Common problems with PAP, and possible solutions

     
   Problem    Possible cause

    Solution
Mask leaks Strap adjustment too loose or too tight Readjust headgear straps. The mask should be as loose as possible while still creating a seal. Fit mask with air turned on.
Skin irritation Incorrect mask size Consult respiratory therapist for a mask fitting. Nasal pillows or full-face mask may provide a better fit.
Pressure sores or blisters Worn-out mask

Dirty mask		 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 he considered.
Add heated humidification.
Sore, dry, irritated or swollen eyes; conjunctivitis Mask leaks, Mask too tight Try resealing 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 Pressure requirement may be lower at beginning of sleep period Try pressure ramp at beginning of sleep period.
Aerophagia   Reduce pressure with bilevel positive airway pressure.
Sinus discomfort Initial adjustment period Try to reduce pressure requirement by using oral appliance and PAP (no data available).
Difficulty exhaling Blocked air intake Check if air filter is clean and not blocked by outside items.
PAP unit too noisy Too close to sleeping area 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 (A.W.A.K.E. Network of the American Sleep Apnea Association).