Nasal stuffiness or congestion is the most common side effect of PAP therapy and is often a nasal reaction to airflow from the PAP device. More than half of patients experience some increased nasal stuffiness when they first begin PAP treatment. The symptoms often disappear within a month of use.
CPAP users may also report nasal itching, runny nose, nosebleeds and nose dryness as other frequent nasal problems. In general, PAP-related nasal symptoms are treated with the techniques given below:
Applying a few sprays of nasal saline solution (a combination of salt and water) in each nostril before using PAP eases nasal symptoms. This solution is available at a pharmacy without prescription. Oral antihistamines may also be useful to control PAP-related nasal discomfort. Nozoil (a nasal lubricant oil spray) has been shown to be of some assistance with nasal discomfort.
Prescription antihistamines are also available. Consult your healthcare professional before using any prescription or non-prescription medication for PAP problems.
CPAP/BPAP/AutoPAP devices can be connected to specially designed humidifiers that will greatly reduce nasal symptoms. Humidifiers add moisture to the pressurized air PAP devices use. All humidifiers can add cool moisture and some can add heated moisture. If a cool air humidifier fails to relieve your nasal symptoms, consider trying a heated humidifier, available on all modern devices. PAP humidifiers will need to be prescribed by a healthcare provider and should be carefully maintained according to the manufacturer’s instructions to avoid nasal and sinus infections.
Several prescription medications can be used to combat PAP-related nasal discomforts. Anti-allergic nasal sprays may be of help, particularly if you have nasal allergies. Atrovent® or a nasal spray can be used to combat nasal problems and runny nose not caused by allergies. Nasal discomforts from PAP devices are usually simple to control with one or more of the suggestions above. If symptoms persist contact you healthcare professional.
PAP devices may cause dryness and pain the throat. Often the discomfort is caused by air blowing through an open mouth. A chinstrap to keep the mouth closed or a mask that covers the nose and mouth can eliminate this complaint. Humidifiers for PAP machines can also help control discomforts.
MASK AIR LEAKS
Symptoms of mask air lead are red eyes, loss of beneficial effects of PAP and return of snoring or apnoea. Air leaks are most often the result of a poorly fitting mask. Sometimes a different mask or a mask of a different size is needed. If you continue to experience significant air leaks despite using a chin strap consider a mask designed to fit inside your nostrils (nasal pillows). A mask that moulds to your face may be another option. Remember, if your mask and PAP therapy worked well for you in the beginning you should check to see whether your mask is worn out or torn. Contact your PAP equipment supplier and ask for help.
NOISE FROM THE MACHINE OR MASK VENTS
Newer PAP machines are much quieter than older models, but all make some sound. Placing the machine under the bed or on the floor may solve this problem. Again, the PAP supplier can provide advice and assistance.
SORE, DRY OR RED EYES
These problems can result from an air leak from your mask. Try reapplying the mask and readjusting the headgear. If the problem continues, contact your PAP supplier to determine whether you need to try to different mask size, nasal pillows or different headgear.
SKIN REDNESS OR IRRITATION
If you develop reddened areas or sores on or above the bridge of your nose or on your forehead, first check to see whether your mask is pressed too tightly to your face. Your mask needs to be fitted and adjusted to eliminate air leaks without putting excessive pressure on your skin. Sometimes spacers and air cushions can help ease the pressure points. If you need to loosen your mask so much that leaks develop, ask your PAP supplier whether your mask is the right type and size and is properly adjusted.
If redness occurs wherever the mask touches your skin, loosen the headgear slightly, but not so much as to cause an air leak. If you think you might be allergic to a mask, try applying a paper tape over areas where the mask touches your skin. If that eliminates the problem, contact your PAP supplier to find out whether a different mask or nasal pillows might be beneficial. Fortunately, modern PAP masks are made of materials designed to minimise allergic responses.
TOO MUCH AIR
Especially when first using PAP some people complain that the pressure of air through the nose seems too high. If this sensation makes it difficult for you to fall asleep, try using your PAP for short periods during the day or while watching TV to get used to it. If that fails try using a pressure ramp. Most PAP machines have ramp capability. The ramp starts the machine at a very low pressure and gradually raises it to the right amount over a period of minutes. Using lower pressures at the beginning may help you fall asleep more easily.
Most PAP machines will allow you to adjust your ramp time.
Many people find they prefer longer ramp times (10 to 20 minutes) when they first start using PAP. As you get used to PAP, or if the air pressure doesn’t bother you, set your ramp to shorter times so you get the full benefits of the correct PAP pressure from the beginning.