When you have obstructive sleep apnea (OSA), your doctor will recommend treatment with a device or oral appliance. Both options can take some getting used to, but when you use them right, they can keep your airways open at night so you can get restful, quality sleep.
As you begin wearing these treatments, you may have an adjustment period with some discomfort. It’s important to learn what you can work on to make things easier, and what’s abnormal.
Wearing a Mask
The most common treatment for OSA a is a device called a continuous positive airway pressure (CPAP) machine. You might use a bilevel positive airway pressure (BiPAP or BPAP) machine, or auto-titrating positive airway pressure (APAP) machine instead.
All three options involve wearing a mask or other device that fits over your nose or your nose and mouth together. There are also usually straps that position the mask, and a tube connected to the machine’s motor. The motor blows air into the tube.
Getting Used to the Feel
It will probably be an adjustment learning how to sleep comfortably with a CPAP on your face. You can ease into it by wearing your device during the day for short periods of time – like while you’re watching TV. Start by wearing it turned off, and then practice
wearing it while the machine is running. The sooner you start wearing it to sleep, the faster you’ll get used to it. You should get to a point where you can wear the CPAP comfortably every time you sleep, even during naps.
You may also need some time to learn to tolerate forced air. Some machines come with a “ramp” feature that starts with low pressure and slowly moves up to higher air pressure as you fall asleep. You may find it most comfortable to use a BiPAP, since it gives you high-pressure air only as you breathe in and lowers it as you breathe out.
Some people report feeling claustrophobic (like you’re uncomfortably confined in a small space) when they wear their CPAP masks. Wearing your mask some during the day may help your body get used to the feeling. You can also practice relaxation techniques after you put it on that can ease anxiety.
Getting the Right Fit
There are various types of masks and devices that can deliver the air to your airways. If the type you have continues to bother you even after you’ve worn it for a while, talk to your doctor about trying one that fits differently.
- Nasal pillow masks fit in your nostrils only and sit slightly below the nose.
- Nasal masks fit over your nose only.
- Full face masks cover your nose and mouth.
- Oral masks cover only your mouth.
Keep in mind that you’ll also need to consider things such as how often you move around in your sleep, whether you have facial hair, and what type of air pressure you need to help you choose the right mask.
No matter which type of mask you choose, make sure the sizing is also correct. Your straps will make some adjustment possible, but check with your doctor that you’re using the correct size to fit your face comfortably.
In addition to letting the air you need leak out, a mask that doesn’t fit well can point air toward your eyes, drying them out. Your nose may also get dried out, and your skin may get irritated. Your priority should be getting a mask that fits well, but you can try petroleum jelly on your skin and saline spray for your nose to help with dryness in the meantime.
CPAP Noise
Newer models of CPAP machines are very quiet, but some can make a noise that might bother you. Be sure your hose, mask, and filter are all clean to help it run most efficiently. You may also be able to get extra-long tubing so that you can place the part with the motor farther away from you at night. Earplugs can also block out the sound.
Oral Appliances
The two types of oral appliances that treat OSA are mandibular advancement devices (MADs) and tongue-retaining devices (TRDs). MADs push your jaw forward to create more room for your airway, while TRDs support or stabilize your tongue so it stays out of the way for you to breathe.
When you wear these appliances, you may have:
- Bite changes
- Pain in your jaw, teeth, or temporomandibular joint (TMJ)
- Drooling
- Mouth dryness
You may also notice some of your teeth become looser.
These side effects tend to be temporary and should improve after a few weeks of wearing the appliance. If you continue to deal with them past that point, talk to your doctor.
You shouldn’t use an oral appliance if you:
- Are missing teeth that hold it in place
- Have a disease of your jaw joint or can’t move it
- Have periodontal disease or a gum infection
- Wear teeth realignment devices such as braces or retainers
When to Call the Doctor
It’s common to have some side effects such as minor skin irritation, headaches, nasal congestion, or stomach bloating when you start CPAP therapy. But call your doctor if you:
- Continue to wake up and find the mask off
- Get sores because of your mask
- Aren’t seeing your OSA symptoms improve
Show Sources
Photo Credit: Jean Paul Chassenet/Dreamstime
SOURCES:
Sleep Foundation: “Obstructive Sleep Apnea.”
National Heart, Lung, and Blood Institute: “CPAP.”
Mayo Clinic: “CPAP machines: Tips for avoiding 10 common problems,” “Which CPAP masks are best for you?”
Stanford Medicine: “Oral Appliance Devices,” “Side Effects of PAP Therapy.”
Cleveland Clinic: “Oral Appliance Therapy for Obstructive Sleep Apnea.”
Sleepapnea.org: “Sleep Apnea Mouth Guard.”
