There are great advantages to using continuous positive airway pressure (CPAP) to treat obstructive sleep apnea (OSA). The steady air flow of a CPAP machine keeps your airway open and prevents the pauses in breathing that can put your health at risk. This helps you breathe easier and sleep better. As a result, you feel more alert and refreshed when you wake up.

The following tips will help you solve the five problems that are common to both new and experienced CPAP users. These simple solutions will help you maintain a long-term commitment to improve your sleep and your health with CPAP. Remember to always talk to your CPAP supplier if you have questions about your CPAP. Contact your doctor if you have ongoing problems. He or she can help make CPAP an effective and comfortable treatment for your OSA.

Problem #1: You seem to have more nasal congestion from using CPAP.
Nasal stuffiness is the most common side effect of CPAP therapy. You may also have a runny, itchy or dry nose, or nosebleeds. Nasal congestion often goes away after your first month of use. Keep in mind that many people with OSA naturally have an increased level of nasal congestion. This congestion is more common in the winter and during allergy season. It is not always a result of CPAP. Talk to your doctor if your congestion is severe, or if you have nasal, sinus or ear pain. These tips can help reduce your nasal problems:

• Try using a saline nasal spray. This solution is simply a mixture of salt and water. You can find it on the shelf at your local drugstore. Apply a few sprays in each nostril before using your CPAP.
  
• Try a nasal decongestant. This can be either a spray or a tablet that you take by mouth. Some types require that you have a prescription from your doctor. Never use a spray for more than a few days. Ask your doctor to recommend a decongestant for you.
  
• Try using a CPAP humidifier. The moisture that it adds to the forced air will reduce your nasal symptoms. Some CPAP models come with an "integrated" humidifier that is connected to the unit. You will need to make sure that you keep your humidifier clean to prevent infections. Ask your sleep doctor about using a humidifier with your CPAP. There are two types of CPAP humidifiers available to you:
  • Cold "passover" humidifier
  • Heated humidifier

Although either type can help you breathe easier, a heated humidifier is the first option that the sleep experts recommend.

Problem #2: You have trouble breathing with so much air coming in through your mask.
This problem is common if your OSA is severe; you need a high level of air pressure to keep your airway open. It can feel like you are getting too much air at too high of a pressure level. You should never reduce your air pressure setting without first talking to your sleep doctor. Instead, try these tips:

• Begin using CPAP for short periods of time during the day. Use it while you are watching TV or reading. This can help your body begin to adjust to the air pressure. You may need to start by using it for only a few minutes at a time. Gradually increase the length of your sessions. Focus on breathing at a nice, slow pace.
  
• Use your unit's "ramp" setting. This starts the machine at a very low level of air pressure. It slowly raises the pressure until it is at the right level. As you get used to it, you can begin to reduce the length of time for your ramp setting.

Problem #3: You have a dry or sore throat from using CPAP.
Anyone who breathes through his or her mouth during sleep may have this problem. You should talk to your doctor if your sore throat is very painful. These tips may help relieve throat irritation caused by CPAP:

• Use a chin strap with your nasal mask to keep your mouth closed while you sleep.
  
• Try using a full face mask that covers your nose and mouth. Try using a heated humidifier that fits your CPAP unit to moisten and warm the air blowing into your throat.

Problem #4: You may have red eyes, continue snoring or stop breathing during sleep.
These problems are all signs that air may be leaking out of your mask. These tips can help you correct the problem:

• Adjust the straps and headgear on your mask to obtain a better fit.
  
• If you have had your mask for a while, check to make sure that it is not worn or torn.
  
• You may need to try a different size mask.
  
• A different type of mask may work better for you. Either a full face mask or nasal pillows may eliminate the air leaks.
  
• Talk to your doctor or CPAP supplier about trying a mask that will mold to the shape of your face.
  
• Talk to your CPAP supplier if you continue to have problems with air leaks.
  

Problem #5: You develop redness or sore spots on your face, nose or forehead from the mask or straps.
Most masks now have improved cushioning for a more comfortable fit. If your mask does cause soreness, these simple steps can help solve the problem:

• Loosen your straps slightly so that they are not too tight. Make sure that your mask is still snug enough to prevent air leaks, but not so tight that it hurts your skin.
  
• Consider buying pads that slip over your straps. Made of fleece or other soft material, they keep the straps from rubbing against your skin.
  
• Talk to your CPAP supplier about trying a mask that will mold to the shape of your face.
  
• Talk to your CPAP supplier if your mask continues to irritate your skin or cause soreness.

Talk to your CPAP supplier if you have any other questions or concerns about using CPAP. Call your primary care doctor or your sleep doctor if you have ongoing problems with the treatment.