Side-Effects and What to Expect from CPAP, Bi-PAP, and PAP Therapy

This SleepSomatics blog article is part five of a six part series on CPAP Therapy, Bi-PAP (or Bi-Level) Therapy, and Treating Sleep-Disordered Breathing (Sleep Apnea) with Non-Invasive PAP Therapy.

Part One: Drowsy Driving Kills

Part Two: What are CPAP, Bi-PAP, and PAP Therapy

Part Three: Insurance Coverage for CPAP, Bi-PAP, and PAP Therapy

Part Four: PAP Masks: Keep it Simple, Small, and Silent

Part Five: Side-Effects and What to Expect from CPAP, Bi-PAP, and PAP Therapy

Part Six: Cleaning and Servicing your CPAP, Bi-PAP, and PAP Therapy

All medical treatments and therapies come with side-effects. CPAP, Bi-PAP, and PAP Therapy are no exception to this rule. However, as the non-invasive gold-standard treatment option for sleep apnea and snoring, CPAP has perhaps the fewest and minimal side-effects compared to invasive surgical treatment options.

What to Expect with Initial CPAP Therapy Usage

The first couple of weeks with initial CPAP therapy usage should result in sleep restoration. Sleep apnea patients often have severely fragmented sleep architectures, which means that sleep continuity correction with CPAP can result in a "sleep rebound" effect. Some mornings may result in earlier-than-normal wakefulness with higher energy, whereas other mornings may feel sluggish and tired more than usual. This is known as sleep debt, and it may take several weeks of consistent CPAP therapy usage for sleep to fully restore. During initial therapy usage, we advise patients to listen to their bodies and sleep or nap whenever they feel tired. Just make sure you are always sleeping with your CPAP therapy whenever sleeping, napping, or traveling ... particularly in later-morning hours. It is particularly important during these initial weeks on CPAP therapy for sleep apnea patients to exercise caution when driving or operating heavy machinery until their daytime sleepiness symptoms resolve with consistently refreshing sleep.

Common CPAP side-effects include initial nasal irritation and nasal dryness. Initial nasal irritation is generally corrected with proper humidification and cleaning of the therapy equipment. Other side-effects like nose or forehead marks (also known as pressure sores) and morning gas are less common and usually indicative of incorrect mask usage. These are the main side-effects we see in our patients at SleepSomatics, which our sleep clinicians proactively manage with our highly-effective approach to CPAP mask selection known as KISS: Keep it Simple, Small, Silent.

Initial nasal dryness, however, isn't the side-effect patients ask our sleep clinicians about. The CPAP side-effects patients most often are worried about are those we discuss below. This SleepSomatics article on CPAP side-effects takes an admittedly tongue-and-cheek approach to the side-effects discussion. A degree of both humor and levity are employed for effect.

Remember: at SleepSomatics, many of our sleep clinicians also have sleep disorders themselves. Our clinical team includes current CPAP users. We understand your reservations--we've had them, too. Give us an opportunity to help you transition into therapy and start getting restorative, restful sleep!

CPAP "Side-Effect" #1: CPAP isn't sexy

"CPAP isn't sexy. "

"CPAP is sexier than a heart attack."

Untreated sleep apnea increases your risk for heart attack by 30%. Regardless of diet, exercise, and medication, a heavy snorer with sleep apnea has a one-third or higher risk for a heart attack. Heart attacks aren't fun, and they certainly aren't sexy.

CPAP attractiveness is a concern for some patients. We understand you want to look good when you sleep, and CPAP mask interfaces exist as small as 1.94 ounces. However, when a sleep apnea patient sleeps, his or her airway collapses, resulting in repeated snoring, choking, gasping, and drooling. This isn't attractive. This is decidedly the opposite of attractive.

If you feel silly wearing the mask, consider what you look like in your sleep when you're snorting, twitching, and flailing from suffocation. Juxtapose this with the relative serenity of a quietly immobile, gently sleeping patient who happens to have a small, 1.94 ounce nasal mask beneath his or her nose?

Consider also that treating sleep apnea with CPAP has been shown to improve sex.

From Psychology Today:

Researchers at Walter Reed National Military Medical Center have found that regular CPAP use can improve both sexual function and sexual desire among men with obstructive sleep apnea. Their study examined erectile function and libido among 92 men who’d recently been diagnosed with sleep apnea and were using CPAP therapy. All the men were under the age of 60—their average age was 45—and none were diabetic. Researchers, testing the men at the outset of the study, found that nearly 50% of the 92 participants were suffering from some degree of erectile dysfunction. This is not surprising—we know (link is external) that men with sleep apnea are also significantly more likely to suffer from ED than men without sleep apnea.

Researchers evaluated the men at 1, 3, and 6 months after beginning CPAP therapy. They found that all the men experienced improvement in both erectile function and libido as CPAP treatment progressed. The men who had been diagnosed with erectile dysfunction at the beginning of the study experienced the most significant improvement to their sexual function and desire. But even the men without ED saw improvements to their libido and sexual function after using the CPAP to treat their sleep apnea.

CPAP "Side-Effect" #2: I look dumb wearing that mask

"How do I sleep next to my girlfriend wearing that?!"

"How does your girlfriend sleep next to YOU sounding like that?"

Untreated moderate to severe sleep apnea patients have a four (4) times greater risk for a stroke. CPAP masks may make it difficult to talk, but strokes make it harder.

Sleep apnea is a loud, disruptive sleep disorder. Spouses and bed partners rarely sleep fully or comfortably next to an untreated sleep apnea sufferer. CPAP Therapy treats sleep apnea and snoring, resulting in a quieter bedroom environment--whisper quiet, in fact. There should be no significant noise, vibration, or disturbance coming from the CPAP equipment or mask. Juxtapose this relative silence with an untreated sleep apnea patient who is choking, gasping, twitching, or flailing around in their sleep each night.

Trust us when we tell you that your bed partner will be happy for the silence. And if your bed partner loves you, then he or she will be happy you're not dying in your sleep.

If you need to take a selfie each night before bed, then take the selfie, put your mask on, and get some restful, restorative sleep.  You'd be surprised how much better those selfies will look when you don't have bags under your eyes from poor, fragmented sleep.

CPAP "Side-Effect" #3: CPAP takes up room on my nightstand

"I don't have room on my nightstand for my CPAP."

"Your iPhone's feelings won't be hurt if you leave it on the dresser."

CPAP Therapy devices are small, quiet, and unobtrusive. CPAP takes up a lot less room than your laptop, smart phone, and tablets stacked atop each other with multiple chords jammed into a power strip competing for recharge power. 

We know getting that Facebook status update at 3:46 AM from your friend in New Jersey who can't sleep and is binge-watching Netflix is super important. But ... may we suggest that humans have survived (and in fact thrived) for thousands of years without waking up every thirty minutes to check if their Instagram of their dinner got Liked?

We live on our phones. And if insomnia is a problem, we would suggest sleep hygiene practices that including turning those phones off at night. But CPAP Therapy equipment is small and doesn't take up much room. In fact, we would suggest that your bedroom environment should promote restful, restorative sleep instead of encouraging fragmented, disrupted sleep. 

Common CPAP side-effects like first-week nasal irritation or dryness are easily resolved with correct humidification and clean therapy equipment. Technology has sufficiently advanced to offer sleep apnea and snoring sufferers with small, lightweight, and whisper-quiet CPAP therapy and treatment options. Working with experienced sleep clinicians at SleepSomatics can provide you with effective treatment so you and your spouse can return to having quiet, restorative sleep ... the kind of restorative sleep that will make those selfies just shine the next day.

If you have sleep apnea, identifying the correct treatment begins with accredited sleep testing at SleepSomatics. If CPAP or Bi-PAP (Bi-Level) Therapy is recommended, our sleep clinicians excel at supporting your initial PAP acclimation period. Getting a better night's sleep starts with a single phone call to SleepSomatics. Our excellent patient reviews attest to the sleep treatment services provided at SleepSomatics.

Concerned you aren't getting enough sleep? If you or someone you care about snores or is tired and fatigued during the day, sleep-disordered breathing (and sleep apnea) may be a serious risk. Get your sleep tested today by SleepSomatics, a professionally credentialed and accredited sleep test center located in Austin since 1999. Call 512.323.9253.

For more information on CPAP Therapy for patients being treated for sleep apnea and snoring, read this SleepSomatics article's sources:

American Academy of Sleep Medicine. "Study links severe sleep apnea to increased risk of stroke, cancer and death"

CNN. "Snoring, sleep problems may signal heart risk"

Daily Mail UK. "Men who snore 'are twice as likely to die early': But is noisy sleep a sign of poor health or the cause?"

NBC News. "Not-so-sexy CPAP can boost men's sex lives, study finds"

Science News. "American Thoracic Society - Sleep Apnea Increases Risk Of Heart Attack Or Death By 30 Percent"

This blog article's thumbnail image credit goes to: CPAP Times.


SleepSomatics Diagnostic Center is a credentialed and accredited sleep center serving Austin and Central Texas since 1999. We provide sleep diagnostic and therapy services including In-Lab Sleep Study, Take-Home Sleep Test, and Sleep Therapy. We gladly accept most insurances and provide you with a written quote of any costs. Questions? Get answers. Let's talk. Call us. We're ready when you are. Call SleepSomatics at (512) 323-9253.