CPAP is a very effective way to treat sleep apnea and snoring. When used correctly and fitted well, CPAP can dramatically reduce apneic events as well as greatly decreasing snoring volume and frequency.

Unfortunately, many users don’t get this far because the discomfort they feel makes them give up before CPAP can have a positive effect.

CPAP can be uncomfortable and does take some getting used to. It is also perceived as the most extreme type of snoring remedy, and many people don’t like the idea of this large, quite invasive device.

Here, we address the most common problems people have with CPAP, giving you advice on the best way to fix these issues. We also have some SnoreLab top tips on how to get the most from CPAP to snore less and sleep better.

Side note: what is CPAP?

A CPAP device uses a mask to force air into your nose and throat to keep your airways open.

CPAP does not give you more oxygen. Instead, it introduces a current of normal air that creates positive pressure; this props open your airway to stop it from collapsing.

The CPAP machine links to the mask via a hose, and continuously gives positive pressure into your airway; hence the name “continuous positive airway pressure”.

Frequent CPAP problems and how to rectify them

Claustrophobia

CPAP masks, in particular full-face masks, can feel stifling and claustrophobic. This is particularly poignant when you are new to CPAP and could wake up forgetting you are wearing it, causing brief panic.

The best way to get beyond this is to get used to wearing your CPAP mask as much as possible before wearing it for a full night. An hour or so before bed, put on your mask and carry on with your evening; read a book, watch television; do what you would normally do.

You needn’t turn it on to start with, just get used to the feeling of having the device on your face. Shortly before you go to sleep, turn the device on to a low setting to accustom yourself to the sensation of the forced air.

If you really don’t like the sensation of having something over your face, consider the less invasive CPAP mask options like nasal cushions.

Leaking air

This is often due to a poor fit or an inappropriate mask type. A leaking CPAP is inefficient. This air should be stopping your sleep apnea and instead it is being lost to your surroundings. It can also dry out your eyes.

When initially being fitted for your CPAP device, make sure you get the fit right. Highlight any comfort concerns with the professional fitting it for you. Masks come in different sizes, so be sure to try a few. Also ensure you get the right type of mask for your circumstances. See SnoreLab’s guide to the different types of CPAP mask.

At home, to stop the mask leaking, adjust the various pads and straps to get it fitting comfortably and snugly (but not too tightly). Also make sure that the mask doesn’t come too high up on the bridge of your nose.

If you’re overweight and using CPAP, hopefully, your improved sleep will help you lose weight. If you do lose a lot, particularly around your neck and face, you may need to consult your healthcare provider to get a different mask.

Pressure sores

Pressure sores are painful skin blemishes caused by your mask rubbing. Preventing pressure sores comes down to getting the right fit. Ill-fitting masks can rub uncomfortably when they move around. They may have to be tightened too much to force a suitable fit. Remember to check that the mask fits correctly in your initial consultation. When wearing at home, try not to pull the straps too tight.

CPAP masks can also create uneven pressures on your face due to misalignment caused by your regular pillow. There are specifically designed CPAP pillows available that have ergonomically designed cutaways to comfortably accommodate CPAP masks.

If you continue to get pressure sores, consult your healthcare provider.

Dry mouth and nose

A dry mouth is often a result of breathing through your mouth too much. If you can comfortably breathe through your nose you should try to encourage it whilst you sleep. This is because your nose warms, humidifies and filters air before it gets to the rest of your airway and is the healthier way to breathe.

There are devices available to close your mouth and encourage nose breathing, including chin straps and SomniFix mouth strips. Read SnoreLab’s review of SomniFix.

If you struggle to breathe through your nose there are numerous remedies that can help. There are many reasons why you may not be able to breathe through your nose, so check out our guide to nasal blockage induced snoring and the appropriate remedies for each cause.

With a blocked nose, nasal CPAP fails to work. A full-face mask is a good option for people who struggle to breathe through their nose, but sometimes this air can dry out and irritate your airway. Humidifiers can help moisten your airways, helping you to breathe and sleep better. Some CPAP flow generators even come with an in-built humidifier.

Forced air is very uncomfortable

Some CPAP users can’t tolerate the level of air coming through the mask. This can be helped in several ways:

• Get the air pressure setting right – setting your CPAP at high pressures is typically more uncomfortable than running the device at lower pressures.
• Ease yourself in – like getting used to the mask itself, try getting used to the sensation of forced air. Turn the device on before you go to sleep to get used to the feeling. There are some more sophisticated CPAP devices available that have a ramp feature, where the machine slowly and automatically increases the pressure.
• Choose the right type of mask – direct contact masks like nasal pillows can feel especially uncomfortable at higher pressures as there is nowhere else for the air to go. If you need to run your CPAP at high pressures, consider a full-face mask.

Removed mask by accident

To stop your CPAP mask coming off during the night, make sure it fits correctly and that the straps are sitting in the correct orientation.

Dislodging your mask could also be down to the mask type and its design. Full face masks are less likely to come off. If you are a side sleeper your pillow could be pushing the mask out of place. Consider looking for a specifically designed CPAP pillow with cutaways that accommodate CPAP masks.

You may also involuntarily pull the mask off whilst you sleep if it is causing you breathing difficulty. Make sure that you can breathe clearly through your nose if you are using any devices that keep your mouth closed.

Can’t sleep

Alongside practicing good sleep hygiene, you should also practice using the mask whilst awake so you are comfortable with it once you try to sleep.

Good sleep hygiene dictates that in the run up to bedtime, you should not be eating and instead do some gentle, non-stimulating activity like reading. This is a great time to wear your CPAP device and get yourself used to the mask.

Noise

Sound from the machine might also prevent restful sleep. Most CPAP machines are nearly silent. If you find that yours is making excessive noise, it might be because the flow generator’s air filter is dirty. Make sure you read your unit’s instructions and keep on top of the required maintenance.

Try to keep the flow generator unit as far away from your head as the hose’s length will permit.

If the noise persists despite cleaning, the unit could be faulty. Return it to the provider to get it checked over.

Facial hair

Beards and moustaches can inhibit the seal that is formed around the edges of the CPAP mask. If you are as attached to your facial hair as it is to you, and shaving simply isn’t an option, make sure you pick the right type of mask.

Nasal cushions are the most appropriate type for people with facial hair. This is because the seal is formed on the nostrils as opposed to other areas of your face.

Top tips for getting the most out of CPAP

Given these frequent problems that CPAP users come up against, here are our tips for making sure that your CPAP device is having the desired effect:

• Get the right mask for you – nasal masks, nasal cushions and face masks all have their good and bad points, and are suitable for different people. Read SnoreLab’s guide to the different types of mask to decide which one is best for you.
• Fit your mask properly – during your initial fitting, make sure you let your healthcare provider know if it feels unduly uncomfortable or doesn’t fit correctly. Find out the best way to adjust the straps and make sure to seek a change if your face shape changes significantly due to weight loss.
• Practice – everything gets easier with practice and CPAP is no different. Whilst it might seem weird at first, remember it will get better. Getting used to wearing the mask and feeling the air current whilst you are awake is a great way to ease yourself into using CPAP.
• Treat your blocked nose – it is particularly important to clear your nose if you are using a nasal mask or nasal cushion. Your device will not work effectively if your mouth falls open whilst using these types of CPAP. Check out SnoreLab’s guide to nasal snoring remedies.
• Keep on top of maintenance – as well as regularly cleaning the flow generator’s filter to prevent noise, also check for mold that can form (particularly if using a humidifying flow generator) and wash the straps to keep them clean and fitting well.
• See the big picture – remember, CPAP isn’t designed to make you feel uncomfortable, it is there to help you. Use SnoreLab to help remind yourself of this fact, as you should start seeing your Snore Scores drop, meaning you are well on your way to healthier, more peaceful sleep.

‍