Continuous positive airway pressure therapy (CPAP) is one of the most effective tools for treating obstructive sleep apnea (OSA). This disorder occurs when the airway is repeatedly blocked or narrowed during sleep, resulting in the cessation of breathing. CPAP helps to keep the airway open by delivering a constant stream of air via a mask, but it is not without potential drawbacks.
CPAP therapy is not a silver bullet solution for everyone with mild to severe sleep apnea. Although CPAP has proven to be effective in most users, not every patient responds well to therapy. A large portion of CPAP users will experience difficulty tolerating the mask and the associated noise. Studies show that as many as one in three people who start CPAP therapy discontinue treatment within the first three months because of these issues.
In addition to potential issues with user tolerance, there are also downsides to long-term CPAP use that don’t receive as much attention. Excessive dry mouth and airway congestion are two of the most common complaints among CPAP users. Dry mouth can be extremely uncomfortable, and it can lead to an increased risk of infection in the mouth and throat. Airway congestion is another concern, particularly for users with allergies or asthma. CPAP systems can introduce air that is too dry or too cold, causing the airway to constrict and exacerbating breathing difficulties.
CPAP and Sleep Disruption
CPAP use can also lead to sleep disruption. Symptoms associated with increased sleep disruption include impaired memory and problem solving, increased irritability, and depressed mood. These symptoms can impair quality of life and may contribute to the overall reduction in life expectancy for people with sleep apnea. In one study, researchers found that CPAP users experienced interrupted sleep more frequently than non-users. One of the reasons cited for this is the noise and vibration emanating from the device, which can be a particular nuisance to the user as well as his or her bed partner.
Negative Effect on Health
In addition to these short-term issues, long-term CPAP use may also have negative health implications. One study that looked at data from over 100,000 users found an increased risk of pneumonia among CPAP users. The researchers hypothesized that the combination of prolonged mask use and the constant introduction of dry air can lead to impaired mucociliary function of the respiratory tract, making users more susceptible to bacterial infection.
Strategies for Reducing Potential Risks
Given the potential drawbacks of CPAP therapy, it is important for users to take steps to reduce potential risks. One of the most important things a user can do is to keep the device clean. The mask, tubing, and humidifier need to be cleaned on a regular basis in order to prevent the growth of bacteria and mold, which can exacerbate respiratory symptoms. Additionally, the temperature of the air being delivered through the mask should be set at the proper level in order to help prevent congestion. Users also need to be mindful of any new symptoms that develop. If users find that they are experiencing increased dry mouth, airway congestion, sleep disruption, or other symptoms, it is important for users to talk to their healthcare providers about these issues.
Closing Thoughts
CPAP therapy is a highly effective treatment for people with obstructive sleep apnea, but it is not without potential pitfalls. A large portion of users will experience difficulty tolerating the mask and the noise associated with the device. Additionally, long-term CPAP use may lead to airway congestion, increased sleep disruption, and an increased risk of pneumonia. It is important for users to take steps to reduce potential risks, such as keeping the device clean and setting the temperature of the air being delivered through the mask to the proper level. If users experience new symptoms that could be related to their CPAP use, it is important for users to talk to their healthcare providers about these issues.
