Solve Your CPAP Problems With These Tips

Continuous positive airway pressure (CPAP) is a treatment that keeps the air pressure in your airways steady. It prevents your upper airway from collapsing and makes it easier to breathe while you sleep. CPAP is a common treatment for obstructive sleep apnea and acute heart failure.

CPAP devices are reliable and effective. Even so, some users have problems with the device that can complicate treatment. This article takes a look at 10 solutions that can help overcome these challenges and improve your CPAP experience.


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 hardest adjustments when you first begin is learning to breathe out against the pressure. Try setting the machine at a lower pressure when you first put it on. You can gradually raise the pressure as you start to fall asleep. This is known as a ramp function.

Some machines also have bi-level (BiPAP) or C-Flex settings. They alternate between inhalation and exhalation pressure so it's more like natural breathing.

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


Swallowing Air

Swallowing air is uncomfortable for some CPAP users. It may leave you feeling bloated or cause you to burp. This could mean your pressure is set too high.

To correct this, you may need to:

  • Decrease the pressure
  • Get a ramp pressure device
  • Have a new CPAP titration study to find a better pressure level

Overcoming Claustrophobia

A CPAP device fits over your face. The snug fit makes some people feel stifled or smothered. That feeling may make your heart race. You might feel like tearing off the mask. Those are signs that you are having claustrophobia.

Some people overcome this by getting a mask that does not enclose the nose. Nasal pillows are good examples. Other people use relaxation or distraction techniques, such as watching TV or listening to music. These strategies help them gradually adjust to the sensation of wearing a mask.

If the claustrophobia doesn't get better, you may want to seek alternative CPAP therapies. Speak with your healthcare provider.


Dealing With Condensation

Extra moisture in the air can make breathing more comfortable. But sometimes water droplets collect inside the CPAP tubing. This extra water can end up reducing your airflow. Too much moisture is a common complaint among those who use a heated humidifier and sleep in a cooler room.

To overcome this, turn down your humidifier temperature. You could also try to keep the CPAP tubing slightly warmer by putting it under blankets. Or you might opt for a newer CPAP unit with heated climate-adjusted tubing.

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


Developing a Dry Mouth

Your mouth shouldn't dry out when you use a CPAP machine. If it does, your mouth may be falling open with the mask on. When this happens, the airflow will escape from your mouth and make it very dry.

To prevent this, try:

  • Using a heated humidifier
  • Wearing a chin strap to keep the mouth closed
  • Changing to a mask that covers the nose and mouth
  • Speaking with your healthcare provider about adjusting the pressure setting on your machine

Smelling Unpleasant Odors

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

If your CPAP mask develops a smell that won't go away, you may need new equipment. Any off-putting "new" smell should lessen over time.

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


Leaving Marks on Your Face

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 mean your mask doesn't fit properly. 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, try using a face cream or petroleum jelly to prevent abrasion. CPAP liners create a barrier between the mask and your skin.

A CPAP mask should never give you sores. If yours does, tell your healthcare provider so they can adjust or replace your mask.


Coping With Nasal Congestion

People with a deviated septum or a history of allergies or nasal congestion may find it harder to breathe through the nose with a CPAP mask.

A heated humidifier or saline nasal spray can sometimes open nasal passages. Oral antihistamines or a prescription nasal spray can help with chronic or seasonal allergies.

For those who simply cannot breathe through the nose, there are alternatives that may help. You could try a CPAP mask that covers the nose and mouth. You could also opt for a newer oral CPAP mask that delivers pressure through the mouth only. If those don't work, you may need to consider other treatments.


Waking With Dry, Red Eyes

Dry, red eyes may mean that air is leaking from your mask into your eyes while you sleep. To stop this, try tightening the mask slightly. If this does not work, you may need to find a better-fitting mask. Saline eye drops may also help ease some of the redness and discomfort.


Returning Symptoms

Excessive daytime sleepiness often decreases when you start using CPAP. Over time, however, symptoms can return for some people.

If this occurs, have your equipment checked to make sure it is delivering the prescribed pressure. It may also be necessary to have a new titration study to find a better pressure. As people age or have weight changes, the initial pressure setting may no longer be correct. It may need adjustment.

If you start to snore while using CPAP, your pressure level may no longer be right for you. It may need fine-tuning.


CPAP machines are a tried and true treatment for people with breathing problems. But that doesn't mean they are problem-free. Some problems occur because the pressure setting is too high. Others are related to a mask that doesn't fit quite right or trouble with the tubing. In some cases, other health conditions complicate the treatment. If you're having problems with your CPAP device, talk to your healthcare provider. A simple solution may be available to help you get a better night's sleep.

Frequently Asked Questions

  • How can I stop skin irritation from a CPAP mask?

    If your mask is irritating your face, it may not be sized or fitted correctly. If you’ve ensured that you do have the proper fit, the mask cushion may be worn out, so you need to replace it. You might also try getting a mask liner.

  • Why do I have stomach pains after using my CPAP?

    If the air pressure is too high on the CPAP, you may end up swallowing air. This is called aerophagia. It can cause stomach discomfort, bloating, and gas pain. Adjusting the pressure or using a different type of mask may help relieve the pain.

  • How can I stop nose bleeds caused by the CPAP?

    The air from the CPAP machine can dry out your nasal passages. You should be able to adjust the humidifier or temperature on the CPAP machine to help avoid this. You can also try a mask that covers the nose and mouth or just the mouth to avoid drying out your nasal passages.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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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.

  4. American Sleep Apnea Association. Troubleshooting Guide for CPAP Problems.

  5. American Sleep Association. Side Effects.

By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.