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6 Tips to Help You Kick a “CPAP Cough” for Good

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Man coughing after waking up with CPAP

💡 Key Takeaways

  • Identify the Cause: CPAP-induced coughing can stem from various factors such as sensitivity to airflow, equipment irritation, or an underlying health issue. Knowing the cause is crucial for effective management.
  • Adjust Humidity Settings: One of the most straightforward solutions to CPAP cough is to increase the humidity settings on your machine. This can alleviate dryness and irritation in your airway that may be the source of your cough.
  • Check Mask Fit and Equipment Cleanliness: Ensure your mask fits well to prevent air leaks. Regularly clean your CPAP equipment to avoid bacterial buildup, which can exacerbate coughing.
  • Address Mouth Leaks: If you’re using a nasal CPAP mask and are experiencing a cough, consider mouth leaks a potential issue. Solutions include tongue and jaw exercises, mouth tape, a CPAP chinstrap, or switching to a full face mask.
  • Consult Your Doctor: If your cough persists despite trying various solutions, it may be time to consult a healthcare provider for a comprehensive evaluation.

CPAP therapy has a ton of great benefits for people with sleep apnea, but if you aren’t careful, it can also come with some unpleasant side effects, such as sinus irritation, dermatitis, and dry mouth. Some people who use CPAP develop a persistent cough, oftentimes referred to as a CPAP cough.

This particular type of cough may not respond to typical treatments. It can be very frustrating because coughing makes it difficult to use your CPAP machine and can even keep you awake at night.

If you are struggling with this issue, we’re here to help you move past it with some information about why CPAP makes you cough and how to fix it!

Why Does My CPAP Make Me Cough?

If you’re coughing from CPAP, it’s important to understand the causes so that you can address it and prevent it in the future. This cough usually comes down to one of two main issues: sensitivity to airflow or irritation from your equipment.

Your throat and airway are made of sensitive soft tissue, which can become dried out or irritated due to the constant airflow. To complicate things even more, your CPAP equipment is an ideal home for germs and can build up different types of allergens and irritants over time.

Your Symptoms Can Tell You Why You’re Coughing With CPAP

Understanding the link between using your CPAP and cough symptoms is key to figuring out why CPAP is making you cough. It’s a lot harder to manage CPAP coughing when you don’t know the cause.

So, why is CPAP making you cough? It could be a combination of one or multiple issues. Let’s discuss a few signs that can help you narrow down the culprits!

Your Cough Only Happens While Using CPAP

You may experience a cough that starts within minutes of putting on your mask and goes away soon after you take it off. You may also notice that your CPAP causes a tickle in your throat right before the coughing begins, and you may even experience a sore throat or coughing up phlegm.

These signs could indicate some sort of allergy or sensitivity to your equipment, or it may be that the CPAP air is drying out your throat.

Your Cough Gets Better Within Hours of Waking Up

If you notice that your cough only develops after using your machine for more than a couple of hours, you could be mouth breathing or experiencing air leak issues. It is also possible that your humidity is too low. If this is the case, you may wake up with a cough in the middle of the night.

However, some people sleep through the initial discomfort and only notice their CPAP cough in the morning when they first wake up. This cough is often accompanied by dry mouth, sore throat, or nasal congestion and usually subsides within a few hours.

You Develop a Persistent Cough That Worsens During CPAP Therapy

After multiple days of experiencing airflow issues, low humidity, or mouth breathing while using a nasal mask, the nightly irritation can lead to a chronic cough from your CPAP machine.

If your throat or airway is irritated on a regular basis, the tissue will eventually become inflamed, triggering a persistent cough that worsens after using CPAP but may also linger throughout the day.

You Began Chronically Coughing Up Phlegm After Starting CPAP

If you’ve experienced CPAP chest congestion that won’t go away or have been coughing up phlegm that has worsened with time, this could be a sign that you have developed an infection in your upper airway or lungs.

CPAP infections are rare and are usually caused by dirty CPAP equipment that has been contaminated by bacteria, viruses, mold, or mildew, which makes you sick over time. This type of cough isn’t always accompanied by a fever.

Chronic cases of mild CPAP pneumonia may leave you feeling run down but without the other, more widely recognized signs of infection.

Your Cough Does Not Change Whether or Not You Use a CPAP Machine

Sometimes, using a CPAP and coughing occur at the same time, but out of pure coincidence.

Over time, you may notice your cough does not get better, no matter what solutions you try. If this sounds familiar, you may be experiencing a chronic condition that is not caused by CPAP.

This cough might be accompanied by other symptoms that could hint at the underlying cause, such as temporary illnesses or chronic medical conditions.

How to Get Rid of a CPAP Cough

While your cough may be caused by sensitivity in your airway or dirty equipment, there are several ways to address those issues and prevent them from turning your next CPAP session into a coughing fit.

1. Increase Your CPAP Humidity

Dry air is a common culprit for coughing. Doctors often suggest using a humidifier when you have a cold. CPAP machines are no different. They are designed to push air directly into your airway, and if that air doesn’t have a lot of moisture, you’ll start feeling the effects early on in the night.

The easiest way to address this is by increasing your humidity settings on your CPAP. Most new CPAP machines are equipped with heated humidifiers, which boost moisture and allow you to increase the humidity and the temperature settings to meet your comfort level. If your machine has an integrated humidifier, you can adjust how much humidity it supplies in your settings menu without oversight from your healthcare provider.

If you already sleep with a heated humidifier and are still struggling with a cough, we recommend using a heated tube to boost your CPAP humidity even more. These products are available for all the biggest CPAP brands and can prevent heat and moisture loss as the humidified air is transported to your CPAP mask.

2. Check Your Mask Fit

A bad mask fit will lead to all sorts of unpleasant CPAP side effects, including a cough. If your mask isn’t sealed correctly, it can cause mask leaks, which causes you to lose humidified air produced by your CPAP machine in exchange for cool, dry room air. When this happens, it can irritate your mouth, throat, and airway, leading to a CPAP cough.

Some CPAP machines will tell you if you are experiencing mask leaks, but it’s best to double-check that your mask seal is secure before beginning therapy each night.

Start by putting your mask on like normal, then turn on your CPAP machine. Pay special attention to the area around your mask cushion, feeling for areas where air leaks may occur. Many modern CPAP machines even have a “Mask Fit Check” feature in the settings that’s designed to help you find leaks before bed.

If you have adjusted your mask and are still struggling to prevent air leaks, try a cushioned mask liner! These easy-to-use mask accessories will provide extra padding to your CPAP mask, protect your cushion from wear and tear, and help it stay sealed against the contours of your face.

3. Prevent Mouth Leaks

If you use a nasal CPAP mask and regularly wake up with a sore throat, dry mouth, or a cough, you may be experiencing mouth leaks. When you use a nasal mask correctly, CPAP air enters your nose and travels down your throat and airway.

However, if you sleep with your mouth open while using these masks, some of that humidified CPAP air will escape out of your mouth. At the same time, you’re bringing in dry room air, causing irritation and making you cough, even when you aren’t using a CPAP machine.

Luckily, you can train your mouth to stay closed while you are sleeping by doing tongue and jaw exercises. If those don’t help, you can also try mouth tape or a CPAP chinstrap. Either option helps to hold your mouth closed and prevent mouth leaks while using your CPAP machine. And if you really can’t seem to keep your mouth closed, you can always try a full face mask.

4. Keep Your CPAP Equipment Clean

When you’re trying to stop a CPAP cough, the most important thing you can do is clean your CPAP equipment regularly! While lack of moisture can be annoying and cause irritation, the germs that grow on your CPAP mask, hose, and water reservoir can seriously damage your health.

Your CPAP machine and mask are the perfect environment for bacteria and mold to grow and thrive. When you clean your equipment correctly, those disease-causing organisms are removed before they can make you sick. But when you use dirty equipment, you are left breathing in all those pathogens, which can collect in your lungs and lead to sinus infections, bronchitis, or even pneumonia.

To ensure that you remove all of the germs from your CPAP equipment, we suggest thoroughly wiping down your mask, hose, and water reservoir before thoroughly washing them in the sink with warm water.

If you have a weakened immune system or simply want to make sure your gear is as sanitized as possible, you can purchase a CPAP cleaning machine, which uses UV light to kill any leftover organisms after your standard cleaning routine.

5. Avoid Allergens and Irritants

If you have addressed all the factors listed above and are still experiencing CPAP coughing, you could have an allergy to something on or in your CPAP mask, hose, or water reservoir. These sensitivities could be related to the materials used to make your CPAP equipment (such as silicone) or the products you are using to clean that equipment.

Manufacturers state that CPAP masks, hoses, and water reservoirs should only be washed in mild soap and warm water or with products cleared for use on CPAP devices. After washing, some people spray their equipment with Lysol to kill any lingering germs. However, sanitizing sprays can irritate the lungs and worsen your cough. This practice isn’t recommended, but if you’re going to do it, let your equipment air out for a few hours before using your CPAP.

6. See Your Doctor About a Chronic Cough

Sometimes, a chronic cough after starting CPAP isn’t actually an issue caused by the CPAP device itself but a sign that you are experiencing an underlying health issue, which may or may not be related to your sleep apnea. If you have a persistent cough that won’t go away no matter what you do, it may be time to go see your doctor to discuss potential causes.

Frequently Asked Questions

Why Do I Cough When I Put My CPAP Mask On?

If you start to cough soon after putting your CPAP mask on, the humidity levels in your CPAP air may be too low. If your humidity levels are high, you may be experiencing an allergy or sensitivity to the cleaning supplies you are using to wash your CPAP equipment.

What Are the Symptoms of a Dirty CPAP Machine?

If your CPAP filter is worn out or your humidifier water reservoir is dirty, you may develop a cough or sinus infection. It’s also common to notice an unpleasant smell or residue growing on your CPAP machine.

Why Do You Wake Up Coughing With Sleep Apnea?

Yes. Sleep apnea can cause you to wake up gasping for air or choking, which may cause you to cough. It has also been linked to other conditions associated with coughing, including GERD, asthma, and respiratory infections.

Can CPAP Cause Sore Throat and Cough?

If CPAP makes you cough, there is a good chance that you may also be experiencing other signs, including sore throat, dry mouth, and lost voice. This combination of signs suggests that your CPAP air is too dry, you’re experiencing air leaks, or you are mouth breathing with a nasal CPAP mask.

Final Thoughts

Having a CPAP cough is no fun, but it can also be a sign that you need to make some changes. If CPAP is causing a cough, the easiest fix is to increase your humidifier settings. You should also check for air leaks, and if you use a nasal CPAP mask, you should also consider whether or not you are sleeping with your mouth open. Most importantly, you must clean your CPAP equipment regularly with CPAP-approved soap and warm water.

  • Kenzie Dubs

    Kenzie is a science-based content writer who has a passion for educating the public on the healing powers of sleep! She graduated with a bachelor's degree in biology in 2016 and went on to earn a second degree in nuclear medicine shortly after. She has several years of professional experience in healthcare, including emergency medicine, radiology, and general care. Along with her unique background, Kenzie also has personal experience with sleep apnea, including loved ones who have recently begun their own CPAP journeys. With each article, she aims to provide our readers with honest, accurate information that they can use to improve their health and wellness!

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