Tag CPAP problems

Will the Noise from CPAP Bother My Spouse?

“My spouse already has sleep difficulties, Will my CPAP machine make the insomnia worse?” I reassure such patients that all the new models of CPAP devices are almost silent producing only 24 to 29 decibels. 

How loud is 29 decibels? Here is a list of common noises and their decibel levels:

Normal conversation (60)
Refrigerator humming (40)
Whisper at 6 feet (29)
Whisper (20)
Calm breathing (10)

I further explain that most spouses find the soft, continuous, humming noise beneficial in helping them fall asleep, just like white noise would. Spouses have also shared with me that they sleep soundly knowing that CPAP is taking care of those dangerous episodes of cessation of respirations. They prefer this soft hum over stentorian snoring as the former represents continued breathing.

If you find a device’s noise is bothersome, first check to make sure the CPAP’s air filter is clean and unblocked.

If this doesn’t help, have your CPAP supplier check the device to ensure it’s working properly.

Also make sure that the CPAP mask is fitting properly as a large air leak from an ill-fitting mask can exacerbate the noise.

If the noise is still bothersome, try earplugs or a white noise sound machine to mask the noise.

Go through above checklist diligently.

Please continue to use CPAP as untreated sleep apnea affects your quality of life besides increasing your risk of hypertension, cardiovascular diseases, stroke, and drowsy driving.


Why do I Pull Off my CPAP Mask in Sleep?


“Doc, I put the CPAP mask on every night, but wake up with the mask on the bed. I don’t remember pulling it off,” frustrated patients often share with me. 

In my experience, nasal obstruction is the commonest cause of such occurrences. Studies have indeed shown that avoiding allergen exposure,  and using nasal steroid spray at bedtime help keep the nasal passages open.

For such patients, we first do allergy skin testing followed by an intensive allergen avoidance education. We prescribe allergy medications like Zyrtec (Cetirizine) at bedtime along with fluticasone nasal spray to be used 2 sprays each nostril prior to putting the CPAP mask on.

If you still suffer from nasal obstruction, adding singular (montelukast) tablet as a maintenance medicine can help. Allergy shots (injecting measured dosage of allergens in your skin on a weekly basis) can alleviate your allergy symptoms and the need for allergy medicines.

Talk to your doctor about these interventions and follow them. Be patient and persistent. Put on the CPAP mask every night and ultimately, one day, you shall wake with the mask on your face as opposed to your bed!

Best wishes.

Sleep Well, Lead Well.

Do call us if we can be of any help.

I Sleep with my Face Buried in Pillow. Can I Still Use CPAP?


We get that question often. “I sleep on stomach with face buried in a pillow. How can I use CPAP?” I reassure them that we do have quite a few patients, who use CPAP religiously despite their habit of sleeping prone.

We also remind them that the CPAP masks and cannula are stiff enough that the weight of your head will not cause collapse and obstruction to airflow. Most patients do however prefer a nasal cannula as opposed to a mask as the later can be difficult to sleep with the face down.

My patients with sensitive skin love this Nuance interface.

Our patients find this Nuance interface easy to sleep face down.

You may also find the ResMed interface shown below comfortable.

Air Fit P10 can also work even if you sleep face down in the pillow.

Air Fit P10 can also work even if you sleep face down in the pillow.

These interfaces work the best provided you do not have nasal allergies leading to nasal obstruction, in which case allergy skin testing followed by allergen avoidance, allergy medication, and allergy shots can help.

What if I breathe through the mouth? Well, we can prescribe a chin strap to keep your mouth closed during sleep.

Please do not let your sleep position scare you from getting treated for Obstructive Sleep Apnea. Untreated sleep apnea increases your risk of stroke, heart attack, high blood pressure, drowsy driving, and sudden death.

Sleep Well, Live Well.

CPAP Mask is Irritating my Skin!

I recently saw a young lady with red, irritated skin around the nose and mouth, where the CPAP (Continuous Pressure Airway Pressure) mask comes in contact with the face. Such irritation commonly occurs in patients with sensitive skin, environmental allergy, excessive sweating, and higher pressure requirement.

This can be frustrating, but there are things you can do to minimize and reverse this.

1. Do not put the mask too tight. CPAP machines can compensate for the small amount of air leak. When we review your CPAP compliance report, we can make sure this air leak is not causing apnea (cessation of respirations) or hypopnea (shallow respirations).

2. Apply talc powder before you put the mask on if you have oily skin. You may already have done this. Baby powder works the best in absorbing excess moisture and sweat.

3. Get tested for allergies especially the indoor allergies like dust, mold, and pets. Skin testing is safe, quick, and painless.

4. Switch to a different interface; try a nasal cannula shown below as it would minimize the contact with skin or a smaller mask from a different manufacturer.

My patients with sensitive skin love this Nuance interface.

My patients with sensitive skin love this Nuance interface.


5. Use a moisturizer cream if your skin is dry. We have also used Elocon, a non-steroidal skin ointment to reduce the inflammation.

Work with us through this irritation, but do not ever stop using the CPAP as untreated sleep apnea increases the risk of stroke, heart attack, high blood pressure, diabetes, and drowsy driving death.

Sleep Well, Live Well.

God Bless You.

PTSD and CPAP Intolerance? These 5 Tips can Help.


Treatment of Obstructive Sleep Apnea has been shown to improve anxiety, depression, and other symptoms of Post-Traumatic Sleep Disorder but compliance with Continuous Positive Airway Pressure (CPAP) has been worse in these patients. My patients suffering from anxiety, depression, insomnia and similar symptoms do find it difficult to sleep with the CPAP.

If you or someone you know is suffering from PTSD and OSA, the following tips can help.

1. Get treated for PTSD. The treatment by your therapist or psychiatrist will improve your sleep quality and thereby your CPAP adherence, which in turn will help alleviate your PTSD symptoms. We request that you regroup and see them regularly.

2. Try a mild anxiety or sedative medicine. Talk to your physician about this. This will help you adjust to CPAP.

3. Practice Self-relaxation, meditation, and yoga. This can help reduce your anxiety about CPAP initiation. In our experience, these interventions are far more effective in the long run than the medications for anxiety or insomnia.

4. Use a small, non-intrusive nasal cannula instead of a large, bulky, suffocating mask. This will minimize claustrophobia and resultant anxiety panic feeling.

5. Attend a local CPAP support group. Studies have shown that such participation improves CPAP experience and adherence.

It can be difficult to get used to CPAP, but it is worth the pain. It not only improves your psychiatric symptoms, but would also improve your energy level and alertness. It will also reduce your risk of stroke, heart attack, high blood pressure, and drowsy driving death.

So, start using CPAP. Stay with it. Don’t quit on it. Call us if we can help.

Sleep Well, Live Well.

Should I Try a Mask or a Cannula for My CPAP?

You are recently diagnosed with Obstructive Sleep Apnea, a serious disease in which a person’s respirations become shallow or stop completely repeatedly during sleep. Your doctor has prescribed a Continuous Positive Airway Pressure (CPAP) to keep your upper airway open and your respirations going. This treatment reduces your fatigue, tiredness, and daytime sleepiness besides reducing your risk of stroke, heart attack, uncontrolled blood pressure, and of drowsy driving death.

You are overwhelmed though. You are anxious if you will be able to sleep soundly with CPAP. You are wondering if you should choose a nasal mask, or a full facemask, or just a tiny tiny nasal cannula to connect to your CPAP machine.

The choice depends on several factors.

If you are a mouth breather, a full facemask may work better. The Amara full-face mask from Philips Respironics is a popular choice of my patients. It is lighter, smaller, and has significantly fewer parts than leading traditional full-face masks. In fact, it requires just a single click to disassemble and reassemble the cushion and the mask frame for quick cleaning and replacement.

If you breath through your nose, a small mask that just covers your nose would work well. The picture below is of an Airfit N10 mask from ResMed. My patients prefer this because of its cushion that fits comfortably on the face and the SoftEdge™ headgear, which minimizes facial marks.

If you suffer from are claustrophobia, a nasal cannula may work better. The picture below shows an AirFit P10 from Respironics.

If your mouth opens up during sleep, you can always add a chin strap to your nasal mask or cannula.

Whether you choose a nasal mask, or a full facemask or a cannula, remember to try several different sizes and shapes of that nasal interface. You may end up changing it over first several months until you find one that feels most comfortable.

Good luck and best wishes. Stay persistent. Stay pleasant. Stay asleep.  

Starting CPAP Therapy? You Should See a Sleep Specialist – a Study.


A recent study published in Journal of Clinical Sleep Medicine  looked at various cues that the CPAP users found important from treatment initiation and adherence standpoint.

Obstructive Sleep Apnea (OSA) is a common sleep
disorder for which continuous positive airway pressure
(CPAP) therapy is the standard treatment for most patients with
moderate to severe disease. Although this treatment is effective
in reducing airway obstruction to nonclinical levels, CPAP
acceptance (commencement) and adherence is suboptimal.

In this study by The University of Queensland, Australia, 63 adult patients diagnosed with OSA who had never tried CPAP were asked at 1 month as to why they started and persisted with CPAP use.

My sleep physician said that I should 

My sleep physician was worried about my OSA

I was worried about the health consequences of my sleep problem 

I was so tired all of the time

I was worried about my heart 

Partner encouraged me to start using CPAP 

My partner couldn’t sleep because of my snoring 

I was worried that I would have a car accident 

These findings suggest that patients rate advice from
health professionals (specifically their sleep physician) as very
important in their decision to commence on CPAP.

More than 80% of patients indicated that sleep physician-prompting to use
CPAP and a perception of sleep-physician concern regarding
the patient’s OSA were crucial cues to commence on CPAP.

The study suggests that a clear communication by the health professional is vital to patients in supporting treatment uptake.

In summary, consulting a sleep physician regarding your sleep apnea treatment will help your CPAP initiation and adherence. Hence, pick up the phone, make an appointment and talk to your sleep physician.

An Alert Life is a Full Life.

Sleep Well, Live Well.

God Bless You.