CPAP machines: Tips for avoiding 10 common problems

CPAP is an important treatment for obstructive sleep apnea, but may be frustrating at first. Learn how to avoid uncomfortable masks and other common CPAP problems.

By Mayo Clinic Staff

Continuous positive airway pressure (CPAP) therapy is a common treatment for obstructive sleep apnea. A CPAP machine uses a hose and mask or nosepiece to deliver constant and steady air pressure.

Common problems with CPAP include a leaky mask, trouble falling asleep, stuffy nose and a dry mouth.

The good news is that if one CPAP mask or device doesn't work for you, you have other options. And most CPAP masks are adjustable, to help make them more comfortable for you.

Here are 10 common CPAP problems and what you can do about them:

1. The wrong size or style CPAP mask

Work closely with your doctor and CPAP supplier to make sure you have a CPAP mask that fits properly. Everyone has different face shapes, so the right style and size mask for someone else may not work for you.

  • Try a different mask. A range of CPAP masks are available. For example, some feature full face masks that cover your mouth and nose, with straps that stretch across your forehead and cheeks. These may make some people feel claustrophobic, but they work well if you prefer to breathe through your mouth during sleep. They also provide a stable fit if you move around a lot in your sleep.

    Other masks feature nasal pillows that fit under your nose and straps that cover less of your face. These can feel less cumbersome.

    Nasal pillows may work well if you wear glasses or read with the mask on, because some don't block your eyes as much as full face masks do. However, this may not be an option if you move around a lot in your sleep or sleep on your side.

  • Pay attention to size. Most masks come in different sizes. Just because you're a certain size in one mask doesn't mean you'll be the same size in another. CPAP masks are usually adjustable.

    Ask your doctor or CPAP supplier to show you how to adjust your mask to get the best fit. Manufacturer product instructions also can help show you how to do this. A properly fitting mask shouldn’t be uncomfortable or cause pain.

2. Trouble getting used to wearing the CPAP device

First, try wearing just the CPAP mask for short periods of time while you're awake — for example, while watching TV. Then try wearing the mask and hose with the device turned on during the day while you're awake.

Once you get used to how that feels, start using the CPAP device every time you sleep — including naps. Just wearing the CPAP device every now and then may delay getting used to it. Stick with it for several weeks or more to see if your mask and pressure are right for you.

3. Difficulty tolerating forced air

You may be able to overcome this by using a machine with a "ramp" feature. This setting allows you to start with low air pressure. The machine then automatically and slowly increases the air pressure to your prescribed setting as you fall asleep. Your doctor can adjust its rate.

If this feature doesn't help, talk with your doctor about changing to a device that automatically and constantly adjusts the pressure while you're sleeping. An example is a bi-level positive airway pressure (BPAP) machine that delivers more pressure when you breathe in (inhale) and less when you breathe out (exhale).

4. Dry, stuffy nose

Check to make sure your mask fits well. A leaky mask can dry out your nose. If you have to tighten straps often to prevent air leakage, the mask does not fit properly.

A CPAP device that features a heated humidifier, which attaches to the air pressure machine, can help. You can adjust the level of humidification. Using a nasal saline spray at bedtime also can help ease a dry, stuffy nose.

5. Feeling claustrophobic

Practice using your mask while you're awake. First, just hold it up to your face without any of the other parts. Once you're comfortable with that, try wearing the mask with the straps.

Next, try holding the mask with the attached hose on your face, without using the straps. Turn on the CPAP machine, perhaps with the ramp feature turned on. Next, do this using the straps too. Finally, try sleeping with the mask and machine on.

Relaxation exercises, such as progressive muscle relaxation, may help reduce anxiety related to CPAP use.

If you're still feeling claustrophobic, talk to your doctor or CPAP supplier. It may help to get a different size mask or try a different style, such as one that uses nasal pillows.

Oct. 26, 2017