COVID-19 : Find updates & care resources here. If you're experiencing symptoms, call our 24-hr call centers: (406) 890-7272 for adults or (406) 890-7273 for children >

When Things Go Wrong with CPAP

KRH Sleep Center
Continuous positive airway pressure (CPAP) is a common and often effective treatment for obstructive sleep apnea. The treatment is provided via a small CPAP machine, which supplies constant air pressure to the patient during the night via a mask or nose piece.
Sinus irritation, mask discomfort and headache are common problems when using CPAP. Don’t let side effects stop you from benefiting from the treatment. Some problems may be solved at home or by talking with your sleep specialist about other options.

Mask Discomfort

Your CPAP mask may be uncomfortable because you have adjusted the headgear too tightly or because the mask is the wrong fit. A CPAP mask should have a snug fit to avoid air leaks but should not be so tight that it feels uncomfortable or causes pain. The best fit depends on the size and shape of your face, whether you have facial hair and how much you move during sleep. Contact your sleep specialist and ask for assistance with fitting your CPAP mask. You may need to try another size or style of mask.

Nasal Congestion, Irritation or Runny Nose

The dry, cool air supplied by CPAP may cause problems such as nasal dryness, congestion, sinus pain, a runny nose or sneezing. When your nasal passages are too dry, your body increases mucus production to add moisture to the sinuses. You shouldn’t have to deal with a constantly dry nose or stuffy nose because of CPAP. Make sure your mask fits well and doesn’t leak, which can dry out your nose. If the mask is not the problem, using a nasal saline spray at bedtime might help. Adding a humidifier to your CPAP also can relieve these symptoms. Ask your sleep specialist about options for a CPAP humidifier or heated humidifier. Heated air carries even more moisture than cool air and can provide the most relief for nasal congestion and sinus irritation.

Difficulty Breathing Through Your Nose

Because CPAP is usually applied through the nose, you may have difficulty using it if you have allergies, chronic sinus problems or a deviated septum. Talk with your doctor about allergy treatments that may relieve nasal congestion. With some CPAP machines you can use special allergy filters. For a deviated septum or other structural sinus issues, consider seeing an ear, nose and throat specialist. You may also consider trying a CPAP mask that fits over the mouth as well as the nose.

Headache or Ear Pressure

Nasal congestion or changes in air pressure relating to CPAP can cause morning headaches for some CPAP users. If you have a cold, sinus infection or ear infection, you may need to avoid using CPAP until you recover. Decongestants or antihistamines may alleviate any lingering congestion. Be sure to check with your doctor before taking any medications. And talk with your sleep specialist if you experience ongoing headaches, ear pressure or ear pain while using CPAP.

Accidentally Removing Your Mask During the Night

Some CPAP users may remove their mask during the night without realizing it. This may be due to mask discomfort, difficulty breathing or a disruption in sleep. Often this happens because you are not yet used to wearing the mask. Make sure you have the right size and style of mask for your face. Give yourself time to get adjusted, or try using it for short periods during the day to become more comfortable with the feeling of the mask and continual air pressure. Remember that over time it will get easier. If after a few weeks you are still removing your mask during the night, ask your sleep specialist for suggestions or adjustments.

Intentionally Removing Your Mask During the Night

If you get up to use the restroom, try leaving your mask on and disconnecting the tubing rather than removing the entire mask. It will be much easier to reattach the tubing before you fall back asleep.

Air in the Stomach

Some CPAP users experience stomach pain or gas due to air being trapped in the stomach. Make sure your head is aligned with your body, not elevated so much that your airway is bent or blocked. You can try raising your upper body while you sleep by using a wedge pillow, or raising the head of your bed by placing books or bricks under the headboard. Talk with your sleep specialist to make sure the air pressure on your CPAP isn’t too high. You may also be able to switch to a setting with varied air pressure, which can provide relief from stomach pain or gas.

Air Is Too Cold

If cold air in your CPAP is bothering you, a heated humidifier should solve this problem. Or simply placing the CPAP tubing underneath the covers next to your body can help warm the air.

Air Is Too Hot

Keep the temperature in your bedroom as low as possible. If that doesn’t help, or if the problem seems to be with your CPAP mask trapping heat, talk with your sleep specialist.

CPAP Is Too Noisy

Most new CPAP machines are very quiet. If you have an older device, talk with your insurance company about getting a newer one. You can also check that the air filter is clean, or add extra tubing and move the device farther from your bed. Earplugs or a white noise machine can also help. Your sleep specialist can check your CPAP device to make sure it’s working correctly.

Tubing Gets in the Way

Try draping the tubing behind you and over the headboard. A CPAP tube stand or hose holder can keep the tubing elevated and out of your way during the night.

Learn More

The specialists at the Kalispell Regional Healthcare Sleep Center can help diagnose and treat sleep disorders such as sleep apnea, including fitting and adjusting CPAP devices. To learn more, call (406) 257-8992.