Sleep apnea is characterized by excessive snoring and periods when breathing stops during the night. Oxygen deprivation leads to daytime sleepiness and is linked to serious health issues such as high blood pressure, stroke, heart disease and mood disorders. The most common treatment is continuous positive airflow pressure (CPAP), according to the American Sleep Apnea Association. The CPAP device forces air through flexible tubing connected to a facemask or other attachment. CPAP prevents the airway from being blocked during sleep. The benefits of CPAP are contingent on consistent use. Side effects are the most common reason for treatment noncompliance.
Device Discomfort
Problems with CPAP may include sores on the bridge of the nose, nasal congestion, or dry mouth. Anxiety about having something on the face is common, according to the University of Maryland Medical Center, and a feeling of being unable to breathe out can be caused by air pressure on too high a setting. A cushioned mask that fits well and doesn't leak will remedy many of these side effects. Dryness may be worse for elderly patients and those who have undergone uvulopalatopharyngoplasty, or surgery to remove excess tissue in the throat. Devices that provide cool or warm humidity are available for use with CPAP. The addition of warmed, humid air decreases the side effect of dryness, according to a study of 44 subjects conducted by German researchers. The scientists noted differences in the laboratory and surveyed patients after a four-week home trial. Dryness of the mouth was alleviated with heat and humidity added to air. Complaints of coldness on the face were reduced, while waking up with a wet face slightly increased. The findings were published in the May 2010 issue of "Sleep Breath."
Respiratory Effects
The University of Maryland Medical Center lists soreness of chest muscles as a side effect of the increased lung volume caused by CPAP therapy. Upper respiratory infections are known to occur with CPAP use and can be prevented by frequent and careful cleaning of the device and using only distilled water in humidifiers. A North Carolina woman who used CPAP without incident for six years developed a prolonged respiratory illness after one night of CPAP use with tap water. The water contained an endotoxin, a substance released by dying pathogens. The case was reported in the December 2009 "Southern Medical Journal."
Rare Side Effects
Obstructive sleep apnea may cause heart rhythm disorders (arrhythmias). A study by Turkish researchers, published in the August 2007 issue of "Sleep Medicine," showed that CPAP can improve a prolonged QT interval in patients who have this irregularity, which is a precursor to more serious arrhythmia. The University of Maryland Medical Center reports that severe side effects of CPAP are very rare but may include cardiac arrhythmias. Severe nose bleeding has occurred due to nasal dryness, and air blown into the eyes may cause irritation or conjunctivitis.
References
- American Sleep Apnea Association: Choosing a CPAP
- UMMC: Obstructive Sleep Apnea Treatment
- "Sleep Breath": Quality of Life, Compliance, Sleep and Nasopharyngeal Side Effects During CPAP Therapy With and Without Controlled Heated Humidification
- "Southern Medical Journal": Prolonged Respiratory Illness After Single Overnight Continuous Positive Airway Pressure Humidification
- "Sleep Medicine": Effect of CPAP on QT Interval Dispersion in Obstructive Sleep Apnea Patients Without Hypertension
