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Possible CPAP Side Effects and How to Handle Them

Continuous positive airway pressure is one of the most common and effective treatments for obstructive sleep apnea. However, the treatment has some possible side effects you should be aware of. The CPAP machine delivers constant and steady air pressure through the hose and mask and it’s a relatively safe treatment. Nevertheless, we decided to focus on some of the possible CPAP side effects and ways how you can handle them. So, without any further ado, let’s take a close look at some of the adverse effects of using CPAP therapy. 

Morning Headaches 

Besides the fact that morning headaches are not among the most common CPAP side effects, they can happen due to sinus related issues or because your pressure is set too high. The morning headache can be triggered when the CPAP is blocking a part of your sinus cavities which causes pressure between your sinus cavities. In order to prevent or treat this issue, you should consider some over-the-counter medicine, which will help you open the sinus passageways. Moreover, you can also try using a heated humidifier to open your sinus passageways. However, if none of these solutions seem to work, make sure you contact your CPAP equipment supplier. 

Wrong CPAP Mask Size

You should always select and get a mask which fits properly. Ask your doctor or CPAP supplier to help you pick the mask which fits your face shape and size. Try several types of masks before selecting the one which fits you perfectly. Some people prefer full-face masks, which cover the whole mouth and nose and feature straps that stretch across your forehead and cheeks. However, you might find such masks claustrophobic. Hence, you can opt for nasal pillows which fit under your nose and straps that cover less of your face. Nasal pillows are the preferred option for people who wear glasses. It’s important to note that the mask should fit your face size. Luckily, the CPAP masks are usually adjustable and you can adjust it on your own with the help of the manufacturer’s product instructions. The mask fits perfectly when it feels comfortable and doesn’t cause pain. 

Air Leaking from CPAP Mask

This is one of the most complaints about CPAP therapy. Air leaking usually occurs when the mask doesn’t fit perfectly and allows the air to escape through the edges. Full face masks are more susceptible to leaks. An air leaking CPAP mask has the potential of compromising the therapy as it will reduce the pressure delivered. Moreover, such masks are noisy and can be quite bothersome. You can reduce air leaking by using a nasal mask or nasal pillows or altering the pressure settings after you discuss it with your doctor. 

Nose or Mouth Dryness from CPAP

If you happen to experience air leaking, you are very likely to have nose or mouth dryness too. Air leaking is often linked to nosebleeds or gums and teeth damage. Moreover, if your mouth is open, it allows air to escape and causes parched tongue or mouth. 

So, if your nose seems dry after using CPAP therapy, you should try using over-the-counter nasal saline spray, a heated humidifier and heated tubing. A heated humidifier adds moisture to your nasal passages and reduces irritation. However, if you are already using a heated humidifier but still experience dry nose or mouth, you should try a higher setting. Moreover, you can also try using a chinstrap or a full-face mask which will prevent your mouth from falling open.

Dry Eyes

This might not be the most common CPAP issue and side effect, but it can definitely happen. So, if you wake up and your eyes feel dry, it probably means that your CPAP mask is leaking at the bridge of your nose. Hence, excessive dryness in the eyes means that you should adjust the mask by adding a nose cushion or nasal pillow. However, if this doesn’t work, it probably means that your mask doesn’t fit the shape of your face. 

Difficulty Getting Used to Wear the CPAP Mask

Getting used to wear a CPAP mask can be a bit challenging at the beginning, but persistence seems to be the key to success. Hence, you should try wearing a CPAP mask for short time periods while you are awake. For instance, start wearing the CPAP mask while watching TV and then, after some time, try wearing it with the device turned on. As soon as the mask starts feeling comfortable, you should then introduce CPAP into the bedroom and use it while you are asleep. Make sure you stick to it and use it for a couple of weeks to see whether the mask and the pressure suit you. 

Discomfort Breathing Out

Many people find breathing out against the pressure quite challenging the first time they start using CPAP. This will probably be resolved over time, but for some people, it triggers insomnia. In order to handle this issue, you should ramp from a lower initial pressure, which will allow an easier exhalation. If that doesn’t help, you might need to move to Bi-level therapy, which uses one pressure to breathe in, but a lower pressure to breathe out. 

Bloating and Gas

These two are probably the most unwanted CPAP side effects. If you notice bloating in your stomach when you wake up, it probably means that you’re swallowing the CPAP air. Unfortunately, this side effect can only be solved by changing your sleeping position. Hence, try sleeping as flat as possible without a pillow. However, if adjusting your sleep position doesn’t seem to help and you still feel bloated, you should talk with your doctor or CPAP supplier about lowering the pressure in your CPAP

Feeling Claustrophobic

This is a common issue for people who choose full face masks, but it can be easily solved. Hence, you should first get used to wearing the CPAP mask while you are awake and as soon as it starts feeling comfortable, start wearing it with the straps. Finally, introduce CPAP into your bedroom and start sleeping with it. Additionally, you can also try some relaxation exercises, such as progressive muscle relaxation, which can help in anxiety reduction. Nevertheless, it nothing seems to help, get in touch with your medical provider and try a different style mask. 

Air Swallowing 

Air swallowing, known as aerophagia, is a common issue for many people who use CPAP therapy. So, if your stomach feels filled with air first thing in the morning, it probably means that you are experiencing aerophagia. Some of the most common symptoms of aerophagia include burping, bloating, and farting. You might experience air swallowing if your CPAP pressures are too high due to which the excessive air enters your stomach via your esophagus. This is an issue which can be easily solved by reducing the pressure, suing medications for heartburn, sleeping wedge pillows, or Bi-level therapy.

Difficulty Falling Asleep

If using CPAP therapy prevents you from falling asleep, you might want to consider using the mask while you are awake at first or using the ramp feature on your CPAP machine. The ramp feature allows the air pressure to increase gradually and slowly. Moreover, you might feel some benefits of following good sleep habits, doing regular exercise, waking a warm bath before going to bed, and avoiding caffeine and alcohol before bedtime. 

Developing Central Sleep Apnea

There are people who experience episodes of breath-holding characteristic of central sleep apnea after using CPAP therapy. This issue can resolve on itself after some time, but it can be better if you lower your CPAP pressure or change to adaptive servo-ventilation therapy. In ASV therapy the volume and speed of air are set to vary based on your needs.

Removing the CPAP Mask During Sleep

This is a common issue which happens completely unintentionally, especially if you move a lot during sleep. Removing your CPAP mask might also happen of your nose is congested. In order to prevent this which can compromise your therapy, try using full face masks with a chin strap and add a CPAP-heated humidifier. However, if this issue seems to persist, ask your partner to check on you during the night. 

Face Growth Problems in Children 

One side effect of CPAP in children who use the therapy is face growth problems. This can happen due to the pressure of the mask across the nose. In order to avoid any growth problems of the mid-face in your child, try newer mask styles, such as nasal pillows, which will minimize the risk. 

Unbearable Noise

The unbearable noise is no longer a common issue as the new models are almost silent. However, if the noise of your CPAP device seems troublesome, you might want to check whether the air filter of your device is clean. The noise is usually worsened by something which blocks the way. Nevertheless, if this doesn’t solve the issue, you can start wearing earplugs or using a white noise sound machine. Moreover, you can also place the CPAP device away from your bed. The noise can also be quite unbearable for your partner, but they’ll probably be happier to hear the noise from the CPAP device than you snoring. 

Inhibited Sex Drive

Many people find the CPAP therapy to be a hindrance to their sex life. The CPAP mask might be unappealing, but not a reason for a lowered sex drive. If this seems to be an issue for you, talk with your partner about ways to avoid such negative feelings. 

Getting used to CPAP can be a challenging thing, especially if you come across some of its side effects. However, persistence and time will show you that beside the few negative aspects, CPAP therapy is packed with advantages and will make your life easier and better. 


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