling is simply unbearable, you may want to seek alternative CPAP therapies. Speak with your healthcare provider.

4

Excessive Condensation

Excessive condensation is a common complaint among CPAP users, especially if they use a heated humidifier and sleep in a cooler room. The extra moisture makes it comfortable to breathe but can also collect condensation within the tubing, impairing airflow.

To overcome this, turn down your humidifier temperature or find a way to keep the CPAP tubing slightly warmer (such as putting it under the blankets). There are also newer CPAP units equipped with heated climate-adjusted tubing to reduce condensation.

Placing the CPAP machine on the floor will also help keep the extra moisture from accumulating in the mask.

5

Dry Mouth

In general, you should not experience significant dry mouth when using a CPAP machine. If you do, this may suggest that your mouth is falling open with the mask on. When this happens, the pressurized air will escape from your mouth and make it extremely dry.

To overcome this, try using a heated humidifier or a chin strap to keep the mouth shut. You can also change to a mask that covers the nose and mouth or speak with your healthcare provider about adjusting the pressure setting on your machine.

6

Unpleasant Smells

It is important to keep your CPAP equipment clean and follow standard cleaning instructions. If you do not, there is a chance that your mask and tubing may begin to smell funny. Cleaning regularly is especially important if you have recently been sick.

If your CPAP mask develops a smell that you cannot erase, you may need to purchase new equipment. It should be noted that new equipment may have an off-putting "new" smell that tends to diminish over time.

If you use a humidifier at night, fill the reservoir with distilled water only to reduce the chance of unpleasant smells and scale buildup.

7

Facial Marks

It is fairly common to get some minor pressure marks on your face when you wear a CPAP mask. If the marks are excessive, it may be due to an ill-fitting mask. In such cases, you may need to try a different size mask or choose a new mask altogether.

Some people find it helpful to switch between different mask types from one night to the next so that the pressure points vary. If your skin becomes irritated, facial cream or petroleum jelly may be useful to alleviate abrasion. There are also CPAP liners you can purchase that provide a barrier between the mask and your skin.

A CPAP mask should never give you sores due to an ill fit. If yours does, let your healthcare provider know so that an adjustment can be made or a replacement found.

8

Nasal Congestion

If you have a deviated septum or a history of allergies or nasal congestion, you may find it difficult to breathe through your nose when using a CPAP mask.

A heated humidifier or saline nasal spray can sometimes help open nasal passages. People with chronic or seasonal allergies usually benefit from oral antihistamines or a prescription nasal spray.

For those who simply cannot breathe through their nose, there are alternatives that may help, including a CPAP mask that covers the nose and mouth or newer oral CPAP masks that deliver pressure through the mouth only. Others may need to consider alternative therapies.

9

Waking With Dry, Red Eyes

Dry, red eyes may suggest that air is leaking from your mask into your eyes while asleep. To overcome this, try tightening the mask slightly. If this does not work, you may need to look into getting a better-fitting mask. Saline eye drops may also help alleviate some of the redness and discomfort.

10

Return of Symptoms

Many people feel an improvement in their excessive daytime sleepiness when they first start to use CPAP. Over time, however, these symptoms can return for some people, suggesting that CPAP is no longer working.

If this occurs, you should have your equipment checked to ensure that it is delivering the prescribed pressure. It may also be necessary to undergo a new titration study so that the correct pressure can be found. As people age or gain excessive weight, the initial pressure setting may no longer be appropriate and require adjustment.

If you find that you are starting to snore while using CPAP, this would indicate that the pressure level is no longer right for you and may require fine-tuning.

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Article Sources
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  2. Edmonds JC, Yang H, King TS, Sawyer DA, Rizzo A, Sawyer AM. Claustrophobic tendencies and continuous positive airway pressure therapy non-adherence in adults with obstructive sleep apnea. Heart Lung. 2015;44(2):100-6. doi:10.1016/j.hrtlng.2015.01.002

  3. National Sleep Foundation. How to use a CPAP machine for better sleep. Updated September 11, 2020.