Troubleshooting CPAP problems

Most people with sleep apnea don’t like CPAP the very first time they use it, although some do. However, with time and some minor modifications, most people can improve their tolerance of the CPAP. If you are having trouble tolerating CPAP when you first start using it, you are not alone. Many people take several weeks to months until they are comfortable using the CPAP.

First off, these suggestions should be used in conjunction with the advice of your physician. These are some helpful hints that can improve your ability to tolerate the CPAP.

Many tolerance problems are related to the interface. For many people, the interface they are given does not fit well. Only by trying on multiple different interfaces can you find the one which fits you best. Is the interface comfortable? Is there excessive air leaking around the mask? Do you have to fit your mask too tightly to your face in order to control the air leak? If these are problems you are having, your interface may not be the right one for you or it may need better adjusting in order to fit properly.

Do you trouble with claustrophobia? Most people do not like having the mask strapped to their face. If this is a significant problem for you, you may find that nasal pillows are less intrusive and better tolerated than the nasal or full facemask.

Do you have a lot of leaking through your mouth? (Not around the mask). This is common with higher pressures that some people require in order to adequately control the sleep apnea. If this is the problem, there are 2 possible fixes for you. If you are using a nasal mask or nasal pillows, a chinstrap can be used. The chinstrap helps keep your mouth closed in order to reduce the mouth leak. Another option is a full face mask. This fits over your nose and mouth and therefore the air cannot leak back out of your mouth.

Do you have a dry mouth when you wake up after using the CPAP? If so, this may be a sign of a large air leak. In addition, if you don’t have humidification as part of the CPAP setup, you may benefit from this as part of your treatment.

Is nasal congestion a problem for you? Often this is related to drying out of the inside of your nose. This can be related to using dry air instead of humidification, or may be related to a large air leak through your mouth. Sometimes the nasal congestion persists despite fixing these problems. Often medications to decrease the congestion are helpful.

Another problem can be related to the pressure being too high or too low for all or part of the night. If the pressure feels too high and interferes with your ability to fall asleep or stay asleep, it may be too high. If you develop snoring or your bed partner tells you still stop breathing while using the CPAP, the pressure may be too low. This often follows a change in weight .

Some people have sleep apnea that is worse during different stages of sleep, or in different body positions. For many people, the sleep apnea is at its worst when you are in rapid eye movement (REM) sleep and while you are laying flat on your back. Many times, this means the CPAP pressure requirement is higher in these positions than at other times. An automatic PAP machine can help when the pressure requirement changes throughout the night.