Common CPAP Side Effects and How to Fix Them

Symptoms, Causes, Fixes, and the Products Recommendations to Help

Continuous Positive Airway Pressure (CPAP) therapy is considered the gold standard for treating sleep apnea. It helps keep airways open during sleep, ensuring proper oxygen flow and improving the quality of rest. However, like any therapy, using a CPAP machine can come with side effects. The good news is that most issues are easy to address, and with a few adjustments, you can comfortably adapt to your CPAP treatment.

“While CPAP therapy is the gold standard for sleep apnea, it’s normal to encounter side effects along the way. With the right adjustments, whether it’s improving mask fit or adding a humidifier, you can turn discomfort into restful, uninterrupted sleep,” says Robert Miller, Apria's Vice President of Sleep Business.

Here are the most common side effects of CPAP therapy, what causes them, and how you can fix them.

1. Dry Mouth

Symptom: Waking up with a parched mouth.

Cause: The airflow from your CPAP machine can dry out your mouth, especially if there’s a leak in the mask. If your machine detects a leak, it may increase the airflow to compensate, further drying out your mouth. Additionally, if you sleep with your mouth open while using a nasal mask, air can escape through your mouth, leading to dryness.
Fixes:

• Fix mask leaks: Ensure your mask fits properly. Adjust the straps or switch to a different mask if it’s too loose or tight.
• Chin strap or mouth tape: If you’re using a nasal mask, try a chin strap or mouth tape to keep your mouth closed during sleep.
• Stay hydrated: Drink plenty of water throughout the day to stay hydrated.
• Humidifier: Add a heated humidifier to your CPAP machine or increase the setting if you already have one.

Helpful Products:

• Chinstrap
• Mouth tape
• Mask liners
• Heated humidifier

2. Dry Nose or Nasal Area

Symptom: Dryness or irritation in the nasal passages; more familiar with nasal masks or nasal pillows.

Cause: Dry or cold air from your CPAP machine can irritate the nasal cavity, which is particularly sensitive to changes in temperature. Full-face mask users may also experience dry nasal passages if there’s a mask leak. A mask leak will lead to increased air pressure that dries out the nasal passages

Fixes:

• Heated humidifier: Turn up the setting on your humidifier or add one if your machine doesn’t have one.
• Fix mask leaks: Ensure your mask is sealed correctly to prevent excessive airflow.
• Saline spray or CPAP gel: Use a saline nasal spray or CPAP gel to moisten your nasal passages. Avoid petroleum-based products like Vaseline, which can break down the materials of the mask.

Helpful Products:

• Heated humidifier
• CPAP gel
• Nasal spray/Saline spray

3. Water Gurgling in the Tube (CPAP Rainout)

Symptom: Hearing water gurgling or feeling water droplets in the tubing.

Cause: Condensation (rainout) occurs when the heated, humidified air in your CPAP tubing cools down as it travels through the tube. This causes moisture to collect in the tube, resulting in gurgling noises or water droplets.

Fixes:

• Lower your humidifier setting: Try turning down the humidifier to reduce condensation.
• Heated tubing: Use heated tubing to maintain a consistent air temperature, preventing condensation from forming.
• Run tubing under blankets: If you don’t have heated tubing, you can try keeping the tubing warm by running it under your blanket or covering it with a fabric sleeve.
• Position your machine lower: Place your CPAP machine lower than your head so any condensation collects at the bottom, away from your mask. This will prevent any condensation from dripping toward your mask and instead will allow gravity to pull the water droplets back toward your machine that is positioned lower.

Helpful Products:

• Heated tubing

4. Skin Irritation

Symptom: Redness, itching, or rash on the skin where the mask touches the face.

Cause: CPAP-related dermatitis can occur when the mask irritates the skin. This could be due to the mask being too tight or too loose, or poor cleaning practices. Too high humidity levels can also lead to skin irritation.

Fixes:

• Adjust your mask fit: Ensure your mask isn’t too tight or loose. A snug but comfortable fit is critical.
• Use a mask liner: A mask liner adds a barrier between your skin and the mask, reducing irritation.
• Clean your mask regularly: Make sure your mask is clean to prevent skin irritation caused by grime or debris. Follow the manufacturer’s guide for mask cleaning and replacement.
• Hydrocortisone cream: If irritation persists, use over-the-counter hydrocortisone cream to soothe the skin.

Helpful Products:

• Mask liner
• CPAP cream

5. CPAP Belly (Aerophagia)

Symptom: Feeling bloated or gassy upon waking up.

Cause: Swallowing air (aerophagia) can happen when CPAP pressure is too high, forcing air into the stomach or too low, causing you to swallow air while gasping for breath.

Fixes:

• Consult your provider: Speak with your doctor or respiratory therapist to check your sleep data and adjust your CPAP pressure. They may recommend increasing or decreasing the pressure.
• Change your sleep position: Sleeping on your side can help reduce the chances of swallowing air.
• Switch to a nasal mask: A nasal mask with a chin strap can help minimize air swallowing, especially if you tend to sleep with your mouth open.

Helpful Products:

• Nasal mask
• Nasal pillow mask
• Chin strap
• Mouth tape

Adapting to CPAP therapy can take time, but with the proper adjustments, you can overcome the most common side effects. Whether you’re dealing with dry mouth, skin irritation, or CPAP rainout, solutions and products are designed to help you have a more comfortable experience. Always consult your healthcare provider to ensure your CPAP settings are optimized for your needs.

References
“ApriaDirect.” Apriadirect.com. Accessed September 23, 2024. https://www.apriadirect.com/.
Mayo Clinic Staff. “CPAP Machines: Tips for Avoiding 10 Common Problems.” Mayo Clinic, March 7, 2024. https://www.mayoclinic.org/diseases-conditions/sleep-apnea/in-depth/cpap/art-20044164.
Peters, Brandon. “Side Effects of CPAP Therapy.” Verywell Health, July 3, 2023. https://www.verywellhealth.com/cpap-therapy-what-are-the-side-effects-3015024.
Professional, Cleveland Clinic medical. “Do CPAP Machines Really Work?” Cleveland Clinic, July 12, 2024. https://my.clevelandclinic.org/health/treatments/22043-cpap-machine.
Summer, Jay, and Abhinav Singh. “Common Side Effects of CPAP.” Sleep Foundation, February 27, 2024. https://www.sleepfoundation.org/cpap/cpap-side-effects. 
 

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