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Troubleshooting guide for CPAP users

Sleep apnea support Nov, 02 2023

Common issues therapy users can experience with their treatment and equipment

When you are new to CPAP* therapy, it is likely you will need to adapt to a new bedtime regimen. Doing so may take time, but being consistent with your therapy and using your mask correctly will pay dividends in terms of achieving better quality sleep.1,2

It is normal to encounter problems along the way as you familiarize yourself with the treatment, and that is why we would like to draw on our 50-plus years of respiratory humidification experience to help you navigate your CPAP journey.

Here we have listed common issues therapy users can experience. These come under four categories: common side effects, equipment solutions, functionality issues and problem prevention through maintenance.

Note, we are unable to provide you with medical advice, so please contact your healthcare professional with your more complex and serious concerns. Any CPAP equipment issues should be handled directly with your equipment provider. 

Common Side Effects

Why is my mouth, throat and nose so dry?

Probable causes: Cold, dry air from your CPAP device can dry out your airways.3 An ill-fitting mask can cause unacceptable levels of air leakage and that too can have a drying effect.

How to resolve these issues: A CPAP humidifer will increase the air moisture levels, and may help combat drying out of the airways. If you are experiencing excessive leakage from your mask, readjust it so it is fitting correctly or change the type of  mask you are using to better suit your sleep style.

See, Which type of CPAP mask is best suited to me?, How to prevent experiencing dry mouth when using CPAP, and Why is heated humidification important in CPAP therapy?


Why is my nose so runny using CPAP?

Probable cause: This is most often caused by the dry air from your CPAP device, which can dry out the delicate mucus membranes in your nasal cavity or upper airway.1

How to resolve this issue: A CPAP humidifier will add moisture to the air and potentially reduce this issue. You may also wish to use a nasal saline spray before bedtime.


CPAP therapy is causing excessive gas and bloating

Probable cause: You may have aerophagia. This condition can cause gas, stomach aches, bloating and belching. This happens when air from your CPAP device goes into your stomach instead of the airways.1

How to resolve this issue: Check your CPAP pressure with your healthcare professional. Set too high, it could be delivering air into the esophagus; set too low, you may be gulping air into your stomach. You may also wish to check you are using the right mask type - mouth breathers can experience aerophagia when they use nasal masks. If this is happening to you, consider changing your mask style or wearing a chin strap to control mouth breathing. 

Go to, What is the best CPAP mouth mask?


CPAP therapy is irritating my skin and causing blemishes, sores and red marks

Probable causes: Skin problems may be caused by incorrectly sized or fitted masks as well as a buildup of sweat, oil, and dead skin cells accumulating on your mask and tubing.1

How to resolve this issue: Your mask is one of the most important components of your CPAP therapy. Choosing a mask that has a secure seal and is comfortable to wear is vital to the success of your treatment, so consider what type of mask will suit your sleeping style and facial features. A good cleaning regimen can also prevent skin irritation. It is advisable to clean your mask and headgear regularly to reduce dirt, allergen or pathogen buildup.

See, How to thoroughly clean your CPAP equipment and Which type of CPAP mask is right for me? 


Why does CPAP make my chest hurt?

Probable causes: Some people say inhaling dry or cold air from their device can give them a burning sensation in the lungs. Others may feel pressure on the chest muscles and lungs because the air pressure is set too high for them to exhale efficiently and comfortably.

How to resolve these issues: Use a humidifier to add moisture to the air you are breathing, and always consult with your healthcare professional about what air pressure you should use. You may also opt for a CPAP device with pressure relief – a feature that lowers pressure upon exhalation. 


Why are my eyes dry and irritated using CPAP?

Probable cause: Waking up with dry, irritated eyes is a sign of excessive mask leak.1

How to resolve this issue: Ensure your mask is fitting correctly (not too loose or tight) and adjust it accordingly. Test how it feels while lying in the position you normally sleep in. If you continue to experience mask leak, you may need to replace the mask.

Go to, How to prevent CPAP mask air leaks.


Why am I feeling uncomfortable using CPAP?

Probable cause: You could be wearing the wrong type of mask for your sleeping style and facial features, or you are not getting the right fit with the mask.

How to resolve this issue: Always read the user instructions to ensure you get a proper fit and ask your doctor or equipment provider to show you how to adjust your mask correctly so you can receive the full benefits from your treatment.


I'm struggling to sleep wearing my CPAP mask

Probable causes: If you are new to the therapy, it is likely you are just adjusting to the equipment - this is normal, and it can take time. Also, check that you are wearing your mask correctly. Worn incorrectly, your mask can cause you discomfort and result in mask leak.

How to resolve this issue: Ease into your therapy. You could wear your mask briefly during the day to help you get accustomed to it. This will also help you to get the right fit, so your mask not only feels comfortable but has an effective seal. Most of all, stick with it because once you are fully familiar with CPAP and the therapy is working efficiently, you will get the restorative sleep you need.


My CPAP mask makes me feel claustrophobic

Probable cause: Sleeping with a mask can be difficult at first for those new to CPAP therapy and they may feel claustrophobic.1 However, most people adjust over time and go on to experience the full benefits of their sleep apnea treatment.

How to resolve this issue: If you find you are just unable to ease into treatment, consider the type of mask you are using. You may be better suited to a nasal, nasal cradle or nasal pillows mask. These have less facial coverage and can be less cumbersome, so you may find them easier to tolerate overnight. Speak to your healthcare provider about which mask type is best suited to you and your breathing style.

Go to, What is the best CPAP nasal mask?

Equipment Solutions

This section is designed to help provide answers to some of the common problems you may experience with your CPAP device, humidifier and mask.

CPAP Device

My CPAP machine is not working

Your CPAP device should start running the moment it is plugged in and turned on. If it does not, check that the plug to the machine is properly in place and the electric outlet is working. If the device still does not start or generate air flow, take it to an equipment provider to check whether it needs to be repaired or replaced. Likewise, if your CPAP device lacks the same pressure or is being temperamental, have it looked at by an expert.


My CPAP machine is too noisy, and it is keeping my bed partner and I awake

Most of today’s CPAP machines run quietly. Many have a decibel (db) rating of about 30, which is equivalent to the sound of a whisper. By comparison, snoring can rate from 60 to 80db. If you find your device is too noisy, you may have an issue with mask or tubing leak. Ensure your mask fits you correctly and that the tubing to your device is set properly. If that fails, check the machine is running smoothly by regularly changing the filters and that the humidifier is running with enough water. If the noise continues to keep you up at night, try moving the machine away from your bed or investing in one of the latest models designed for a more hushed operation.


I keep getting tangled in my CPAP tubing during the night

Try experimenting where you place your tubing. Can you attach it above your bedhead or around a bedhead post so it is lifted out of the way as you sleep? Would it help if you slept closer to the edge of the bed? Some people use CPAP pillows to alleviate this issue, which can be easily sourced online.


I keep tugging my CPAP device off my side table and on to the floor as I sleep 

Doing this can cause your CPAP device serious harm. It is therefore important the CPAP tubing you are using is long enough for your needs. Most CPAP tubes are 6-foot long, but you can buy 10-foot tubing too. It is not recommended under normal circumstances to keep your device on the floor.


My CPAP device is giving me a dry mouth and throat and a runny nose

The cool, dry air from your CPAP machine can cause these issues.1 Try using a CPAP humidifier, which will add moisture to the air and deter these problems from impacting on your treatment delivery. Using a nasal spray before you go to bed can also help.

CPAP Humidifiers

Why should I guard against CPAP humidifier water spills?

Spilling water into your machine can cause some serious operational problems for your device. That is why it is advisable to fully remove the water chamber from the machine before you fill it. It is suggested you fill the chamber over your kitchen sink.


Why do I have to use distilled water for my CPAP device?

Distilled water will ensure you are not breathing in the bacteria and chemicals that may exist in your tap or filtered drinking water, and it will make your humidifier a lot easier to clean. It is recommended that you refill your humidifier water chamber with fresh distilled water daily.


Why should I have to clean my CPAP water chamber so often?

It is necessary for you to clean your CPAP humidifier daily with warm water and a mild detergent and to also give it a thorough cleaning at least every two weeks so it remains hygienic for use. Regular cleaning will deter mold and mineral deposits from building up in the chamber and prolong the life of the device.

Go to, How to thoroughly clean your CPAP equipment.

CPAP Masks

Why is my mask irritating my face and causing sores and rashes?

If your CPAP mask is irritating your skin, it is possible that you are wearing a mask that is ill-fitting or not suitable to your sleeping style.1 It is vital to choose a mask you find comfortable to wear and that provides you with a secure seal. Ensuring your mask is regularly cleaned will also deter skin rashes caused by a buildup of sweat, oil and dead skin cells.

See, What are my CPAP mask options?


I wake up without my mask on, but have no memory of removing it during sleep

For your CPAP therapy to be successful, you need to be compliant with the treatment - and that means wearing your mask all night, every night. However, if your mask is so uncomfortably tight or too loose that it is causing excessive mask leak, you can be inclined to take it off during the middle of the night. Do your homework to ensure you select the best mask for your facial shape and sleeping style and always take time to adjust your mask for a personalized, more comfortable fit. If your mask is fitting well, check the pressure settings on your device are correct. Your healthcare professional and equipment provider should be contacted if you think your settings need adjusting.

Go to, How to choose the right CPAP mask.


I am feeling claustrophobic and cannot get used to the CPAP mask

CPAP treatment can take some getting used to, but it does get easier over time. Know that persevering and being consistent with your therapy can pay off in restorative sleep and an overall better quality of life. If you find you are just unable to transition into treatment, consider using a mask that covers less of your face and has a smaller seal coverage, e.g., a nasal or nasal pillows mask could be better suited to you than a full-face mask.

See, What is the smallest CPAP mask?


My CPAP mask makes my eyes sore, swollen and irritated

Irritated eyes are often caused by mask leak resulting from a mask that is fitted too loosely or tightly.1 Adjust your mask accordingly. If you continue to experience excessive mask leakage, it may be time to replace the mask.

Go to, How to prevent CPAP mask leaks.

CPAP Functionality Issues

My heated humidifier water chamber does not seem to need refilling

The amount of water your humidifier uses depends on the humidity in the atmosphere and the humidity and temperature levels you have set on your device. If you find the amount of distilled water you use has dropped, you may have to adjust your settings. If the water is not going down at all, the humidifier may not be operating properly and should be checked by your equipment provider.


Why is my humidifier hot plate not warming properly?

This is a sign there could be an operational problem with your device. You should have your humidifier checked by a professional.


Why is my CPAP machine getting noisier? 

Most of today’s CPAP devices operate at the sound of a whisper or around 30db. If you are finding your CPAP device is getting louder, check your filter is unblocked and clean. Also make sure your mask is working and fitting properly, as an ill-fitting or dysfunctional mask can cause noisy, excessive air leakage. If the CPAP device continues to operate loudly, there could be a problem with the equipment and you should contact your CPAP supplier to check it is working correctly.
See also, How do you put on a CPAP mask?


Preventing Problems With Regular Maintenance

CPAP therapy users can prevent many of the equipment and functionality issues mentioned here by maintaining their equipment properly and regularly. Refer to the user instructions that came with your CPAP equipment for guidance on maintaining your equipment.

For our advice on cleaning your mask and CPAP device, go to How to thoroughly clean your CPAP equipment and How to clean a CPAP mask and hose.

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