While CPAP does not cure sleep apnea, sleep specialists often recommend it as the best course of treatment for the condition. The device itself consists of a mask, a tube, and a fan. The unit is set to a predetermined air pressure that keeps the breathing passageway open while the patient sleeps. In theory this sounds like an ideal solution to a very serious and complex problem. However, there are a number of CPAP problems that some patients find so uncomfortable that they give up on using the device.
The CPAP mask often irritates the skin and nose of the patient. In order to prevent air leaks, the mask is intentionally designed to fit firmly over the nose and cheeks. While this maintains the necessary pressure for effective operation, the irritation it can cause to the skin around the mouth and nose is one of the most common CPAP problems reported to our office. Some patients try switching to a different sized mask. Others try using soft tubular devices called nasal pillows that fit into the nostrils and relieve the pressure on the bridge of the nose. Doctors often recommend alternating between the mask and nasal pillows to alleviate facial irritation.
The pressure produced by the machine is another CPAP problem that many patients find disturbing and uncomfortable. When the pressure prevents a person from falling asleep, many of the benefits of the treatment are negated. Some units can be adjusted to start off with a low pressure that allows a person to fall asleep, and then gradually increase the pressure automatically when sleep finally comes. However, some people simply cannot tolerate any air pressure at all. They find that it impedes their ability to exhale. For these patients, sleep apnea specialists may prescribe a bi-level positive airway machine that reduces air pressure when the patient breathes out.
Some CPAP problems are rooted in the psychological realm.
People who suffer from claustrophobia often feel so much anxiety they simply take the mask off. They may attempt to wear it for a while, but when they feel noticeable signs of anxiety, give up, remove the mask, and turn the CPAP machine off. When such a problem lies completely within the mind, sleep specialists will recommend using the unit a little bit each night, and in the early morning hours when REM sleep and dream activity is most pronounced. (These are also the times that most apneic events occur).
Less common, but nonetheless significant CPAP problems include severe discomfort or even pain caused by the mask. While CPAP specialists do everything they can to adapt these machines as much as possible to the comfort level of the patient, some people simply cannot wear them. Everyone has a different size and contour to their face. Some people have facial structures that are so unique that no mask or amount of adjustment can make CPAP treatment comfortable. People who are significantly overweight or who have very short, thick necks commonly report that their machines hurt them too much to wear for any amount of time.
The solution to these problems may be Bariatric surgery to reduce stomach size sufficiently to facilitate weight loss. Other patients may have nasal diseases such as chronic inflammation, polyps, or deviated septums. Possible nasal surgery may be required to correct these problems.
We recommend surgery only as a last resort due to the widespread availability of sleep apnea oral appliances that have proven effective and safe in treating a wide range of OSA cases. If you are one of the thousands of people plagued with CPAP problems, consider the benefits of using a dental device that may just prove the ideal solution to both your CPAP complications and the obstructive sleep apnea that has been keeping you from getting the good night's sleep you so much deserve.
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