Sleeping With a CPAP Machine for Sleep Apnea

With sleep apnea, your breathing stops and starts while sleeping. But a CPAP machine can help.

Woman with sleep apnea machine

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Sleep can do many things. Beyond decreasing your undereye circles, sleep helps improves your physical and mental health and helps you live a long, healthy life. 

So, if you have restless or disturbed sleep patterns due to sleep apnea, you could be damaging your health in more ways than just waking up groggy. Sleep apnea is a serious condition where your breathing stops and starts while sleeping. 

If you have sleep apnea, Health spoke to David Rapoport, MD, director of the sleep medicine research program at Mount Sinai, to find out what you should know about using a continuous positive airway pressure (CPAP) machine.

What Is Sleep Apena?

Sleep apnea is a disorder that causes abnormal breathing patterns while sleeping. Common symptoms include:

  • Gasping or snoring while sleeping
  • Waking up during the night
  • Waking up tired the next morning

Additionally, there are three primary types of sleep apnea, which include:

  • Obstructive sleep apnea: This is the most common type of sleep apnea. The airway is blocked, and airflow is stopped or reduced.
  • Central sleep apnea: This is a disruption in the signals from your brain to your breathing muscles.
  • Complex syndrome: This involves both obstructive and central sleep apnea.

Risk factors that raise your risk of sleep apnea include being overweight and having heart or kidney disease, a genetic disability, or large tonsils. Healthcare providers usually diagnose sleep apnea using a sleep study and by measuring your oxygen blood levels.

Should You Use a CPAP Machine Every Night?

Some evidence suggests that obstructive sleep apnea returns when you remove your CPAP mask. While you may be able to get away with one or two nights without the machine, the symptoms will eventually come back. So, if you don't wear the mask, you will have sleep apnea episodes.

What Lifestyle Changes Help Sleep Apnea?

There is no cure for sleep apnea. But people with sleep apnea can make lifestyle changes to decrease their symptoms. 

Losing Weight

Some evidence suggests that sleep apnea is associated with a person's weight. Losing weight may reduce sleep apnea symptoms in overweight people, especially those with mild cases of sleep apnea. In some cases, the symptoms may completely disappear.

But reducing sleep apnea symptoms is not necessarily about returning to healthy body weight. You may notice significant improvements in your symptoms after losing some weight. While complete improvement is rare, losing weight may be worth trying.

Sleeping On Your Side

Sleep apnea tends to be worse when sleeping on your back. Gravity increases the likelihood that your tongue falls back over the airway. Your airway muscles and other tissues may collapse and block the airway. Therefore, sleeping on your side may reduce the frequency of sleep apnea.

Exercise the Upper Airways

Upper airway muscle function plays a major role in maintaining the upper airway, especially during sleep. In a study published in 2017 in the Egyptian Journal of Chest Diseases and Tuberculosis, researchers noted that three months of upper airway exercises easily and non-invasively treat sleep apnea.

Is It Safe To Take Sleeping Pills With Sleep Apnea?

If you're using a CPAP machine, taking a mild sleeping pill to deal with mask discomfort and help you fall asleep is safe, as long as you keep the mask on.

However, if you remove the mask—say, you get up in the middle of the night and inadvertently forget to put the mask back on—your sleep apnea will worsen.

Why Does Sleep Apnea Cause Dry Mouth?

A dry mouth is one of the most common complications of CPAP use. Usually, air leakage out of the mouth causes it to become dry.

However, there are two easy fixes. First, increase the humidity of your CPAP machine. Most CPAP machines have humidifiers with various levels, either built-in or sold separately. Second, you can use a chin strap to keep the mouth closed to prevent air from leaking.

Should You Use a CPAP Machine During a Cold?

If you can use a CPAP machine and breathe through your nose, the mask may help with cold symptoms. The heated, moist air, produced by an optional humidifier sold separately, is similar to vaporizers. 

But if your nose is completely blocked, the CPAP machine will not be able to work properly. Still, if you have a cold, you should use a CPAP machine, possibly with a decongestant medicine. The CPAP machine may be helpful despite nasal blockage. And if not, it's no worse than not wearing the mask at all.

Can Pillows Help With Sleep Apnea?

Many pillows advertised to treat sleep apnea encourage you to lie on your side rather than your back. While sleeping positing may improve your sleep apnea symptoms, those pillows are more effective for snoring than sleep apnea. 

However, those pillows work differently for each individual. As long as your mild sleep apnea doesn't require immediate attention, there's nothing wrong with trying it.

Are There Alternatives to CPAP Machines?

There are ways to make the CPAP machine more comfortable. First, make sure your mask fits correctly. Many types are available, and you'll want to ensure your mask properly fits your face.

Secondly, you must use to learn how to use your mask correctly. People often try to alleviate mask discomfort by tightening the device, which makes it worse. 

Similar machines, called bi-level positive airway pressure (BiPAP) and auto-titrating positive airway pressure (APAP) devices, might make the air flow more tolerable.

CPAP machines are one of the most effective treatments for sleep apnea. But some people cannot tolerate the device. If a person has tried using it and is at their absolute wit's end, there are other, less-reliable treatments, which include:

  • Surgical treatment: This involves removing tissue from the back of the throat with a cure rate of about 43%.
  • An oral breathing device: This helps keep the airway open. A healthcare provider may recommend the device for people with mild sleep apnea.
  • An implantable nerve stimulator: This device electrically stimulates the nerve that causes your tongue to move, reducing upper airway blocks. For example, in 2020, the Food and Drug Administration approved the Inspire Upper Airway Stimulation.

However, surgical treatments and oral breathing devices have low cure rates. And with both treatments, you have to pay for them before you find out if they work. But as researchers conduct more studies on sleep apnea, more treatment options may become available.

Is Sleep Apnea Hereditary?

If you have family members with sleep apnea, you may have a high risk of developing the condition. The same goes for those people with a family history of obesity. Obesity is a strong risk factor for sleep apnea. 

If you have a family history of either condition, maintaining a healthy weight can help prevent complications.

Will Losing Weight Cure Sleep Apnea?

Losing weight is one of the best sleep apnea treatments if you're overweight. And even if it doesn't improve your condition, you'll reap many other health benefits that make losing weight worth doing.

But taking into account your medical history is important. For example, suppose you previously didn't snore and didn't have sleep apnea. But later, you gain weight, snore, and develop sleep apnea. 

In that case, there's a high chance that losing weight will reduce your sleep apnea symptoms compared to someone who has snored their entire life. Also, people with a predisposition for sleep apnea may not be affected by weight loss.

Does Sleep Apnea Cause Fatigue?

Sleep apnea may cause fatigue because the condition often leaves people waking up tired. In fact, per one study published in 2021 in the Annals of the American Thoracic Society, many people with sleep apnea also have excessive daytime sleepiness (EDS). EDS can lead to other health complications, like impaired cognition and bad moods.

Can You Have Sleep Apnea Without Snoring?

Sleep apnea can occur in people who don't snore. But sleep apnea symptoms, like gasping for air, are also common with asthma, insomnia, or anxiety. Ultimately, having an overnight sleep study at a sleep center is the definitive way to diagnose sleep apnea.

Does Surgery Cure Sleep Apnea?

Surgery may reduce sleep apnea symptoms, but the cure rate is only about 43%. Most surgeries are relatively safe and benign procedures that you may consider if you don't want to use a CPAP machine.

But keep in mind that surgery is irreversible. In contrast, CPAP machines have few downsides or negative side effects. Always try a CPAP machine before using surgery as a last resort.

Are There Medications To Treat Sleep Apnea?

Before trying medications, check with your sleep specialist to ensure your CPAP machine is functioning properly. If you're using the mask correctly, your sleep should return to normal.

But if you're still sleepy during the day, some medications may help. For example, Provigil (modafinil) is a wakefulness-promoting drug similar to caffeine. However, medications should not be used as a substitute for a CPAP machine. Drugs can trick you into thinking you've been cured while your sleep apnea remains untreated.

How Is Sleep Apnea Diagnosed?

Unattended home sleep tests are available. Those tests involve using a portable-monitoring system you wear while sleeping in bed. 

The American Academy of Sleep Medicine (AASM) has strict guidelines regarding who should use home tests. The AASM recommends that if you have an unattended home sleep test, you only do so alongside seeing a certified sleep specialist. 

In contrast, an attended overnight sleep study is the standard testing method. During the study, healthcare providers can detect all levels of sleep apnea and many other sleep disorders. An unattended home sleep test cannot provide that information. 

Working with a sleep specialist at a clinic will also ensure that you receive detailed information about your sleep and an individualized treatment plan.

A Quick Review

Sleep apnea causes abnormal breathing patterns while sleeping. A CPAP machine is one of the best treatments for sleep apnea. 

There are surgical methods, medications, and devices to control sleep apnea. But those methods don't have as strong of results as the CPAP machine. For mild sleep apnea, pillows or changing your sleep position may help, too.

David Rapoport, MD, is the director of the Sleep Medicine Program at the NYU School of Medicine and director of research at the NYU Sleep Disorders Center at Bellevue Hospital. He is the founder and president of the Foundation for Research in Sleep Disorders and a editorial adviser.

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