CPAP Side Effects

The treatment of choice for obstructive sleep apnea is continuous positive airway pressure (CPAP). CPAP is a mask that fits over the nose and mouth and gently blows air into the airway to help keep it open during sleep.

But there are a few side effects of CPAP therapy such as possible leakage of air, dryness in the nose or mouth, skin marks, breathing discomfort, etc.

What is sleep apnea?

Sleep apnea is a sleep disorder characterized by pauses in breathing or periods of shallow breathing during sleep. Each pause can last for a few seconds to a few minutes, and they happen many times a night.

There are three forms of sleep apnea –

  1. Obstructive sleep apnea
  2. Central sleep apnea
  3. Complex sleep apnea syndrome

What is CPAP therapy?

CPAP stands for continuous positive airway pressure. It is a machine that provides a constant flow of pressurized air that helps to maintain an open airway by preventing its collapse. It is useful in eliminating snoring, which usually occurs due to the vibration of the tissues in the throat. (3)

With a small motor and fan, the CPAP machine takes in room air, filters it, and generates the air pressure that is the mainstay of treating sleep apnea. The prescribed pressure level is often determined through a sleep study called a polysomnogram. Your sleep physician determines the pressure settings and set by your equipment provider.

As a comfort measure, it is possible to add humidity to the air that is delivered with an attached humidifier. There is a water chamber that generally consists of a plastic reservoir that can be filled with distilled water. It is imperative to keep this water reservoir clean, as it can be a source of recurrent respiratory infection or even mold. (4)

Side effects of CPAP therapy

CPAP therapy is relatively safe, but there are a few side effects. The most common complaint relates to air pressure or discomfort from the mask interface. These issues can generally be reduced with some adjustments in the settings or fit of your mask.

1. Air leaking from CPAP mask

Air leak is the most common complaint associated with CPAP use. If the mask doesn’t fit perfectly, air may escape around the edges, especially as you change position while you are sleeping. Using a nasal mask or nasal pillows can reduce air leaks. If you are struggling with the fit of your CPAP mask, altering the pressure settings can sometimes be helpful.

2. Skin marks or rashes from CPAP

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.

3. Dryness in the nose or mouth from CPAP

Dryness of your nose or mouth often accompanies leakage from CPAP machine. This may lead to nosebleeds or may even damage your gums and teeth. 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.

4. Discomfort breathing out

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.

5. Air swallowing or Aerophagia from CPAP

Air swallowing can be a sign of CPAP pressures that are too high. Symptoms include burping, farting, and bloating. Reduced pressure may help to prevent this. Other treatments for Aerophagia include sleeping wedge pillows, medications for heartburn and GERD and bi-level therapy.

6. Face growth problems in children

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.

7. Claustrophobia

Some people feel confined or enclosed when wearing a mask. This typically resolves over time, mainly if you take the time to adjust gradually to using the mask.

8. Reduced sex drive

Some people may complain that the use of a CPAP mask is unappealing and could inhibit sex drive for one or both partners. It is best to have a frank discussion with your partner to decide when you will use it and how to avoid negative feelings about the mask.

9. Loud noise

The noise can interfere with sleep, particularly for the person who you sleep with. Overall, most partners can adapt more quickly to the predictable noise of CPAP than to the sound of snoring, which is very common with obstructive sleep apnea.

10. Developing Central sleep apnea

After using CPAP therapy, some people may start to experience episodes of breath holding characteristic of central sleep apnea. This sometimes resolves over time, and simply lowering the CPAP pressure may alleviate it. Sometimes treatment may require a change to adaptive servo-ventilation (ASV) therapy.

Over to you

CPAP therapy is a safer way to help people when they suffer from sleep apnea. However, there are some side effects of CPAP therapy which can be easily rectified with some adjustments in the fitting of CPAP mask.