Common problems reported with nasal positive airway pressure and trouble-shooting guide

Problem: Mask leaks / Skin irritation / Pressure sores or blisters

Possible Cause:

1. Strap adjustment too loose or too tight
2. Incorrect mask size
3. Worn-out mask
4. Dirty mask

Correction:

1. Readjust headgear straps. The mask should be as loose as possible while still creating a seal
2. Consult respiratory therapist for a mask fitting. Nasal pillows or full-face mask may provide a better fit
3. Inspect mask for stiffness, cracks or breaks. Replace mask if needed
4. Wask mask daily; wash face nightly

Problem: Dry nose and(or) throat / Nasal congestion / Bloody nose

Possible Cause:

1. Dry air

Correction:

1. Try nasal saline spray before bedtime and upon awakening.
2. Add heated humidification
3. Try topical nasal steroid preparation or antihistamines
4. May have some desensitization over time
5. Consult physician if symptoms persist

Problem: Dry mouth

Possible Cause:

1. sleeping with mouth open

Correction:

1. Try a chin strap
2. If this is not helpful, a full-face mask may be considered
3. Add heated humidification

Problem: Sore, Dry, Irritated or Swollen eyes / Conjunctivitis

Possible Cause:

1. Mask leaks
2. Mask too tight

Correction:

1. Try reseating the mask on the face
2. Readjust headgear straps
3. Inspect mask for stiffness, cracks or breaks. Replace mask if needed
4. Use an eye patch

Problem: Rhinorrhea (runny nose)

Possible Cause:

1. Dry air

Correction:

1. Try saline nasal spray before bedtime
2. Try topical nasal steroid preparation or intranasal ipratropium bromide before bedtime
3. Add heated humidification

Problem: Allergic rhinitis

Possible Cause:

1. Irritants drawn in with room air through machine

Correction:

1. Place unit on bedside table to keep dust and/or animal hairs out of machine
2. Consult respiratory therapist: a fine particulate filter can be added to some units
3. Add heated humidification
4. Consult physician if symptoms persist

Problem: Chest discomfort / Sinus discomfort / Difficulty exhaling

Possible Causes:

1. Pressure requirement may be lower at beginning of sleep period
2. Initial adjustment period

Correction:

1. Try pressure ramp at beginning of sleep period
2. Reduce pressure with bilevel positive airway pressure
3. Try to reduce pressure requirement by using oral appliance and CPAP

Problem: CPAP unit too noisy

Possible Cause:

1. Blocked air intake
2. Too close to sleeping area

Correction:

1. Check if air filter is clean and not blocked by outside items
2. Add a length of hose and place unit farther away

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