Most patients will encounter side-effects from the CPAP machine at some point in their experience with it.
An air leak is the most common complaint associated with CPAP use. If the mask does not fit perfectly, air may escape around the edges, especially as you change position while you are sleeping. Larger masks, such as those that cover the nose and mouth, are more prone to leaks. Leaks may compromise your therapy by reducing the pressure delivered, or they may be noisy and disturb your bed partner.
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Your CPAP mask may leave marks on your skin if it doesn't fit properly, possibly leading to sores or even ulcers, especially along the bridge of your nose. People with sensitive skin may also develop a rash or skin irritation, especially with masks that contain latex. Mask liners, barrier creams, loosening the mask, or a better-fitted mask may relieve these symptoms.
Dryness of your nose or mouth often accompanies leakage. This may lead to nosebleeds or may even damage to your gums and teeth. If your mouth falls open, air can escape, leading to a parched mouth or tongue.
If your nose is dry, over-the-counter nasal saline spray can help. Using a heated humidifier and heated tubing can help prevent dryness of the nose and mouth. Using a chinstrap or a full-face mask that covers both the nose and mouth may prevent your mouth from falling open.
Though it is easy to breathe in, you may find it difficult to breathe out against the pressure when you first start using CPAP therapy. This may improve over time, but the effort may also cause insomnia.
In some cases, ramping from a lower initial pressure or a feature to allow easier exhalation can be helpful. It may be necessary to reduce the pressures overall. In rare cases, BiPAP machine—in which one pressure is used to breathe in, and a lower pressure is used to breathe out—may be needed.
Many people experience air swallowing, called aerophagia (literally "air eating"). If you wake and your stomach is filled with air, this may be due to aerophagia. Symptoms include burping, farting, and bloating. Air swallowing can be a sign of CPAP pressures that are too high. Rather than entering your upper airway, the excessive air can enter your stomach via your esophagus. Reduced pressures may help to prevent this. Other treatments for aerophagia include sleeping wedge pillows, medications used for heartburn and GERD, and bi-level therapy.
Children who use CPAP should be monitored to avoid developing growth problems of the mid-face related to the pressure of the mask across the nose. Newer mask styles, including nasal pillows, may reduce this risk.
Some people feel confined or enclosed when wearing a mask. This typically resolves over time, particularly if you take the time to adjust gradually to using the mask.
The noise can interfere with sleep, particularly for the person who you sleep with. While the currently used devices are much quieter than those used in the past, it may take some getting used to. Overall, most partners can adapt more easily to the predictable noise of CPAP than to the noise of snoring, which is very common with obstructive sleep apnea.
Wearing the mask alone for some time during the day may help you get used to how it feels and make it easier to fall asleep at night.
Machines with the ramp feature that slowly and gradually increase the air pressure to your prescribed pressure setting as you fall asleep may make you more comfortable at bedtime.
Following good general sleep habits also are helpful. Exercise regularly and avoid caffeine and alcohol before bedtime. Try to relax. For example, take a warm bath before you go to bed. Don't go to bed until you're tired
It's normal to sometimes wake up to find you've removed the mask in your sleep. If you move a lot in your sleep, you may find that a full face mask will stay on your face better.
You may be pulling off the mask because your nose is congested. If so, ensuring a good mask fit and adding a CPAP-heated humidifier may help. A chin strap also may help keep the device on your face.
If you smoke, snoring and sleep apnea may become more severe. Alcohol use near bedtime can cause muscle relaxation, worsening your obstructive sleep apnea symptoms. Similarly, medications such as muscle relaxants and benzodiazepines may worsen your symptoms. If you discontinue use of any of these substances, your sleep apnea risk may decline, and your pressure needs may also be reduced.
Most new models of CPAP devices are almost silent. But if you find a device's noise is bothersome, first check to make sure the device air filter is clean and unblocked. Something in its way may worsen noise. Ask your doctor or CPAP supplier how to properly clean your mask and hose.
Using a CPAP device can be frustrating as you try to get used to it, but it's important you stick with it. The treatment is essential to avoiding complications of obstructive sleep apnea, such as heart problems and excessive daytime sleepiness.
Work with your doctor and CPAP supplier to ensure the best fit and device for you. It can take a while to find the correct settings and get used to the mask.
Proper Care of your CPAP Machine
Nearly all current CPAP machines now come stock with a heated humidification system that helps cut down on morning dry mouth as well as keeping your nasal turbinates from drying out and becoming irritated and inflamed. However, the humidification chamber needs to be cleaned out daily to prevent bacteria build-up as well as calcification. Here's how:
Your filters are located near the back of the CPAP machine where the device draws air from the room that it compresses to your pressure settings. Nearly all CPAP machines have a disposable white paper filter and some have an additional non-disposable grey filter as well. Here are some cleaning tips for your CPAP filters: