Top 9 Most Common CPAP Side Effects and How to Fix Them

Last Updated: Friday, July 28th, 2023
Written By: Kenzie Dubs

Man sleeping with CPAP mask next to his wife

According to most health experts, Continuous Positive Airway Pressure (CPAP) therapy is considered the most effective way to minimize the effects and reduce health risks associated with sleep apnea. Despite its many benefits, it can take some time to adjust to sleeping with your CPAP machine, and you may experience a few common CPAP side effects throughout the process.

No doubt, these issues can be uncomfortable and are often frustrating to deal with. Unfortunately, these side effects can also lead some people to quit sleep apnea treatment altogether. But with the right tools and information, you can address these complications early on, ensuring long-term CPAP success!

In this article, we want to help you better understand the most common complaints associated with CPAP therapy. We look forward to teaching you how to identify and manage these unpleasant side effects, including ways to prevent things like skin irritation, claustrophobia, and trouble breathing. Then lastly, we’ll touch on some of the long-term side effects of CPAP machines, particularly the benefits you can expect to see over time.

1. Skin Irritation

One of CPAP therapy’s most common side effects is skin irritation or red marks from headgear. These spots typically appear along your cheeks or nose and may become sensitive to touch. Over time, CPAP skin irritations can become infected and require medical intervention.

Causes of CPAP Skin Irritation

Build-Up of Dirt and Debris on Your Mask: Each night, your mask gets covered with facial oils, sweat, dirt, and skin cells. If these contaminants are allowed to build up over time, you are much more likely to experience redness and irritation each time you wear a dirty mask.
Over-Tightened Headgear: It’s easy to accidentally over-tighten your headgear while you’re trying to keep your CPAP mask in place, but unfortunately, doing so can cause pressure sores and other skin irritations.
An Allergic Reaction to the Mask Material: Most modern CPAP masks are made with silicone. A silicone allergy is rare, but when it does happen, it can lead to rashes, redness, or even acne. If you have or develop an allergy to silicone while undergoing CPAP therapy, you may need to switch to a gel or cloth mask to find relief.
Exposure to Moisture: Between the humidified air and the droplets released each time you exhale, CPAP involves a lot of moisture. Over time exposure to this kind of environment can weaken the skin barrier and cause skin irritation.

How to Manage CPAP Skin Irritation

Early Treatment is Key: If you develop red marks, CPAP dermatitis, or other related skin irritation, it’s important to treat the area early on.
Address the Irritant: Start by identifying the cause of your issue. In many cases, once the source of irritation is addressed, most of these spots clear themselves up.
Keep the Affected Area Clean: To prevent infection, you must keep your face clean and dry. Our faces have tons of germs on them, so if you develop skin irritation from your CPAP mask, keep in mind that it is a prime spot for an infection to develop.
Use Ice or Heat: If you experience discomfort or the area is slightly swollen, apply a cold, wet compress to your face. Your doctor may also encourage you to try a warm compress if you develop an open wound, have CPAP acne, or develop an active infection.
Try Over-the-Counter Solutions: Your doctor may suggest using over-the-counter creams or lotions to treat the affected area. Topical steroid cream, calamine lotion, aloe, and lanolin cream are often effective for CPAP-related skin conditions. Avoid using petroleum jelly-based products while wearing your CPAP mask, as this ingredient can degrade your CPAP mask.
Seek Professional Advice: If you begin to see signs of infection, contact your healthcare provider.

Tips for Preventing CPAP Skin Irritation

Check Your Mask Fit: To avoid over-tightening your mask, make small adjustments to the headgear until the mask is secure but not overly tight. If you need to over-tighten your headgear to get a good seal, it may be a sign that it’s time to replace your cushions.
Keep Your Equipment Clean: You should clean your mask cushion, nasal pillows, and nasal prongs daily. Be sure to use mild soap and warm water. Harsh cleaners can cause skin irritation.
Try Comfort Accessories for Comfort: If you have checked all the above factors and are still having trouble, consider adding mask strap pads—a soft covering for your headgear straps—to your CPAP set-up.

Products to Help Skin Irritation From CPAP

2. Claustrophobia

When you’re first adjusting to wearing a CPAP mask, it can be hard to get used to sleeping with something attached to your face each night. In particular, traditional-style face masks have been linked to anxiety, as some people feel smothered while wearing something that covers their nose and mouth.

Causes of CPAP Claustrophobia

Reaction to Having Part of Your Face Covered: It is common to feel claustrophobic while wearing something that covers your face. Even simple face coverings can trick your brain into thinking you are trapped and unable to breathe.
Size of Your Mask: Studies suggest that the size of your mask influences your likelihood of developing claustrophobia. You are much more likely to feel claustrophobic wearing a full face mask versus a nasal pillow mask.

How to Manage CPAP Claustrophobia

Remind Yourself That You Are Safe: Claustrophobia often makes you feel like you can’t breathe. It’s important to remember that wearing breathable face coverings should not actually impact your ability to breathe unless you have been diagnosed with significant lung disease.
Try to Distract Yourself: Try using distraction techniques, such as reading a book or listening to music while trying to fall asleep. Doing so can take your mind off the discomfort and help you focus on something more pleasant.

Tips for Preventing CPAP Claustrophobia

Wear Your Mask During the Day: If you are struggling to adjust to wearing your mask, we suggest wearing it around the house during the day. We suggest trying it during moments when you are already distracted, such as watching TV.
Try a Different Mask: If this becomes a long-term issue, you may benefit from selecting a different style of mask. For example, nasal pillow masks are much more compact and may be less likely to trigger claustrophobia.

Products to Help Claustrophobia From CPAP

3. Shortness of Breath

If you’re having difficulty exhaling against your therapy pressure, it may cause an anxious choking episode, making you feel like you are short of breath. As you adjust to breathing with a CPAP machine, this will most likely get better over time, but there are other things you can do to help yourself breathe a little easier.

Causes of CPAP Shortness of Breath

You Are Still Adjusting to CPAP Therapy: Remember that it takes time to get used to breathing with CPAP. Even at low-pressure settings, your body may initially struggle to adjust to breathing out against a stream of pressurized air.
Exhalation Pressure Is Too High: If you are struggling to exhale against your CPAP machine, you may feel as though you are short of breath.
Your Pressure Needs Adjusting: If you have addressed all the other potential causes of shortness of breath and are still struggling, it may be a sign that your CPAP pressure is too high.

How to Manage CPAP Shortness of Breath

Remind Yourself That You Can Breathe: Even if it feels like you cannot breathe normally with your CPAP device, stay calm and remind yourself that you are safe and have access to air.
Use Distraction Techniques: It’s easy to become anxious when hyperfocused on breathing. Try to distract yourself by watching TV, reading a book, or meditating.

Tips for Preventing CPAP Shortness of Breath

Adjust Your Expiratory Pressure: If your CPAP device features expiratory pressure relief, changing those settings may make breathing easier.
Check Out the V-Com: The V-Com is a relatively new product with promising results already! It is designed to make CPAP airflow more comfortable and easier to adjust to, so it’s a great solution for anyone struggling to breathe with their CPAP machine.
Talk to Your Doctor About an APAP Machine: If your CPAP aerophagia is bad enough to make you consider quitting CPAP therapy, it may be time to talk to your healthcare provider about switching to an APAP machine, which delivers the lowest air pressure possible to still keep your airway open.

Products to Help CPAP Shortness of Breath

SleepRes V-Com CPAP Comfort Accessory

4. Dry Mouth

Dry mouth is fairly common in people who breathe through their mouth at night, especially those that sleep with CPAP machines. Over time, dry mouth can lead to gum disease, tooth decay, bad breath, and a higher likelihood of mouth sores.

Causes of CPAP Dry Mouth

You’re Leaking Air From Your Mouth: For nasal or nasal pillow mask owners, CPAP dry mouth typically happens when you begin breathing through your mouth while wearing a nasal-only mask. This impacts the effectiveness of your CPAP treatment due to your therapy air escaping but also causes dry mouth.
CPAP Airflow Is Drying Out Your Mouth: You can also experience mouth dryness with a full face mask. These CPAP masks are designed to push air into your mouth and airway. So, similar to using a fan to dry a wet floor, your CPAP may cause the moisture in your mouth to evaporate.

How to Manage CPAP Dry Mouth

Drink Water: As with eye or nasal dryness, hydration is key to fixing your dry mouth fast! When you first wake up, drink at least one glass of water to start your day.
Moisturizing Mouth Wash: Some companies produce moisturizing mouthwash to relieve the effects of dry mouth and prevent loss of water throughout the night.
Avoid Dehydrating Substances: Keep in mind that things like alcohol, caffeine, and some medications can worsen dry mouth.

Tips for Preventing CPAP Dry Mouth

Try a CPAP Chinstrap: Adding a CPAP chinstrap can help your jaw stay closed and encourages nasal breathing. Ultimately, this reduces your chances of waking up with a dry mouth.
Use Mouth Tape: There are many products on the market that are designed to tape your mouth closed. Doing this prevents moisture loss through your mouth, reducing mouth dryness.
Change Masks: If other solutions are not helpful, you may want to consider changing to a CPAP mask that is specifically designed for mouth breathers, such as a full face mask.
Add a Heated Humidifier: Regardless of the type of mask you wear, adding heated humidification to your CPAP equipment can help reduce dryness.

Products to Help Dry Mouth From CPAP

5. Dry Nose

You may experience slight pain and increased sensitivity throughout your sinuses when you have a dry nose. It’s also not unusual to see a little bit of blood after blowing your nose while using a CPAP machine. If this becomes a chronic problem, it can lead to nosebleeds, infections, and may even change your sense of smell.

Causes of CPAP Dry Nose

Dry Pressurized Air Dries Mucus Membranes: Nasal dryness usually indicates that you do not have enough humidity in the air you breathe in.
Your CPAP Air Is Too Cold: Our mucus membranes need warm air to keep from drying out. Cold or even cool air can dry you out.
You’re Adjusting to Your Nasal Pillow Mask: Unlike traditional CPAP masks, nasal pillows direct airflow straight into your nostrils. It often takes a bit of time to adjust to this style of continuous positive airway pressure delivery, and can cause your nose to dry out.

How to Manage CPAP Dry Nose

Stay Hydrated: Drinking water before and after sleep can boost hydration and help your dry nose recover after a night of using your CPAP machine.
Use Saline Spray: Saline spray provides much-needed hydration to dry and irritated sinuses. This not only replenishes the moisture in your nose but also relieves some of the discomfort associated with a CPAP-related dry nose.
Apply a Soothing Nasal Gel: Hydrating gels like over-the-counter nasal gel, aloe vera, lanolin, or vitamin E oil can be soothing when applied to dry, sensitive mucus membranes.
See a Specialist If the Problem Persists: 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.

Tips for Preventing CPAP Dry Nose

Add a Heated Humidifier: A heated humidifier adds moisture to nasal passages, reducing nasal irritation. If you are already using a heated humidifier, you can also try a higher humidification setting.
Try Products that Warm Your CPAP Hose: If a heated humidifier isn’t an option for you or hasn’t helped, it may be worth purchasing a heated CPAP hose to warm up the tubing your CPAP air flows through.
Apply Lanolin Before Putting on Your CPAP Mask: You may be tempted to apply a bit of Vaseline inside your nostrils. This is not advised, as Vaseline contains petroleum. However, some sleep apnea experts do suggest using a small amount of lanolin cream, as it is similar to Vaseline, but with a different active ingredient.

Products to Help Dry Nose From CPAP

6. Dry Eyes

If you wake up with irritated, dry, or itchy eyes after sleeping with your CPAP device, you may be experiencing CPAP-related dry eyes. This CPAP side effect is usually limited to certain types of CPAP masks and is more common in traditional-style full face or nasal masks.

Causes of CPAP Dry Eyes

Air Leaks from Your Mask: If you’re waking up with dry eyes after using your CPAP, you may likely have an air leak from your CPAP mask, most likely coming from the bridge of your nose.
Improper Mask Fit: The most common reason for air leaks around the nose bridge is that your mask is too big or long.
Your Sleep Apnea Is Not Being Treated Effectively: Scientists believe that Obstructive Sleep Apnea can actually cause dry eyes. So if your sleep apnea treatment is ineffective, you may continue to experience dry eyes until your CPAP settings are adjusted to better meet your needs.

How to Manage CPAP Dry Eyes

Drink Water: The added hydration will allow your eyes to begin producing tears, which should help improve any eye irritation or dryness.
Apply Artificial Tears: When you first wake up with dry eyes, it can be hard to see. Keeping artificial tears beside your bed may help your eyes recover faster after waking up.
Try Lubricating Eye Drops: If this becomes a common issue, your doctor may suggest using lubricating eye drops to provide your eyes with additional moisture.
Apply a Wet Compress: A warm compress opens up the tear ducts and encourages your eyes to lubricate themselves. Cold compresses have also been shown to have similar effects to artificial tears.

Tips for Preventing CPAP Dry Eyes

Keep Your Mask Clean: It is possible that oils from your face, moisturizer, or make-up are compromising your mask seal. Be sure to thoroughly clean your mask in the morning.
Adjust Your Mask Fit: A well-fitting CPAP mask can help you avoid dry eyes. If you need to over-tighten your headgear just to get a good seal, you may benefit from trying another cushion size or a different mask.
Try a Mask Liner: Mask liners can help you maintain a stronger seal throughout the night. Some mask liners are designed to soak up facial oils and sweat so that your mask cushion does not shift as you sleep.
Check That Your CPAP Pressure Is High Enough: If you continue to experience dry eyes, check with your healthcare provider to make sure your CPAP machine settings are correct. In some cases, your doctor may decide to increase your CPAP air pressure.

Products to Help Dry Eyes From CPAP

7. Sinus Irritation

Between sinus congestion, nose sores, and nasal dryness, CPAP therapy can be tough on your nose, which can worsen any CPAP headaches you may be experiencing. Without treatment, these sinus issues can develop into an infection or cause permanent nose damage.

Causes of CPAP Sinus Irritation

Sensitivity to Airflow: Breathing in the continuous flow of air from your CPAP machine can easily dry out and irritate your nostrils. Occasionally this can trigger a nosebleed. As a response, your nasal passages may respond by creating a barrier of protection by producing excess mucus, which leads to sinus congestion and irritation.
Chronic Dryness: Over time, the skin barrier inside your nose can weaken in response to nasal dryness, leaving your nose prone to injury and even infection.
Dry Airflow Is Irritating Your Sinuses: Your sinuses need to be moist at all times. When you regularly breathe in dry air, it can cause your sinuses to become inflamed.
Your Nasal Pillow Mask Is Causing Nasal Sores: Some people have difficulty adjusting to having airflow directed straight into their nostrils. Additionally, the nasal pillows themselves can irritate the inside of your nose.

How to Manage CPAP Sinus Irritation

Hydrate Before and After Using Your CPAP: Dehydration plays a big role in your nose’s sensitivity to irritants and injury. If your nose is too dry, it worsens sinus congestion.
Add Moisture to Your Sinuses: Adding moisture to your sinuses encourages congested mucus to thin out while also reducing the inflammation that adds to your sinus congestion. Your healthcare provider may encourage you to breathe in steam from the bathroom or try artificial moisturizers, such as sinus sprays or nasal gels.
Soothe the Affected Area: If you develop a CPAP nose sore, you may benefit from applying a soothing gel or cream to the affected area, such as aloe or Lansinoh, to prevent further irritation.

Tips for Preventing CPAP Sinus Irritation

Use a Heated Humidifier: A heated humidifier is a tried-and-true method to direct moisture to your airway and can help you get relief from congestion.
Try Aromatherapy: Add aromatherapy to your CPAP regimen by using mint or eucalyptus-based scents. Please note that you should never add the oil directly to your humidifier. Instead, it’s best to place a couple of drops on a small cotton pad and place it in front of your machine’s air intake/filter.
Use a Nasal Pillow Mask Liner: The inside of your nose tends to be quite sensitive, so your nostrils may have trouble adjusting to your nasal pillows. Mask liners can help reduce some of the pressure nasal pillows put onto the nostril while still maintaining a strong mask seal.
Try a Nasal Cradle Mask: If you enjoy the compact size and targeted delivery of a nasal pillow mask but don’t like having something inserted directly into your nostrils, you may find a nasal cradle mask to be just right for you.

Products to Help Sinus Irritation From CPAP

8. CPAP Headaches

Although CPAP therapy has been proven to actually reduce headaches caused by sleep apnea, a small number of people do experience headaches the morning after using their CPAP machine. If you are undergoing CPAP therapy and regularly wake up to pain on both sides of your head, you may be experiencing a CPAP headache.

Causes of CPAP Headaches

CPAP Pressure Is Too High: If you experience headaches after starting CPAP therapy, your CPAP pressure may be too high. Speak to your healthcare provider about your CPAP pressure settings.
Sinus Congestion: Sinus congestion is a common cause of CPAP headaches and is more likely to occur when your CPAP pressure is too high or you do not have enough moisture in the air you breathe.
Over-Tightened Headgear: When your headgear is too tight, it can put additional pressure on certain parts of your head and even your neck, leading to muscle tension and tenderness.

How to Manage CPAP Headaches

Give It Time: A CPAP headache typically fades within a few hours, like most morning headaches.
Stay Hydrated: Starting your morning with a glass of water may reduce the likelihood and severity of these headaches.
Speak to Your Provider About OTC Medications: If your morning headache impacts your ability to perform daily tasks, your healthcare provider may suggest taking an over-the-counter pain reliever.
Apply a Hot or Cold Pack: Depending on the cause of your headache, heat and/or ice are a quick and easy way to manage headaches. Heat reduces pain and/or muscle tension. Meanwhile, ice is great for swelling and inflammation.

Tips for Preventing CPAP Headaches

Use a Heated Humidifier: A heated humidifier makes CPAP therapy more comfortable, provides moisture to your sinuses, and increases the effectiveness of your sleep apnea treatment.
Keep Your Sinuses Clear: If your headaches are caused by sinus irritation or inflammation, rinsing your sinuses or using a nasal spray may give you some relief.
Check Your Mask Fit: It’s also possible that your mask fit or style isn’t right. Start by checking your straps to ensure they are not too tight.
Choose the Right Mask For Your Needs: If you’re using a nasal pillow or traditional CPAP nasal mask, you may find sinus relief by switching to a full face mask. If you’re already using a full face mask, switching to a hybrid mask may reduce pressure around your sinuses.
Speak to Your Doctor About Your Air Pressure: If your headaches are related to your CPAP air pressure, the best course of action is to consult your healthcare provider about lowering your pressure setting or trying an APAP machine.

Products to Help With Headaches From CPAP

9. Bloating and Gas

While not exclusive to CPAP, another side effect that can occur with CPAP is gas and/or bloating. Sometimes referred to as aerophagia, this unpleasant CPAP side effect occurs when you swallow CPAP air at night, and it tends to be very uncomfortable.

Causes of CPAP Bloating and Gas

Your Pressure Needs Adjusting: Bloating and gas occur when your therapy pressure is too high or too low. It’s easy to accidentally ingest too much air when your pressure is too high, but if it’s too low, you may swallow air in gulps during each sleep apnea episode.
You Are Mouth Breathing: If you wear a nasal or nasal pillow mask, your mouth may fall open while you sleep. This lets air pressure escape through your mouth, which can cause you to begin unconsciously gasping for air while swallowing some in the process.
Exhalation Pressure Is Too High: If you are having difficulty exhaling while using your CPAP machine, it may cause you to accidentally swallow air as you struggle to breathe out.

How to Manage CPAP Bloating and Gas

Move Around After Waking Up: If you wake up feeling bloated or full of air, try walking around the house for a few minutes to allow all that extra air to move out of your body.
Try Over-the-Counter Treatments: If this becomes a regular problem, talk to your doctor about trying over-the-counter anti-gas medications.
Use Heat to Reduce Bloating and Pain: A heating pad or warm bath may encourage trapped air to move through your body so that it can be released.

Tips for Preventing CPAP Bloating and Gas

Wear a Chinstrap or Mouth Tape: If you have a nasal CPAP mask, keeping your mouth closed may reduce the amount of air you swallow at night.
Adjust Your Expiratory Pressure: Some CPAP machines feature expiratory pressure relief, which can be used to reduce the air pressure while you are exhaling, making it easier to breathe out.
Check Out the V-Com: This cool new product recently hit the market but already shows promising results. Designed to make even high-pressure airflow more comfortable, the V-Com is a great solution for anyone struggling to breathe with their CPAP machine.
Consider a Different Mask: Switching to a different mask style may help you breathe a little easier, making you less likely to swallow air.
Talk to Your Doctor About an APAP Machine: If your CPAP aerophagia is bad enough to make you consider quitting CPAP therapy, it may be time to talk to your healthcare provider about switching to an APAP machine, which delivers the lowest air pressure possible to still keep your airway open.

Products to Help CPAP Bloating and Gas

Long-Term Side Effects of CPAP Machines

There is no denying that continuous positive airway pressure therapy can impact you over time, usually for the better. And while the vast majority of the long-term side effects of CPAP machines are very beneficial, a couple of rare negative effects can occur from time to time. Luckily, most of those issues can be easily addressed.

Complex Sleep Apnea

Occasionally referred to as Treatment-Emergent Sleep Apnea, Complex Sleep Apnea (CompSA) arises when a person undergoing treatment for Obstructive Sleep Apnea begins to show signs of Central Sleep Apnea as well. Your doctor will likely suggest changing your CPAP pressure or even switching to a new positive airway pressure (PAP) machine, such as Adaptive Servo Ventilation.

Voice Changes

Scientists are still debating whether CPAP therapy can cause voice changes over time. That said, some studies have suggested that using a CPAP machine may cause mild hoarseness in a small number of people. This issue is thought to stem from recurring dryness in the mouth, throat, and airway.

Why Continuous Positive Airway Pressure Therapy Matters

For millions of people, Continuous Positive Airway Pressure therapy is the key to living a better life despite sleep apnea! Beyond making you feel tired and run down, this condition also puts you at higher risk for serious health complications. That’s why it is so important to find CPAP solutions that work with you, so you can stick with your treatment plan, even if you experience a few setbacks here and there.

Here are some of the long-term benefits of CPAP machines!

Better Sleep
Improved Mood
Higher Work Performance
More Energy
Fewer Health Complications
Weight Loss

Frequently Asked Questions About CPAP Side Effects

How Do I Avoid Red Marks From CPAP Mask?

CPAP red marks can be caused by over-tightening your CPAP mask. Additionally, you may be using a mask that does not fit your face properly. If you regularly experience red marks from your CPAP mask, you can try headgear covers or gel pads to reduce the pressure placed directly against your skin.

Why Is The Bridge of My Nose Sore from CPAP?

Sores are usually indicative of your headgear straps being over-tightened. You may be tightening your headgear too much to reduce or eliminate an air leak, but over-tightening your headgear can cause soreness—and it usually means your mask is too large, too old, or not the best style for your needs.

Why Is My Face Breaking Out Around My Nose After Using CPAP?

You may notice acne or pimples along the area where your mask is worn—especially if your skin is prone to breakouts—due to your facial oils building 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.

Final Thoughts

In time, adhering to your sleep apnea treatment will help you avoid complications, ranging from excessive daytime sleepiness to cardiovascular events. It can be frustrating to get used to 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.

To troubleshoot your CPAP side effects, the best place to start is by evaluating your mask fit and cleaning habits. Heated humidification can help relieve dried airways, and mask liners may be the key to securing your CPAP mask seal.

Always talk with your doctor before making any major changes to your current CPAP routine. Keep in mind that you cannot change the pressure settings on your CPAP machine without a healthcare provider’s approval.

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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