CPAP is the acronym used for a machine which delivers continuous positive airway pressure. At the present time, it is the most effective treatment for obstructive sleep apnea. However, when the machine is left unattended and unused at the bedside it has no benefit at all. According to the American Sleep Apnea Association, estimates of compliance are approximately 60 percent. One reason may be the side effects that some individuals experience. However, when health professionals are made aware of the problem, many of these issues can be positively addressed and dealt with. (Reference 1)
Comfort
The CPAP machine delivers continuous positive pressure through a mask that may cover both nose and mouth or may just deliver airway pressure through the nose. According to the American Sleep Apnea Association, poor fit of the head mask can arise when the headgear is too tight or if the mask was not fit properly to the individual's facial structure. The mask should fit the face snugly to avoid any air leaks but should not be pulled tightly to prevent those leaks. Some individuals experienced claustrophobia when the mask placed over the nose and mouth. Nasal pillows are a new head gear option that helps to decrease claustrophobia. Another problem is when the tubing that connects the face mask to the machine gets in the way of sleeping during the night. By draping it over the head board or using a device that attaches to tubing to the bed, individuals may find relief. (Reference 1)
Nasal Irritation and Congestion
According to the University of Maryland Medical Center physicians, irritation to the nose and throat is one of the most common complaints received. This may be caused by nasal congestion or dry mouth that is the result of leakage of air from the system. The nose is the natural humidifier for the upper respiratory system. When CPAP dries the air, the body increases production of mucus, which may cause nasal congestion and a runny nose. In some cases chinstraps, saline spray or humidifiers in the tubing can help prevent these side effects. (Reference 2)
Headaches and Ear Pressure
According to the National Heart Lung and Blood Institute, individuals who use CPAP machines may also experience headaches and ear pressure in the morning when they awaken. When the CPAP machine is being used, some of the sinus cavities are blocked. This creates a situation where there is a pressure differential between each of the sinus cavities. These pressure differences can be felt as a sinus headache when an individual wakens in the morning but should resolve spontaneously and quickly. In some cases, a heated humidifier in the CPAP line will alleviate this problem. (Reference 3)
Gastrointestinal Effects
Occasionally, individuals will experience bloating, or trapped gas in the stomach, when they awaken. This is sometimes caused from sleep positions or an inappropriately positioned facial mask. According to American Sleep Apnea Association, sleeping with the head aligned with the body can help alleviate the problem. The head should never be elevated using two or three pillows. Rather, a wedge should be placed under the head, mattress or bricks under the headboard to achieve the height desired. By using several pillows, the head tilt may block the airway and allow more air into the stomach. (Reference 1)
Improvements
One of the positive side effects of using continuous positive airway pressure to treat sleep apnea is the improvement in fatigue and sleepiness that are common symptoms. Individuals often find symptoms improve as soon as CPAP is started, according to the National Sleep Foundation. Maximum effect is usually achieved in approximately 2 weeks. Individuals who do not experience improvement in symptoms, despite good adherence to their treatment, should consult with their sleep medicine expert for potential additions to the treatment protocol. (Reference 4)
