If lifestyle changes don't improve your sleep apnea, using a continuous positive airway pressure (CPAP) device may be necessary. CPAP, which involves wearing a nasal mask that delivers a steady stream of air to maintain airway pressure and keep the airways open, is effective in 80 to 90 percent of people with sleep apnea.
Although your CPAP mask may take some getting used to, it’s clearly worth making the effort to use it consistently. Here are some common obstacles faced by CPAP users and tips to help overcome them.
You got off to a bad start
Studies suggest that CPAP use habits are established very early in the course of therapy. But the first few nights can be difficult, with users experiencing less sleep than usual as they become accustomed to the device.
If you’re just beginning CPAP therapy (or are hoping to start over and re-establish good habits), ask your doctor if taking sleep medication for a short time is an option.
A 2009 report in the Annals of Internal Medicine followed 160 people with newly diagnosed obstructive sleep apnea. About half took 3 mg of the sedative/hypnotic eszopiclone (Lunesta) every night for the first two weeks of CPAP use, while the others took a placebo pill. The group who took the sleeping pill reported a larger improvement in daytime symptoms than did the placebo group; they were also significantly more likely to be using their CPAP appliance six months later.
The mask is uncomfortable
A CPAP mask should fit the face snugly enough to avoid air leaks, but not so tightly that it hurts or causes irritation or sores on your face.
To ensure a proper fit, the masks come in several shapes and sizes. In addition, some are full-face masks that cover your mouth and nose, with straps that stretch across your forehead and cheeks. Other masks feature nasal “pillows” that fit under your nose and straps that cover less of your face.
Work with your doctor or CPAP supplier to find the mask that’s right for your particular face shape, and ask them to show you how to adjust it to get the best fit.
You feel claustrophobic
Some people find that wearing a CPAP mask is claustrophobic. Purchasing a lightweight or transparent mask or a mask with a nasal pillow can help with this problem. It also may help to start by wearing the CPAP mask for short periods of time while you’re awake (while watching TV, for example).
Once you become accustomed to how that feels, start wearing the mask when you sleep. Stick with it for several weeks or more, gradually increasing the amount of time you wear the mask. It can take between 30 and 90 days to adjust to using CPAP.
You have nasal congestion
Because the air from the CPAP machine can dry out your nose, your body will increase its production of mucus to compensate, which can cause nasal congestion and a runny nose.
Using a saline nasal spray at bedtime can help, but the best solution is to have a heated humidifier fitted to your CPAP’s air pressure machine, so that the air that enters your nose is warm and moist.
There’s no way around the fact that being attached to a face mask all night can make you feel self-conscious and potentially be a barrier to intimacy with your partner. But the symptoms of sleep apnea (snoring and fatigue, for example) can also have adverse effects on your relationship, not to mention serious health consequences.
Acknowledging your feelings about your CPAP mask with your sleeping partner and your doctor right from the beginning is one of the best ways to elicit support and improve overall adherence. Otherwise, embarrassment may lead you to reject CPAP therapy.