The treatment of choice for obstructive sleep apnea in continuous positive airway pressure (CPAP). The majority of people who use CPAP find immediate symptom relief and are delighted with their increased energy and mental sharpness during the day. Many patients have said, “CPAP changed my life!” But some patients find CPAP masks uncomfortable, even though it may control their sleep apnea. Many need extra assistance to get a mask that fits correctly. Side effects are usually mild and temporary, and include nasal congestion, sore eyes, headaches and abdominal bloating. Many people get used to CPAP over two-to-twelve weeks, and according to some research studies, less than one-half of CPAP patients discontinue treatment. Below are a few solutions to the five most popular problems patients tend to report:


Problem #1: Nasal Congestion.

Nasal stuffiness including itching and dryness can occur. Nasal congestion often subsides after the first month of CPAP use. Congestion can be common in the winter and during allergy season and it not alway a result of using CPAP. These tips can help reduce congestion:

Try using a nasal saline spray.

Try a nasal decongestant, however, limit use to three days

Use a CPAP humidifier (heated humidity will add moisture to the forced air and reduce nasal symptoms)



Problem #2: Trouble breathing with so much air coming through the mask.

It can feel like too much air depending on the pressure setting prescribed for effective treatment. Try these tips:

Start using CPAP for short periods of time during the day while watching TV or reading.

Use the ramp setting and C-flex or EPR for comfort.

Consider participating in a CPAP desentization program.


Problem #3: Dry or sore throat from using CPAP.

This may be caused from mouth breathing while asleep. These tips may help relieve throat irritation caused by CPAP in addition to using a heated humidifier.

Use a chin strap with a nasal mask to help keep the mouth closed while asleep.

Try using a full face mask that covers the nose and mouth.


Problem #4: Red eyes, continued snoring, or breath holding during sleep.

These problems are all signs that air may be leaking out of the mask. These tips can help correct the problem:

Adjust the straps and headgear on the mask to obtain a better fit.

Contact the CPAP supplier to ensure the mask is not worn or torn.

Try a different size mask or a different type of mask (full face mask or nasal pillows).


Problem #5: Redness or sore spots on the face, nose, or forehead from the mask or headgear.

Most masks have improved cushioning for a more comfortable fit, however follow these steps if soreness develops:

Loosen the headgear so the mask is snug enough to prevent air leaks, however not so tight it hurts.

Consider pads that slip over the headgear straps to prevent skin irritation.

Contact the CPAP supplier if soreness or skin irritation persists and try a different mask.



UAB Medical West Sleep Disorders Center

Professional Building - Suite 304 • Bessemer, AL 35022