CPAP Troubleshooting - Very Basic Information

Table 1. Common problems reported with nasal continuous positive airway pressure and trouble-shooting guide

Problem	Possible Cause	Correction
Mask leaks. Skin irritation. Pressure sores or blisters.	Strap adjustment too loose or too tight. Incorrect mask size. Worn-out mask. Dirty mask.	Readjust headgear straps. The mask should be as loose as possible while still creating a seal. Consult respiratory therapist for a mask fitting. Nasal pillows or full-face mask may provide a better fit. Inspect mask for stiffness, cracks or breaks. Replace mask if needed. Wash mask daily; wash face nightly.
Dry nose and/or throat. Nasal congestion. Epistaxis.	Dry air.	Try nasal saline spray before bedtime and upon awakening. Add heated humidification. Try topical nasal steroid preparation or antihistamines. May have some desensitization over time. Consult physician if symptoms persist.
Dry mouth.	Sleeping with mouth open.	Try a chin strap. If this is not helpful, a full-face mask may be considered. Add heated humidification.
Sore, dry, irritated or swollen eyes; conjunctivitis.	Mask leaks. Mask too tight.	Try reseating the mask on the face. Readjust headgear straps. Inspect mask for stiffness, cracks or breaks. Replace mask if needed. Use an eye patch.
Rhinorrhea.	Dry air.	Try saline nasal spray before bedtime. Try topical nasal steroid preparation or intranasal ipratropium bromide before bedtime. Add heated humidification.
Allergic rhinitis.	Irritants drawn in with room air through machine.	Place unit on bedside table to keep dust and/or animal hairs out of machine. Consult respiratory therapist: a fine particulate filter can be added to some units. Add heated humidification. Consult physician if symptoms persist (may require medication).
Chest discomfort. Aerophagia. Sinus discomfort. Difficulty exhaling.	Pressure requirement may be lower at beginning of sleep period. Initial adjustment period.	Try pressure ramp at beginning of sleep period. Reduce pressure with bilevel positive airway pressure. Try to reduce pressure requirement by using oral appliance and CPAP (no data available).
CPAP unit too noisy.	Blocked air intake. Too close to sleeping area.	Check if air filter is clean and not blocked by outside items. Add a length of hose and place unit farther away.
Bed partner intolerance.	Multiple factors (noise, anxiety).	Promote education of the patient and bed partner. Recommend attending a patient support group (i.e., A.W.A.K.E. Network of the American Sleep Apnea Association).