Common CPAP Therapy Challenges

A woman struggling with her CPAP mask

Continuous Positive Airway Pressure (CPAP) therapy is often prescribed as treatment for obstructive sleep apnea (OSA), the most common sleep-related breathing disorder. While CPAP therapy can be highly effective, patients may struggle with treatment. [2] Here are some common CPAP therapy challenges and ideas for how to overcome them:

Mask discomfort 

It is important to find a comfortable mask that fits properly to help ensure adherence. Many patients struggle with discomfort, irritation, or pressure sores caused by masks that don’t fit correctly. Patients will sometimes remove their mask while sleeping due to discomfort. Some patients find that wearing the wrong mask makes them feel claustrophobic. Try wearing your mask during the day while reading or restful activity to help you acclimate to the mask. Your healthcare provider or CPAP supplier can help you choose the right mask for you and show you how to adjust it for the best fit.[3] [4]

Nasal congestion and dryness

CPAP therapy can cause nasal congestion and dryness, leading to discomfort, nosebleeds, or nasal irritation. This may be due to a leaky mask and made worse during the winter months or in dry climates. Using a CPAP machine with a heated humidifier can alleviate some of these symptoms. [5]

Mask leaks

Mask leaks can compromise the effectiveness of therapy, cause skin irritation, and even lead to lack of compliance. When masks leak they cause air to escape, reducing the air pressure delivered to the airways and can cause eye irritation. Leaks can be caused by improper mask fit, an old or damaged mask, movement during sleep, or facial hair interfering with the seal. Proper mask size, style and fit and regularly inspecting and adjusting the mask and straps can help minimize leaks. [6]

Difficulty adjusting to airflow pressure

Some patients may find it challenging to adapt to the continuous airflow pressure delivered by the CPAP machine, particularly during the initial stages of therapy. This sensation of pressure may cause discomfort or difficulty exhaling against the airflow. Talk to your healthcare provider about a machine that can automatically adjust the pressure while you are sleeping. [7]

Difficulty Falling Asleep

Another of the CPAP therapy challenges is the required an adjustment period of using the machine. Getting used to wearing a CPAP mask can be challenging for some users, leading to difficulties falling asleep. Try wearing your mask for short periods during the day to adjust to the feeling on your face. Next try wearing it with the pressure on to get used to the sensation. This could take several weeks but should begin to feel more natural with time. [8]

Skin irritation

Wearing a CPAP mask can lead to skin irritation, pressure sores, or allergic reactions. Common causes of skin irritation are improper mask fit, the mask not being cleaned regularly or having sensitive skin. Adjusting your mask style or fit, using a hypoallergenic masks or mask liners and keeping your mask clean can help prevent skin issues. [9]

Noise and discomfort from the CPAP machine

Newer models of CPAP machines are almost noise free. If your CPAP is loud, make sure your CPAP machine’s air filter is clean and not blocked. Have your supplier check that your machine is operating correctly. If the sound still bothers you, try ear plugs or a white noise machine. If the tubing feels cumbersome and disrupts your sleep, try a specially designed CPAP pillow. [5] [8]

Maintenance and cleaning

CPAP machines and equipment require regular maintenance and cleaning to prevent growth of mold, bacteria and viruses and to ensure optimal performance. This can be cumbersome for some patients but regular care and cleaning will prolong the life of your CPAP machine and help prevent illness. [10]

Traveling with CPAP

Transporting CPAP equipment during travel can be inconvenient, but it’s important. Your CPAP machine is a medical device so it’s not counted as carry-on luggage. Make sure you have a good carrying case and bring distilled water if needed. [11]

Maintaining compliance

Patients who develop good CPAP compliance early on are more likely to continue to adhere to CPAP therapy. CPAP treatment is essential to avoiding complications related to Sleep Apnea. Work with your healthcare provider and your CPAP supplier to work through CPAP therapy challenges that arise. Get tips and advice from online communities and support groups. For your quality of life and health, stick with it! [7] [12]

References:

  1. Mayo Clinic, Sleep Apnea
  2. NCBI, Predictors of continuous positive airway pressure adherence
  3. Mayo Clinic, CPAP machines: Tips for avoiding 10 common problems 
  4. Sleep Foundation, Common Side Effects of CPAP
  5. Mayo Clinic CPAP machines: Tips for avoiding 10 common problems
  6. Sleep Doctor, CPAP Mask Leaks: Causes and Prevention
  7. Mayo Clinic, CPAP machines: Tips for avoiding 10 common problems
  8. Home Sleep Delivered, Tips for Falling Asleep with Your CPAP 
  9. Sleep Apnea Org, CPAP Dermatitis: Causes and Prevention
  10. Sleep Foundation, How to Clean a CPAP Machine
  11. CPAP.com, Traveling and Flying With Your CPAP Machine in 2024: Top 10 Tips and Checklist
  12. Sleep Foundation, What is CPAP Compliance?
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Written and reviewed by our CPAP Cleaning Machines Team

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