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Pros and Cons of Using A CPAP Machine: Is It Still the Top Choice for Sleep Apnea Treatment? 

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Illustration of a man using a CPAP

Obstructive Sleep Apnea (OSA) is a sleep-related breathing disorder marked by pauses and breathing stoppages caused by the airway’s physical obstruction. This condition affects sleep quality and can impact your quality of life by resulting in daytime fatigue, anxiety, and depression, and it can even raise your risk for other health consequences like Alzheimer’s and cardiovascular disease.

While there is no permanent cure for the condition, those with mild to moderate OSA might find relief from their symptoms with some simple lifestyle changes like sticking to a regular exercise routine, practicing tongue slides or other mouth-strengthening exercises, and side-sleeping.

For more severe cases, a continuous positive airway pressure (CPAP) machine is the gold standard for treating sleep apnea. So, why is a CPAP machine still the top choice for sleep apnea treatment?

Also known as a sleep apnea machine, your CPAP delivers pressurized air to your mouth or nose by way of a CPAP mask to hold your airway open where your tongue or excess tissue usually blocks it. This allows for more normal breathing and blood oxygenation and reduces sleep interruptions, thus improving your sleep quality. 

However, some drawbacks may be holding you back from using it for the long term, like feelings of claustrophobia or nasal congestion. Many people experience the cons of CPAP before they see the pros, and we want to reassure you that sticking with your CPAP therapy is genuinely life-changing and worth committing to.  

This article will discuss the top CPAP machine pros and cons to provide you with a better understanding of the equipment, as well as a better understanding of the therapy itself and why it’s worth sticking to, regardless of the side effects. The CPAP pros are noteworthy, while the side effects or cons are typically mild and manageable with the right planning and information. 

Read on to learn more about why we consider a CPAP machine the best choice for sleep apnea, despite its drawbacks!

The Pros of CPAP Machines

CPAP machines are the go-to treatment modality for sleep apnea. By holding your airway open during sleep, the device helps you maintain a regular breathing pattern, improving your sleep quality and overall quality of life.

Here are some of the most prominent advantages of treating your sleep apnea with a CPAP machine:

Improved Sleep Quality 

When discussing the pros and cons of treating sleep apnea with a CPAP machine, better sleep quality is at the core of the argument. Sleep affects all other areas of life, so when you aren’t sleeping well, and especially when you’re losing sleep to breathless nights or waking up gasping for air, you’ll likely notice yourself falling short at work or in your relationships, too.

A CPAP machine can significantly improve sleep duration and quality by preventing airway obstruction and allowing the lungs to function normally. A controlled study concluded that a CPAP improves sleep quality by consolidating sleep and enhancing REM sleep (rapid eye movement) and that it had a more significant impact on sleep quality than placebo or nocturnal oxygen therapy. 

Ultimately, sleeping with a CPAP means less snoring, more restful sleep, and far fewer disruptions to your sleep throughout the night.

Improved Quality of Life

CPAP treatment improves your quality of sleep and boosts your daytime performance with increased energy levels, better mood regulation, and cognitive functioning. Sleep apnea has been shown to significantly impact your daytime functioning, and researchers agree that any form of treatment for sleep apnea is better than none at all.

A 2017 study showed that CPAP effectively improves health-related quality of life in those with OSA.

A 2021 study further concluded that long-term CPAP therapy not only improves sleep quality and daytime sleepiness but also alleviates symptoms of anxiety and depression. The study participants had evident mood elevations after three years of CPAP therapy while adhering to a median time of 6.6 hours per night and a median pressure of 11 cmH2O.

Furthering the quality of life argument is the finding that men treating their OSA with CPAP saw an improvement in sexual and intimate relationships with their partners. In a completely different vein, you’re much more likely to be involved in multiple motor vehicle accidents with untreated OSA, and your risk is lowered by maintaining CPAP therapy. 

With all this in mind, it is easy to see how successful CPAP therapy can have a far-reaching impact on your overall quality of life in multiple important areas. 

Lowered Risk of Chronic Diseases

Untreated OSA can increase your chances of chronic ailments such as diabetes, cardiovascular (heart) disease, Alzheimer’s, and stroke. 

Treating your OSA with a CPAP machine can help prevent the development of deadly diseases. Controlled trials reveal that CPAP lowers blood pressure, improves heart muscle function (systolic), and enhances the heart’s ejection fraction. It also decreases the risk of ischemic stroke.

We also know that sleep is important for proper immune system function and that untreated OSA raises your risk for influenza infection, allowing us to conclude that successful therapy will positively impact your immune system’s ability to ward off illness. 

Cons of CPAP

Like most good things, the benefits of CPAP are tempered by the drawbacks, but rest assured that the cons of CPAP are very manageable and worth overcoming when you consider the life-changing benefits of successful therapy. Below, you’ll find a list of common CPAP complaints and our favorite solutions for overcoming them.

Operating Noise 

CPAP machines typically check in under 30 decibels while in operation, which is commonly compared to the sound of a whisper or quiet conversation. Many CPAP owners liken their machine’s sound output to that of a white noise machine and, after a brief adjustment period, most people are able to sleep soundly with their CPAP machine. 

That said, some people are more sensitive to sound, or more specifically, the particular pitch at which their CPAP machine operates. The small compressor can get a little loud, especially in travel-sized CPAP machines or at higher pressure levels. You can resolve this issue by wearing earplugs to sleep or ensuring that you learn about the quietest CPAP machines before buying your first machine. It’s also a good idea to watch a few videos about machines before buying to get a better idea of what each one sounds like. You may even have a local retailer in town that you could visit to hear it in person. 

In many cases, CPAP machine noise can be attributed to a loosely fitted mask leaking pressurized air or a leaky or improperly connected hose, both of which can easily be remedied. 

Adjusting to Therapy

When first starting CPAP therapy, you’ll likely run into a range of experiences that may discourage you from keeping up with it. Feelings of claustrophobia are incredibly common and can be alleviated by ‘practicing’ wearing your mask during the day and napping with your CPAP machine. Acclimating to the mask during your waking hours will also reduce your chances of waking up in the middle of the night to find that you’ve ripped your mask off, as you’ll be more familiar with the feeling of wearing the mask. 

Other common frustrations when beginning CPAP include:

  • Facial Irritation
  • Dry or Itchy Eyes
  • A Dry Mouth
  • A Dry Throat
  • Sore Spots On and Around the Nose

For more information about combatting these common issues, keep reading below, then check out our guide to tackling the most common CPAP side effects

Dry Mouth 

The pressurized air from a CPAP can eliminate the moisture from your oral and nasal structures, which is why most modern CPAP machines include an integrated heated humidifier. Mask leaks are a common culprit of CPAP dry mouth, but it’s especially common for those wearing a nasal or nasal pillow mask. 

CPAP masks that only deliver air to the nose can result in the mouth opening during the night, allowing the pressure to escape out your mouth, drying it out while also robbing you of the benefits of successful therapy. You can alleviate CPAP dry mouth for a better therapy experience by switching to a full face mask that covers your entire mouth and nose or adding mouth tape or a CPAP chinstrap if you sleep with a nasal mask. 

Nasal Congestion

Nasal congestion is another commonly-reported side effect of CPAP machines. Using CPAP without a humidifier dries the nasal mucosa and can induce nasal congestion. A heated humidifier effectively reduces the issue of nasal dryness and congestion because it supplies the moisture that your nasal cavity provides during normal breathing. It can also help to reduce irritation and inflammation. 

CPAP humidifiers offer multiple levels of humidification, and experts recommend that you start just below half of your humidifier’s maximum setting, which will be a 3 or 4 on most machines. From there, you can dial in your humidity setting to find the perfect output for waking up without dryness or congestion.

Bloating and Gas 

Experiencing bloating and gas from your CPAP therapy is not uncommon, and there are a few courses of action you might be able to take to find relief. 

Also known as CPAP aerophagia, gas and bloating due to CPAP therapy is typically caused by a pressure setting that is too high or too low. Difficulty exhaling against your pressure can also lead to aerophagia. An APAP machine may eliminate this issue, but first, you should try changing your sleeping position or increasing your machine’s expiratory pressure relief setting to prevent you from accidentally gulping air while unconscious. 

Skin Irritations

Skin irritation is a common issue with CPAP therapy, but thankfully, it is pretty straightforward to deal with. Ensure that you maintain a consistent cleaning routine of, at the very least, wiping your mask cushion down in the morning with a mask wipe. Ideally, cleaning your mask and cushion with soap and water every morning will have the best results, as irritation is typically caused by dirt and oils on your cushion from the previous night. 

If your issues persist, try adding a mask liner to your setup for a better seal, a different cushion size, or even a different mask style entirely. 

Sinus Infections

A 2016 study found that those with OSA were more likely than those without OSA to develop rhinosinusitis, also known as sinus infections. That said, a separate study from 2012 found that regular CPAP therapy significantly reduced incidences of rhinosinusitis, so you can rest assured that maintaining your CPAP therapy will reduce your chances of getting a sinus infection. 

That’s not to say it isn’t possible, however. Always use distilled water in your humidifier chamber and ensure that your hose and water chamber remain dry and disinfected while not in use, as the real culprit for CPAP sinus infections is dirty equipment, more often than not.

Frequently Asked Questions About CPAP Machines for Sleep Apnea 

Is a CPAP Machine Worth It?

CPAP is the gold standard for treating sleep apnea, and any drawbacks are easily outweighed by the positive impact of CPAP therapy on your alertness and energy levels, as well as its association with reduced risk for diabetes, heart failure, Alzheimer’s, and even motor vehicle accidents. Many people notice the benefits of CPAP therapy within the first two weeks, and long-term usage yields even better results. 

Is Sleeping With a CPAP Machine Good for You?

For those with Obstructive Sleep Apnea, sleeping with a CPAP machine will prevent your airway from collapsing, allowing your lungs to function normally and provide you with the restorative sleep you need. Not only are CPAP machines good for your health in both the short and long term, but they will impact your work life and personal relationships, too!

Does Using CPAP Cause Weight Gain?

Some evidence suggests that CPAP can alter the basal metabolic rate and lead to weight changes, but rather than fat being the culprit, researchers found that lean body mass was actually responsible for the weight gain from CPAP. In short, those undergoing CPAP therapy had more energy to exercise and gained more healthy weight, while fat presence remained relatively unchanged. 

How Long Can You Stay on CPAP?

CPAP therapy is safe for the long term and is encouraged as a lifelong treatment option or as long as your Obstructive Sleep Apnea persists. You should only cease CPAP therapy with the approval of your healthcare provider. 

How Many Hours per Night Should CPAP Be Used?

Sleep specialists recommend using CPAP for more than 7 hours per night, though the ideal time is hard to achieve for everyone. Using it for a minimum of four hours is considered acceptable compliance, though you will notice the benefits more quickly with more hours per night.

Will a CPAP Stop Snoring?

The continuous positive airway pressure provided by your CPAP machine should also eliminate your snoring problem, but if not, it may be a sign that something isn’t working properly. Possible culprits include your sleeping position, pressure setting, mask or hose seal, or mouth breathing. If you’re still snoring with CPAP, talk to your healthcare provider for guidance and solutions. 

How Long Does It Take CPAP To Make a Difference?

This can vary greatly from person to person, but with good adherence, you should notice the benefits of CPAP therapy within the first two weeks. Some even notice a difference after the very first night of sleeping with their CPAP, but even if you don’t immediately notice the benefits, you should stick with your therapy for as long as possible. 

Conclusion

CPAP machines are the preferred treatment to manage moderate to severe OSA. When it comes to CPAP machine pros and cons, the benefits outweigh the side effects, hands down.

The cons of CPAP are numerous, though they should be considered small and manageable obstacles because many solutions exist for common CPAP side effects like dry mouth and skin irritation. There are also excellent communities out there, such as CPAPtalk.com, which are full of people who are experienced with CPAP therapy and love helping newcomers adjust and find success. Considering the significant impact on the rest of your waking life, the decreased risk of serious disease, and the newfound energy levels and mood stability associated with CPAP therapy, it becomes clear that the cons are worth navigating. 

If you have any trouble acclimating to your therapy, or if you have a question about a product or an order, give our expert customer service team a call at 1-800-356-5221, text us at 832-308-2219, or reach out using the Live Chat feature on our website for answers and support. We’re available from 8 a.m. to 8 p.m. (CST) Monday through Friday and 8 a.m. to 5 p.m. on Saturdays, so don’t hesitate to reach out so we can help you get acclimated and start enjoying the benefits of successful CPAP therapy!  

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