When you first begin CPAP therapy for your obstructive sleep apnea, hopefully, you will notice improvements right away: deeper, more restorative sleep and the positives that come with it, including better mood, more energy, and more focus.
However, not everyone’s CPAP experience is 100% positive at first. CPAP therapy can have some side effects, mainly discomfort. While new users are adjusting to a first-ever apnea mask and machine, they may experience nasal congestion and irritation, mask tightness, chafing, skin irritation, and headaches. In fact, nasal symptoms have been found to be a top reason CPAP users abandon wearing their masks.
The good news is, none of these side effects has to be a deal-breaker. CPAP manufacturers, suppliers, and sleep medicine physicians want you to stick with your therapy and see improvement in your sleep and your health. Apnea is serious. A small, easily addressable side effect should not derail you from a long-term treatment plan that can make you healthier.
Fortunately, CPAP machine and accessory manufacturers know that apnea masks are not “one size fits all.” People have different facial contours, hair, allergies, skin reactions, and so on. In response, the apnea therapy industry has developed many different products and “hacks” to help improve your individual comfort when wearing a mask.
If your CPAP mask is causing you problems, read on to learn about tips, tricks, and products to help you get a better fit and a more comfortable sleep experience.
Tips, Tricks, and Products to Make Your CPAP Mask More Comfortable
Is your CPAP mask uncomfortable? Maybe it’s too tight, too loose, or sits uncomfortably over your nose, mouth, or cheekbones. Maybe the contact between your skin and the mask has lead to skin breakouts and soreness. Or perhaps the filtered, pressurized air pressure has dried out your nose and mouth.
We’ve compiled some of the common CPAP comfort-related complaints below, along with some solutions—products and accessories that can make your life with CPAP a little easier.
“My CPAP is too tight—I wake up with red marks on my skin.”
Sometimes, users may complain of red marks from direct, firm pressure on their skin from the CPAP masks or straps. The nose, cheeks, sides of the face, or ears may show these marks or become sore.
Fortunately, CPAP headgear can be manually adjusted. We advise you tighten down your mask just enough to create a seal. Overdoing the tightness is what leads to red marks on the face. While the air is blowing, pull the mask 1-2 inches from your face to give the outer cushion layer time to inflate. Gently seat the mask by lowering it back down over your nose and/or mouth, and make small adjustments in a clockwise fashion until you have a good seal and feel comfortable.
If you continue to wake up with red marks, Mask Strap Pads or Strap Covers can cushion the straps of your headgear so it doesn’t press directly into your skin.
Other items that may help with skin irritation from direct contact with the gear include:
- Padded Full-face Mask Liners
- Padded Nasal Mask Liners
- Padded Nasal Pillow Mask Liners
- Cheek Pads
- Gel Pads for the nose
- Ear Loop Protectors
“I have sores inside my nose, in the nostrils.”
Sometimes, apnea patients may wind up with nasal pillows or nasal prong devices that are a poor fit for their noses or nostrils. Sometimes the process of getting used to CPAP can require some trial and error until you find the product and fit that suits your face.
In some cases, however, the skin inside your nose just needs time to thicken in response to a foreign object creating a tight seal against the skin—sort of like a runner developing a heel callus when coming into repeated contact with the pavement.
Another possibility is that the pressurized air is drying out your mucous membranes, which can reduce your nose’s natural lubrication and make you more prone to tiny scrapes and cuts that develop into sores. These cuts can also open up paths for bacteria to enter your bloodstream, leading to infections.
However, a stinging nostril can be painful and irritating. In the interim, while you wait for your body to adjust, there are some products that can help add moisture and reduce irritation and inflammation. These include:
- Heated Humidifiers
- Nose Lubricants
- Moisture Therapy Cream
- Mask Wipes
If your sores don’t heal, tell your physician. Nasal prongs or pillows may not be the right option for you.
“My nose is dried out. Sometimes I even get nosebleeds.”
If you don’t use a CPAP Heated Humidifier, you may be breathing in unmoisturized room air when you sleep, which can dry out the mucous membranes and leave the inside of your nose vulnerable to dry skin, cracks and fissures, and even nosebleeds. Infection an become a problem without the nose’s natural mucus to clear out particles and bacteria. You may also develop congestion as your nose tries to compensate for the lack of moisture by manufacturing extra mucus.
Some products that can help with a dry nose include:
- Heated Humidifiers
- Insulating Covers for your CPAP hose (to protect against excess condensation)
- Nose Lubricant to moisturize the inside of the nose
- Moisture Therapy Cream
- Heated Tubing
“I’m waking up with headaches after wearing my CPAP.”
If you’re waking up with a headache after using your CPAP mask, two possible factors may be the cause: overly high air pressure or a sinus issue.
If your air pressure is too high, talk to your sleep medicine physician or sleep techs about resetting your machine to a lower pressure. A different type of machine such as APAP or BiPAP may also work better for you.
If you have sinus problems, these may manifest as a headache behind the ears, behind the cheekbones, or in the forehead or eye area. Sometimes, sinus headaches are caused by an infection like sinusitis. You may also have congestion or a pressure differential that announces itself as pain, or dry sinuses from the pressurized air.
If you suspect a sinus issue, you may get some benefit from trying:
- Over-the-counter decongestants
- A CPAP Heated Humidifier, to moisten the sinuses
- Bacteria Filters
- A Vapor Clear Sinus Blaster
- Nasal Sprays
- A Sinus Rinse Kit
Don’t ignore a persistent sinus pain problem, however, as infections can spread and become worse without medication like antibiotics or antivirals.
“I have dry mouth.”
If you have a dry, sandpapery, sticky mouth when you wake up in the morning, it could be a sign that you’re mouth breathing during sleep—an unconscious behavior that actually decreases the effectiveness of your therapy. And if your apnea mask only covers your nose, you’ll also be missing out on the humidification and moisture offered by your humidifier.
Users with dry mouth should first check to see if the CPAP mask is leaking due to age or other issues (like the lack of a firm seal). If a leak isn’t the issue, you may need either a Chin Strap to keep your mouth from hanging open or a full-face CPAP mask that goes over your nose and mouth.
Recommend products that can help with dry mouth include:
- Heated Humidifiers
- Heated Tubing
- Chin Straps
- Full-face Masks
“I’m Breaking out with Acne or Rashes.”
Bumps, pimples, facial sores, and other types of skin breakouts can be the result of an allergic reaction, an overly tight mask, or a buildup of facial oils under the mask. Keeping your skin and your CPAP clean on a daily basis helps to reduce the risk of skin problems from contact, as does loosening the straps so you get a proper fit.
Keeping your mask clean can also help with allergies. Most people are not allergic to silicone in the mask, but rather to the chemicals used to help manufacture the silicone. Removing these chemicals with soap and warm water before you put your mask on can help.
Recommended cleaning products include:
Other issues that can affect comfort include swallowing excess air (aerophagia) that leads to bloating and belching, and dry eyes, which can result from a leak in your CPAP mask. You can learn more about these issues in our CPAP Side Effects FAQ.
CPAP masks take time to integrate into your sleep routines. Not everyone with apnea will have a perfect experience from night one. If you have any comfort or fit issues with your mask, try supplementing your CPAP with accessories to help ease your discomfort.
If none of these modifications are helpful, talk to your doctor about other options, such as trying a different CPAP machine or a new mask or changing your sleep position. The important thing is to not shut the door on apnea therapy altogether: CPAP therapy will make a difference if you can find a way to stick with it.
David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.