The Continuous Positive Airway Pressure (CPAP) machine is the standard treatment for obstructive sleep apnea, delivering pressurized air to keep the airway open during sleep. While effective, many users report waking up with a sore or dry throat. This common side effect is typically manageable and can be resolved by identifying the root cause and making simple adjustments to the equipment or routine. Addressing this discomfort is important for maintaining consistent adherence to the treatment.
Why CPAP Leads to Throat Irritation
The primary cause of a sore throat from CPAP is the drying effect the continuous stream of air has on the mucosal membranes of the mouth and throat. Airflow that is not adequately moistened strips away natural lubrication, leading to irritation and a scratchy sensation upon waking. Inadequate humidification exacerbates this issue, especially if the air delivered is too cold or too dry. If the CPAP water chamber runs dry overnight, the resulting blast of unhumidified air can severely irritate the airways.
Air leaks from the mask are a major mechanical contributor to dryness. If the mask is poorly fitted or shifts during sleep, pressurized air escapes, compromising therapy effectiveness and causing moisture loss. This is particularly problematic for individuals who breathe through their mouth while using a nasal mask. When the mouth falls open, the pressurized air bypasses the nasal passages and flows directly over the throat, accelerating the drying process.
The device’s pressure settings can also play a role in throat discomfort. Higher pressure settings deliver a stronger airflow, which intensifies the drying effect if not balanced with sufficient humidification. The constant pressure may also impede the natural flow of saliva, further contributing to oral dryness and subsequent throat soreness.
Equipment Adjustments to Stop the Sore Throat
Optimizing the machine’s humidification system is the most direct solution to prevent throat dryness. Most modern machines feature an integrated heated humidifier, and adjusting its settings to a higher level can mitigate irritation. Using a heated tube prevents the warm, moist air from cooling down as it travels to the mask. This avoids “rainout,” or condensation buildup, and ensures consistent moisture delivery.
The type and fit of the mask are influential factors. Individuals who routinely breathe through their mouth should consider switching from a nasal mask to a full-face mask, which covers both the nose and mouth. This ensures the pressurized air remains within the breathing circuit. For those who prefer a nasal mask but experience mouth leaks, a chin strap can be used to keep the jaw closed during sleep.
A proper seal is paramount. Users should regularly check their mask for signs of wear, such as degraded cushions or stretched headgear, which cause air leaks. An improperly fitted mask, whether too loose or overtightened, can distort the seal and cause air to escape. If the pressure setting is suspected to be the cause of discomfort, adjustments should only be made after consultation with a healthcare provider or sleep specialist.
User Actions and Maintenance for Relief
Maintaining meticulous hygiene of the CPAP equipment is a preventative measure against throat irritation. Regular cleaning of the mask, tubing, and water chamber prevents the buildup of bacteria, mold, or allergens that can cause inflammation. Using only distilled water in the humidifier is recommended to prevent mineral deposits from forming within the machine’s components.
Behavioral adjustments also support a comfortable therapy experience. Ensuring adequate hydration throughout the day helps the body maintain moisture in the mucosal tissues, making them less susceptible to the drying effects of the airflow. Underlying health conditions, such as chronic nasal congestion or allergies, should be addressed, as they can force mouth breathing and exacerbate dryness. A saline nasal spray can be used before bed to moisturize the nasal passages and encourage nasal breathing.