Continuous positive airway pressure (CPAP) is currently the most effective treatment option for mild to moderate obstructive sleep apnea (OSA). However, it is possible you’ll experience a few common CPAP side effects throughout your sleep therapy journey.
The only way to gain the full benefits of sleep apnea therapy is to continually use your CPAP equipment. Therefore, recognizing and solving these problems early is critical to the long-term success of treating your apnea.
In this article, we aim to help you to identify and mitigate these side effects so you can experience the full benefits of this highly effective treatment for sleep apnea and improve your overall CPAP compliance.
The good news is that many of these side effects associated with CPAP therapy can be fixed with proper adjustments to your equipment or by adding other products to your regimen.
Keep in mind, there are multiple variables to consider, so only make these changes with the assistance of your sleep specialist.
Let’s get started!
Here Are the Most Common CPAP Side Effects
Some of the most common reported side effects from CPAP therapy can include:
- Dry Eyes
- Dry Mouth
- Dry Nose
- Sinus Infections
- Skin Irritation
#1 Dry Eyes Caused by Air Leaks From Your CPAP Mask
If you’re waking up with dry eyes, you may have a leak in your CPAP mask at the bridge of your nose. The most common reason for air leaks around the bridge of your nose is that your mask is too big or too long for your nose.
Choosing the best fitting CPAP mask can help, but we don’t recommend over-tightening your mask since it can cause bruising or even open sores if worn long enough. Instead, we suggest adding a nose cushion or mask liner to help keep the mask flush with your skin.
These items may help reduce mask leaks and prevent dry eyes when using CPAP:
#2 Dry Mouth When Using CPAP
You may be wondering “How can I prevent dry mouth with CPAP?” if you’re waking up with a dry mouth. Sleeping with your mouth open can inhibit the effectiveness of your CPAP treatment. But, there are three quick solutions for CPAP dry mouth that you can try right now—including checking for leaks, trying a chinstrap, or adding a heated humidifier.
Leaking masks over six months old should be replaced soon, but if your mask is brand new and showing signs of leaking, you may need to adjust the fit. If you use a full-face CPAP mask and haven’t observed signs of leaking, consider using a heated humidifier; the added moisture can help relieve dry mouth. If you have a nasal mask instead, you may benefit from a chin strap to prevent your mouth from dropping open as you sleep.
Still experiencing dry mouth after trying these solutions? Try a mask designed for mouth breathing.
#3 Nasal Dryness with CPAP (Dry Nose)
Waking up with a dry nose or congestion is common and usually indicates a lack of humidification. You may be wondering, “Why am I congested from CPAP use?”
The air from your CPAP blows through your nasal passages, which can cause irritation ranging from dry nose to nosebleeds. On the other hand, your nasal passages may be trying to create a barrier of protection by producing excess mucus, which causes you to become congested.
Whether your nose is dry or full of mucus, a heated humidifier can add the moisture your nasal passages need to reduce or eliminate the irritation. Already using a heated humidifier? Try a higher setting, an insulating cover for the hose, or add a soothing nasal spray to your care routine.
It’s important to correct this issue since dry, cracked, or bleeding nasal passages make you susceptible to infection. As a general rule, those with Obstructive Sleep Apnea (OSA) should avoid using sedative medicines since the sedative can relax the muscles of the air passage and affect your apneas.
If you’re asking, “What can I do for sinus and congestion relief?” and looking for suggestions, try these items which may help dry nasal passages:
If you’re still experiencing issues after trying these recommendations, you may need to visit your ENT (be sure to let them know you’re on CPAP therapy) for guidance.
#4 CPAP and Sinus Infections
Some new to CPAP therapy report side effects like sore throat, mucus in throat, post-nasal drip, runny nose, and clogged ears after using their CPAP machine.
When using a nasal mask, sinus congestion can occur. Using a heated humidifier, though, adds moisture back into the air and helps alleviate irritation. Less irritation means less produced mucus, and less mucus means less congestion. Our online catalog features sinus relief products that are designed to relieve sinus congestion.
#5 CPAP and Headaches
After waking up with a pulsing throb at your temples, you may be wondering to yourself: “Can a CPAP give you a headache?”
Morning headaches from untreated sleep apnea can occur, but side effects from using a CPAP machine typically do not include headaches.
If you are experiencing a headache after starting CPAP therapy, your CPAP pressure may be too high or your equipment could be causing a sinus blockage, creating the pressure in your head that causes a CPAP sinus headache.
Over-the-counter medication may help open your sinus passageways, giving you the sinus congestion relief you need, or you may benefit from using a heated humidifier. Another option is to add aromatherapy into your CPAP regimen, such as using the CPAP Vapor Clear Sinus Blaster.
If you’ve tried these solutions and still don’t have any relief, you may need to contact your ENT.
#6 CPAP Mask Skin Irritation: Break-Outs, Sores, and Red Marks
CPAP side effects may include skin irritation, particularly along your cheeks or nose. Bumps, sores, and redness are usually caused by three main reasons: build-up of facial oils underneath the mask, an overly-tight mask, or an allergic reaction to the mask material.
Why Is My Face Breaking Out Around My Nose?
You may notice acne or pimples along the area where your mask is worn—especially if your skin is prone to breakouts—due to facial oil build-up under your mask. You can minimize this reaction by washing your face each evening before applying your mask and by wiping down your mask each morning. If you are still experiencing breakouts, you may want to consider a nasal pillow mask since the design makes less direct contact with your skin.
Another cause of your breakouts could be an allergic reaction since many masks are made of silicone. The chemicals in which the mask is manufactured degrade and disperse over time, but may cause an allergic reaction when the mask is first used. Though an allergic reaction isn’t common, washing the mask (especially in warm soapy water) before use can help prevent an allergic reaction.
You can keep your mask clean, which may reduce or eliminate breakouts, with the following:
Why Am I Getting Sores Inside My Nose?
Wearing nasal pillows or nasal prong devices that are too big or the wrong shape for your nose can cause sores.
If you use nasal pillows, try the smallest size available that seals around your nares. It may take time for your nose to adjust, but switching back and forth between a nasal pillow mask and a nasal mask might help. Using a nasal lubricant can help reduce irritation, too.
Nasal prongs are worn inside the nostrils where they seal tightly, which may cause some initial irritation. Try switching back and forth between the nasal prong device and a nasal mask; if you don’t notice a difference, we suggest talking with your sleep care provider about discontinuing the use of the nasal prongs.
Additionally, sores inside the nose can be caused by the CPAP air drying out the mucous membrane. Adding moisture from a heated humidifier is your best solution however these items can help too:
Sores at the bridge of your nose may be caused by over-tightened headgear. The pressure can create soreness and then a bruise, which may become an open sore if left untreated. If you have to over-tighten your mask to get a good seal, consider switching to another mask type.
Why Is The Bridge of My Nose Sore?
Sores or soreness at the bridge of your nose is usually indicative of over-tightened headgear straps. You may be tightening your headgear too much to reduce or eliminate an air leak, but over-tightening the headgear can cause soreness—and it usually means the mask is too large, too old, or not the best style for your needs.
If your mask is six to nine months old and the silicone is worn and won’t hold a seal, it’s time for a replacement. You can use our handy Replacement Part Finder to get the parts you need.
You may need to stop wearing your mask to allow the sores or soreness to heal; in the meantime, you can wear nasal pillows to continue your sleep therapy.
Other items that may help with a sore nasal bridge include:
How Do I Avoid Red Marks?
Similar to nasal sores and other skin irritation, red marks can be caused by over-tightening your CPAP mask. Your mask should only be tightened enough to create a seal; to avoid over-tightening your mask, work clockwise to make small adjustments to the headgear until the mask is secure but not overly tight. Cleaning your mask cushion, nasal pillows, and nasal prongs on a daily basis helps you achieve a better seal, too.
If you know your mask fits and you are routinely cleaning it, consider adding mask strap pads—a soft covering for the headgear straps—to your CPAP set-up.
Red marks from your CPAP mask can be upsetting, but there are several products designed to target and minimize red marks and other skin irritation, including:
Other CPAP Side Effects You Should Know About
Nasal congestion and mild facial soreness are some of the more common CPAP side effects, but there are some lesser-known side effects that you may be experiencing.
Why Do I Wake Up Feeling Bloated With Air In My Stomach and Intestines?
CPAP users who wake up feeling bloated or who experience other uncomfortable gastrointestinal symptoms such as belching, flatulence, or abdominal distension may have CPAP-related aerophagia. Aerophagia is a medical term for excessive and repetitive air swallowing, and it can happen during your sleep therapy if you are swallowing the CPAP air.
Though there isn’t a medical solution for this, it may help to adjust your sleeping position. Try laying as flat as possible, even without a pillow. If that doesn’t work, try sleeping on your side or in an elevated position. (The new sleeping position should be different than your current sleeping position.)
If changing your position doesn’t work and you’re still feeling bloated, speak to your doctor about lowering your CPAP pressure settings. This may cause a slight increase of apnea episodes (though the relief from the severe bloating you’re feeling may be worth letting a few apneas through), so be sure to consult with your doctor before making any adjustments to your current settings.
Why Are My Lungs Burning?
Some CPAP patients complain of a burning sensation in the lungs, which is often a result of dry or cold air being inhaled through the CPAP mask. This uncomfortable CPAP side effect can possibly be reduced by using warm humidification. Lung discomfort can also be caused by CPAP-related aerophagia.
How Can I Feel Less Claustrophobic During CPAP Treatment?
Those who wear a full face mask that fits around the nose and mouth may experience claustrophobia. In fact, one study found that 63% of participants experienced claustrophobic tendencies that caused short-term and long-term adherence issues. Wearing a smaller CPAP mask may help, including one with an open line of sight, may help.
Questions You May Have About CPAP Therapy
Some of the first questions people have when they are first diagnosed with sleep apnea is if CPAP treatment is dangerous and if there are alternatives to CPAP therapy.
Is CPAP Dangerous?
CPAP treatment itself is not dangerous, but leaving sleep apnea untreated poses numerous risks to your cardiovascular and metabolic health. If you suspect your partner has sleep apnea, consider a home sleep test.
Are There Alternatives to CPAP Therapy?
Approximately 22 million Americans have sleep apnea, and while PAP therapy (positive airway pressure therapy) is the gold standard for sleep apnea treatment, some people can’t tolerate it. If you’re in the minority of sleep apnea sufferers in this category and have mild sleep apnea, you may benefit from positional therapy, surgery, oral appliances, and other alternatives.
While this guide is packed with helpful information about CPAP side effects you may experience, you may have other questions about sleep apnea or your sleep apnea treatment. We encourage you to talk with your primary care physician for further guidance.
Adjusting Your CPAP Pressure to Avoid CPAP Side Effects
Still experiencing adverse side effects after trying the applicable methods in this article? Fortunately, changes to your pressure settings can often be made to improve unwanted side effects.
Before requesting changes from your doctor, double-check your pressure settings to ensure the numbers match what your sleep care physician prescribed.
If you’ve recently quit smoking or consuming alcohol, experienced weight loss or weight gain, or had changes to your health (such as a diabetes diagnosis), changes may need to be made to your pressure settings. Your doctor can review your CPAP data to make a determination of the pressure settings that will benefit you best.
Always consult your doctor before making any changes to your sleep therapy treatment, and consider these quick tips below to help prevent the CPAP side effects you’re experiencing.
How to Prevent CPAP Side Effects
Unwanted side effects can be discouraging, but don’t give up on your sleep apnea treatment just yet. The following recommendations may reduce or completely eliminate some of the issues you’re experiencing:
- Ensure You Have the Proper Mask Fit
- Double-Check The Straps Are Secured
- Clean Your CPAP Equipment Regularly
- Avoid Using Oil-Based Cleaning Products
- Add Humidification or Mask Barrier Products
- Consider Sinus Medication or Heated Tubing
- Use Water-Soluble Saline Gel on Nostrils
Ultimately, adhering to your sleep apnea treatment will help you avoid complications ranging from excessive daytime sleepiness to cardiovascular events. It can be frustrating to use a CPAP device, but it’s crucial to stick with it. While CPAP therapy can cause certain side effects, the benefits and advantages almost always outweigh the drawbacks.
While many people don’t have any difficulty using their CPAP and report having the best sleep of their lives after the initial start of their sleep therapy, some people do still experience minor side effects like dry eyes and nasal sores. Remember to always talk with your doctor before making any changes to your current CPAP routine.
Time, patience, and attending all regularly scheduled doctor visits to troubleshoot issues can empower you to wear your CPAP comfortably and consistently, which will positively affect your health and impact your quality of life.
Daniela has researched and published over 60 articles covering topics that aim to inform and empower people living with Sleep Apnea. As an avid reader and researcher, Daniela continues to grow her knowledge about Sleep Apnea and CPAP therapy everyday with the help of coworkers, CPAP.com customers, and members of other CPAP communities online.