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Side Effects of CPAP Therapy

October 22, 2024

Common Side Effects of Using CPAP Machines

Continuous Positive Airway Pressure (CPAP) machines are one of the most effective treatments for obstructive sleep apnea (OSA), a condition where the airway becomes blocked during sleep, leading to breathing interruptions. CPAP therapy works by delivering a continuous stream of air through a mask, keeping the airway open and ensuring uninterrupted breathing throughout the night. While CPAP is highly effective for many, some users may experience side effects, particularly in the initial stages of use. Understanding these common issues can help patients adjust to their CPAP machines and work towards a better night’s sleep.

1. Dry Mouth and Throat Irritation

One of the most frequently reported side effects of using a CPAP machine is waking up with a dry mouth or throat. This happens when the forced air from the CPAP machine dries out the nasal passages and mouth, particularly if you're a mouth breather. While this can be uncomfortable, most CPAP machines have built-in humidifiers that can help add moisture to the air and reduce dryness. Additionally, using a chin strap to keep the mouth closed may also alleviate this issue.

2. Nasal Congestion or Irritation

CPAP users may experience nasal congestion, a runny nose, or irritation of the nasal passages. The constant airflow can sometimes irritate the sensitive tissues inside the nose, leading to congestion or even nosebleeds. Nasal dryness can also make it harder to breathe through the nose, which can lead to more frequent mouth breathing. Using a CPAP machine with a heated humidifier and saline nasal sprays can help reduce these symptoms by keeping the nasal passages moist.

3. Mask Discomfort or Skin Irritation

Wearing a CPAP mask every night can cause discomfort, particularly if the mask doesn’t fit properly. Common issues include pressure sores on the nose or around the mask area, red marks, or even rashes caused by skin irritation. Adjusting the fit of the mask is essential to avoid excessive pressure on the skin, and there are different mask types available (full-face, nasal, or nasal pillow masks) that can offer better comfort for various users. Additionally, mask liners or special CPAP-friendly moisturizers can help prevent skin irritation.

4. Difficulty Adjusting to Air Pressure

Many new CPAP users find it difficult to get used to the continuous airflow, especially if the prescribed air pressure is higher. This can make it hard to fall asleep or cause discomfort during the night. Modern CPAP machines often come with “ramp” features that start at a lower pressure and gradually increase to the prescribed setting, making it easier to adjust. Some users may also benefit from bilevel positive airway pressure (BiPAP) machines, which provide different pressures for inhalation and exhalation, offering more comfort.

5. Aerophagia (Swallowing Air)

Aerophagia, or the unintentional swallowing of air, can occur in CPAP users, leading to bloating, gas, or abdominal discomfort. This happens when air enters the stomach instead of the lungs. Adjusting the air pressure settings, using a different mask type, or changing sleeping positions can help alleviate this issue. If the problem persists, consulting a healthcare provider or sleep specialist is essential for making the necessary adjustments to the machine.

6. Claustrophobia

Wearing a CPAP mask can make some users feel claustrophobic or anxious, especially those who are not accustomed to wearing something on their face while sleeping. The sensation of being confined by the mask, combined with the sound of airflow, can contribute to discomfort and restlessness. Starting with short periods of CPAP use during the day, trying different mask styles, or using relaxation techniques like deep breathing can help users gradually acclimate to the device.

7. Noise from the Machine

Though modern CPAP machines are quieter than ever, some users may still be bothered by the soft hum of the machine while trying to sleep. This noise, though minimal, can disrupt sleep for both the user and their partner. Placing the machine on a soft surface or using white noise machines or earplugs can reduce the impact of this sound, making it easier to sleep through the night.

8. Eye Irritation

Leaks from the CPAP mask, particularly near the bridge of the nose, can cause air to blow into the eyes. This can lead to eye irritation, dryness, or redness. Ensuring the mask fits properly and doesn’t leak is key to avoiding this issue. Periodic adjustments or trying different mask styles might be necessary to prevent air from escaping near the eyes.

9. Feeling Uncomfortable Sleeping

Many CPAP users initially find it challenging to sleep with the mask and machine, especially if they tend to move around during the night or sleep in positions that are less compatible with CPAP use. For instance, stomach sleepers may find the mask and tubing cumbersome. However, most users find that as they adapt, sleeping with the machine becomes easier. Special CPAP pillows designed to accommodate masks or experimenting with different sleeping positions can help.

Coping with Side Effects and Improving Comfort

While the side effects of CPAP therapy can be frustrating, most are manageable with the right adjustments and support. Here are a few tips for making CPAP therapy more comfortable:
  • Regular Mask Adjustments: If your mask is causing discomfort, try different sizes or types of masks, and ensure a proper fit to minimize air leaks and skin irritation.
  • Use a Humidifier: Adding moisture to the air can help reduce dryness in the nose and throat, making it easier to use the machine long-term.
  • Stay Consistent: It can take time to adjust to CPAP therapy, so it’s important to be patient and use the machine consistently, even if the initial experience is challenging.
Though CPAP therapy is often the first treatment recommended, many people will not be able to tolerate them. If that is the case, leading medical guidelines suggest alternative to CPAP like oral appliance therapy should be considered, rather than sleep apnoea remaining untreated.