Solve Your CPAP Problems With These Tips

If you are having problems with CPAP therapy to treat your sleep apnea, you may wish to discover 10 solutions to improve the experience.


Can't Breathe out Against the Pressure

CPAP machines often have a ramp feature to allow the pressure to be lowered
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The most difficult adjustment to make when beginning to use continuous positive airway pressure (CPAP) is learning to breathe out against the pressure. Fortunately, there are some helpful adjustments that can be made. First, if you find this most troublesome as you are falling asleep, the machine's pressure can be set to start lower and then slowly increase as you are falling asleep (sometimes called a ramp function). In some circumstances, a bilevel, BiPAP, or cflex setting that alternates between an inhalation and exhalation pressure can be helpful. If this problem persists, it might be that the pressure setting is simply too high for you.


Mask Makes You Feel Claustrophobic

This is a problem that you will recognize immediately. If after applying the mask for the first time you start to feel smothered, a sense of panic washing over you, your heart rate and breathing rate increasing, with an intense fear and need to escape, you are likely experiencing claustrophobia. If this occurs, you will benefit from a little extra help. It may be possible to find a mask that does not enclose your nose, such as nasal pillows. You may overcome the discomfort by practicing with the machine while doing something relaxing, like watching television. If it is simply unbearable, you may want to seek out alternative CPAP therapies.


Swallowing Air

Swallowing air is a source of great discomfort for some users of CPAP. It can leave you burping and feeling bloated. This may occur if your pressure is set too high. In order to correct it, it may be necessary to have the pressure decreased, get a pressure ramp setting, or perhaps even a new titration study.


Mask Smells Funny

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 clean away, you may need to look into getting new equipment. It should likewise be noted that new equipment may have a peculiar "new" smell that you will become used to. If you have a humidifier, be certain to only put distilled water in the reservoir.


Sores and Marks on Your Face

It is fairly common to get some minor pressure marks on your face when you wear a CPAP mask. If these marks are excessive, it may be due to an ill-fitting mask. If this is the case, you may need to try a different size or even choose a new mask. Some people find it helpful to switch between different mask styles from one night to the next so that the pressure points vary. If your skin becomes irritated by the mask, a skin barrier such as facial cream or petroleum jelly might be useful.

You should not get significant sores on your face from a CPAP mask, so if this occurs you should let your medical provider know.


Mask Fills With Water

This is a very common complaint, especially if you use a heated humidifier. The extra moisture makes it more comfortable to breathe, but it can also collect condensation within the tubing and CPAP mask. This becomes especially true if you sleep in a cooler room. It may be necessary to turn down your humidifier temperature or find a way to keep the CPAP tubing slightly warmer, such as putting it under the blankets. Sometimes placing the CPAP machine on the floor will help the extra moisture to flow back down, rather than into your face.


Dry Mouth When You Use Your CPAP

In general, you should not experience significant dry mouth when using a CPAP. If you do, this may suggest that your mouth is falling open with the mask on. The pressurized air will escape from your mouth and this can make it extremely dry. If this occurs, you may find it helpful to try a heated humidifier or a chinstrap. You may wish to change to a different mask style that includes your mouth or even consider having your machine’s pressure adjusted.


Nose Is Too Congested to Use Your Mask

If you have a history of environmental allergies, nasal congestion, or a deviated septum, you may find it difficult to breathe through your nose when using a CPAP mask. It will be important to maximize your breathing by keeping these issues under control. A heated humidifier or even a saline nasal spray may help. Some people need to take medications to relieve their allergies, including potentially prescription nasal sprays. For those people who simply cannot breathe through their nose, it may be necessary to switch to a CPAP mask that includes the mouth or consider alternative therapies.


Your Symptoms Have Returned

Many people feel an improvement in their excessive daytime sleepiness when they start to use CPAP. Over time, these symptoms may seem to return. If this occurs, you should have your equipment checked to ensure that it is delivering the prescribed CPAP pressure. It may be necessary to have a new titration study or even have your CPAP pressure increased.

Contact your physician if your sleep apnea symptoms have returned after you have been using a CPAP.


Waking up With Dry, Red Eyes

Dry, red eyes may suggest that air is leaking from your mask into your eyes while you are sleeping. You can start by slightly tightening your mask. If this does not work, you may need to look into getting a better fitting mask. The use of saline eye drops might also help alleviate some of the discomfort.

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  1. 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

  2. National Sleep Foundation. How to Use a CPAP Machine for Better Sleep.

  3. American Sleep Apnea Association. When Things Go Wrong with PAP - Sleep Apnea.

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