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CPAP Therapy Side Effects

Understanding CPAP Therapy: Knowing its Side Effects and Remedies

CPAP therapy is the most popular and effective treatment for obstructive sleep apnea. Though effective, this treatment method may cause certain side effects in some users.
Sonia Nair
Last Updated: Mar 26, 2018
According to statistics, two-third of the CPAP users experience side effects. The common causes include use of ill-fitting masks, improper air pressure, and lack of proper training
Sleep apnea is a sleep disorder which is characterized by intermittent cessation of breathing during sleep. The body reacts to this condition, by awakening from sleep, gasping for air due to lack of oxygen. However, it is not necessary that the person who suffers from this condition, is aware of the frequent episodes of difficult breathing or interrupted sleep. Even though, there are three types of sleep apnea; obstructive sleep apnea is the most common one, and it amounts to around 85% of the reported cases. Obstructive sleep apnea is caused by some sort of physical obstruction to the airflow into the lungs. For example, relaxed throat muscles may result in obstructive sleep apnea, as these muscles block the airflow.
What is CPAP Therapy?
The most popular treatment for obstructive sleep apnea is CPAP (Continuous Positive Airway Pressure) therapy. This method of treatment involves use of a device, which provides constant and pressurized airflow to keep the airway open. This facilitates uninterrupted breathing during sleep. The CPAP machine maintains a continuous flow of compressed air through a hose to a nasal mask (nasal pillow or face mask). The air pressure is determined according to the needs of the patient. The right air pressure for a patient is prescribed by the sleep specialist, after conducting a detailed overnight study of the patient's breathing pattern. Such a prescribed air pressure is termed 'titrated pressure'. The CPAP machine is set as per the prescribed air pressure. When it is turned on, it blows air at the titrated pressure, so as to hold the air passage open for uninterrupted breathing. Thus, CPAP therapy achieves the desired result, i.e. eliminating apnea.
Adverse Effects of CPAP Therapy
Even though, CPAP therapy is the most successful and widely-accepted treatment option for people affected with sleep apnea, reports of side effects are not uncommon. While most of these side effects are actually caused by ill-fitting masks or incorrect usage, there are some indigenous ones too.
Nasal Congestion: Use of CPAP machines may cause nasal congestion. Some patients may experience nasal irritation and runny nose too. This is because, the air from the machine dries up the nose. The body reacts by producing more mucus in the nose, which leads to nasal congestion. In some patients, there will be no mucus production, and this results in dry nose, which causes nasal irritation, burning sensation, and sneezing. A machine with an inbuilt humidifier may help you address this problem.
Ear Pain: Headache and ear pain are commonly experienced by patients with sinus infections, allergies, and cold. The congestion caused by these medical conditions blocks the ear canals, and the air pressure changes when the patient uses CPAP machine. This leads to trapping of air and changes in the ear pressure, which results in ear pain. You may discontinue use of CPAP machine, if you develop a cold or sinus infection. Make sure that you consult your physician, before stopping its use.
Breathing Problems: Difficulty in breathing through the nose is another common side effect. This is mostly seen in people with a deviated nasal septum, and those who suffer from allergies. Such people may face difficulty in breathing, as most of the CPAP machines are meant for providing air through the nose. They may either consult their doctor to treat the medical condition that causes the discomfort, or try CPAP machines with full face masks. Such machines allow them to breathe through the mouth.
Excess Gas in Stomach: Some users experience stomach pain, gas, and bloating, when they start using CPAP machines. This is due to swallowing of air, which the machine blows into the nasal passage. It will be better to use a CPAP chinstrap, while using the machine. Elevating the head while sleeping may also prove useful. Lowering the air pressure is another remedy, but this may affect the effectiveness of the treatment.
Discomfort: Though not a side effect, the discomfort associated with use of a machine while sleeping, is one of the common complaints from CPAP users. This problem is often associated with the mask, which is fitted over the nose, mouth, or over the full face. People with claustrophobia (fear of being confined in a closed space) may find it difficult to use the mask while sleeping. Some others, who use ill-fitting masks may also face such discomfort. The mask may also interfere with intimacy and restrict the sleeping position. The noise generated by the machine may lead to delayed onset of sleep and discomfort. The machine is also inconvenient for travel.
These are some of the common problems associated with the use of CPAP machines. Use of chinstrap may aggravate the symptoms of Temporomandibular Joint Disorders (TMJ). Some people may feel a sensation of suffocation, whereas others develop chest discomfort and nausea. Exhalation may become difficulty for some users. In some rare cases, serious side effects, like pneumothorax, subcutaneous emphysema, etc., may occur.
Tips to Avoid Side Effects
In case of CPAP side effects, the user must discuss the problem with his physician. The problem can be remedied with some medication; or by making some adjustments in the device, which can also be fitted with some comfort options.
Choose the Right Mask: As mentioned above, an ill-fitting mask is the most common cause for the side effects caused by CPAP machines. There are different types of CPAP masks available in the market. Some of them come with nasal pillows, while others have different types of straps. Choose the size that is perfect for your facial shape. It must fit properly, so that air leak can be avoided. You may also go for customized versions. Be consistent in using the mask, so that you get accustomed to the air pressure settings and the mask itself.

If there is any problem with the air pressure settings, consult your doctor, who can adjust the pressure to eliminate the side effects. If your doctor permits, you may go for automatic CPAP machines that adjust the pressure according to the breath pattern of the user. Some machines start with a low pressure that increases gradually, as the user falls asleep. Another option is a BiPAP machine which maintains a low pressure during exhalation, and a high pressure during inhalation.
Other Remedies: For nasal congestion, use a machine with a dehumidifier. Your doctor may prescribe some nasal decongestants or sprays. If dry mouth is the problem, use a mask that covers the full face, or try chin straps. For bloating, lowering the air pressure setting may work. Those who are claustrophobic may try relaxation exercises. If the noise of the machine is causing discomfort, clean the air filter of the machine, or get it checked by the supplier. You may also get a latest, silent model. Some of the users remove the mask during their sleep. Using a chin strap is a solution for this problem. Otherwise, check in between.
While most of the minor problems can be overcome with constant use and some simple solutions, those who experience severe side effects must talk to the doctor at the earliest. It is always better to use the best available machine that is ideal for you. By far, CPAP therapy is considered the most effective for treating obstructive sleep apnea. If you are not at all comfortable with CPAP therapy, consult your doctor for some alternatives.
According to statistics, one in every 15 Americans is affected by sleep apnea. While most of them are unaware of their condition, only a small percentage of such people get diagnosed and treated properly. If left untreated, sleep apnea may lead to high blood pressure, which in turn raises the risk of heart diseases and stroke. If you experience this condition, seek immediate medical attention.
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice.