How to Keep Using CPAP When You Have Nasal Congestion

Our Chief Medical Officer, Dr. Said Mostafavi, suggest that CPAP users suffering from nasal congestion consider that allergies may not be the cause. In addition to seasonal allergies, changes in climate or a common cold can cause difficulty breathing at night with CPAP.

A less know cause of nasal congestion will affect some CPAP users  6 to 12 months after starting therapy. Because many sleep apnea patients are mouth breathers (due to sleep apnea), when they start using CPAP therapy, they suddenly start breathing through their nose. This “overnight” change can cause irritation and uncover nasal allergies that you may not have been aware of (read more about how nasal resistance can promote mouth breathing here).

Regardless of the cause of nasal congestion or irritation, rather than stopping CPAP therapy, consider these tips to help you continue therapy:

1. Proper humidification can reduce dryness that enhances nasal irritation and congestion

Most new CPAP machines come with a heated humidifier which gently adds moisture to the air that you breathe through your mask. Heated humidification is recommended for comfort for most patients, especially those in dry climates, over age 65 or taking medication that causes dry airways. Read more about humidification for CPAP here.

2. Try heated tubing for added heat and humidification

Heated CPAP tubing keeps the temperature of the air warm as it travels from your heated humidifier through the tubing to the mask and into your airway. Otherwise, the air loses heat and can cool drastically before it reaches your airway. Additionally, the cooling of the air can cause condensation in your tubing which can lead to “rainout” or filling your mask with water. Read more about rainout and how to prevent it here.

3. CPAP filtration can reduce or eliminate irritants in the air

Make sure that your filter is clean and replaced on a regular basis. It’s recommended that you wash your non-disposable filter at least once a week with water and allow it to dry completely before putting it back in the machine.

You can also try a hypoallergenic filter which has a tighter weave to let even fewer particles form the air into your machine.

Read more about different types of CPAP filters here.

4. Try a full face CPAP mask if you’re having a hard time breathing through your nose

Many CPAP users will switch from a pillows or nasal mask when they have nasal congestion from a cold or allergies. A full face mask covers your mouth and nose.

There’s even a mask that has a separate oral and nasal component. You can check it out here.

Learn more about the differences between these mask types here.

5. Avoid eye irritation from mask leak

Proper mask fitting is very important; however, with every mask there will still be air leak. The goal is to minimize the air leak and ensure that the air is not causing irritation in your eyes.

If you’re suffering from a cold or allergies air blowing into your eyes at night can cause additional dryness and irritation during the day.
In order to not let this stop your CPAP therapy, ophthalmologists recommend using thick artificial tears (gels and ointments, not thinner or less viscous teardrops) just before bedtime. It is important to treat both sleep apnea and any resulting eye irritation properly, so you should speak to your doctor.

8. Saline sprays or water can reduce congestion and irritation

Nasal spray or Neti pots use saline to help reduce congestion and irritation in the nasal passages.

7. Try allergy medicines, like antihistamines, to reduce the nasal congestion

Selective or non-selective antihistamines can be effective for nasal congestion from allergies. It’s important to consider that some antihistamines can cause drowsiness. There are also nasal steroids available that may help. Talk to your doctor about this.

If none of these tips help to relieve your symptoms, you should talk to your doctor or an ENT to evaluate your symptoms.

Do you suffer from allergies and would like a full face mask or heated tubing?

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  1. Greg Whitman Reply

    I suffer from severe nasal congestion with my CPAP machine full face model. My nose is so stuffy all day and it feels like my eardrums are trying to blow out of my ears. If anyone has anything to suggest as to how to treat this I would greatly appreciate it.

  2. James dodoe Reply

    Practice deepthroating your uncle like you use too

  3. James Boone Reply

    These are some useful tips. Dry nose makes difficult to use CPAP. Of course Saline sprays and allergy medicines are effective in relieving nasal congestion. Thanks for sharing these points. Truly appreciated.

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