No change despite sleep apnea treatment?

Sleep apnea is a breathing disorder that disrupts sleep quality and, with time, overall health. There are three types, the most common being obstructive sleep apnea, where the airways temporarily block during the night, preventing normal airflow. These pauses cause repeated micro-awakenings, fragmented sleep and persistent fatigue upon waking.

To correct these symptoms and regain restorative sleep, several treatments are available, the most common being the use of a continuous positive airway pressure (CPAP) machine. This machine keeps your airways open throughout the night, preventing apnea episodes and allowing you to breathe freely.

Most patients notice significant improvement within the first few nights, experiencing deeper sleep, fewer awakenings and gradually reduced daytime sleepiness.

However, even with regular use, the treatment plan sometimes doesn’t produce the expected results. If you continue to experience fatigue or apnea symptoms, adjustments may be necessary.

In this article, our respiratory therapists explain what to do if your CPAP machine doesn’t seem to be working and how to adjust your treatment to improve comfort and therapy effectiveness.

I’ve been using my CPAP machine. Why am I still tired?

Fatigue may persist even with regular CPAP machine use. This doesn’t necessarily mean the treatment is ineffective, but that further adjustment or follow-up may be needed.

If you continue to feel fatigued despite using your CPAP machine, we recommend consulting a respiratory therapist.

Incorrect CPAP machine settings

Incorrect settings, especially when starting treatment with a CPAP machine, can lead to ineffective therapy. It is crucial to ensure all features are working correctly to minimize errors. Factors to consider include the following:

• Incorrect air pressure: Improper air pressure can compromise the effectiveness of your treatment. If the pressure is too low, it won’t keep your airways open, leading to apnea and micro-awakenings. If it’s too high, it can cause frequent awakenings and discomfort.
• Ill-fitting or uncomfortable mask: A poorly fitting mask can cause air leaks, irritation or discomfort, making treatment less effective. To sleep well with your mask, certain precautions are essential. You’ll need to choose a mask that fits your face and try different models to find the right one. Ensure the mask is snug but not too tight, and that the edges do not let any air out. Regularly check the mask’s condition for wear or deformation, which could compromise its effectiveness.
• Weight gain or health changes: Some factors, like weight gain or changes in your health, may be beyond your control but can directly impact your CPAP machine’s effectiveness. For example, weight gain can reduce space in your airways, making treatment less effective.
• Inappropriate sleep habits: Less than optimal sleep habits can also affect your treatment. For instance, sleeping on your back can promote apnea, even when using a CPAP machine. External factors like a noisy environment or too much light can also disrupt sleep quality. While these things aren’t always controllable, we recommend creating the best sleep environment possible to improve treatment effectiveness.

You should consult a healthcare professional to adjust pressure according to your needs. An auto-adjusting CPAP machine (APAP) may be a good solution.

H3: CPAP machine wear or poor condition

CPAP machines, like all medical equipment, have a limited lifespan. Over time, components wear and must be replaced to maintain effectiveness.

Depending on how often you use your equipment and how you care for it, its lifespan may vary, but here are some manufacturer estimates:

• CPAP machine lifespan: 5 to 7 years
• Sleep apnea mask lifespan : 6 months to 1 year
• Air filter lifespan: 1 to 3 months
• Tubing lifespan: 3 to 6 months
• Humidifier lifespan: 6 months

If your machine or certain components begin to lose effectiveness, this may explain why your treatment is working less well than initially.

Proper maintenance of your CPAP machine and accessories is essential for optimal performance and long-term effectiveness. If you’d like to know more, check out our comprehensive guide on cleaning your CPAP machine step by step.

H3: Side effects of sleep apnea treatment

CPAP machine use can cause a number of side effects, but these can usually be mitigated by properly adjusting the machine and adopting certain habits.

Some users mention having trouble sleeping well with a sleep apnea mask due to discomfort.

An initial adjustment period is normal, but persistent issues may indicate a poorly fitted mask causing pressure on the face and leading to pain or skin irritation, or even air leaks that make treatment less effective.

Another common side effect is dryness in the nose or mouth. The air from a CPAP machine can dry out the mucous membranes, particularly if you are using a nasal mask and tend to breathe through your mouth during the night. This can cause discomfort and irritation and lead to awakenings. Adding a humidifier to your machine can help a lot by keeping humidity at the right level. Humidification helps reduce dryness in both the nose and mouth, for more comfortable breathing and more restorative sleep.

Lastly, many CPAP users experience frequent awakenings. This issue can be caused by air leaks or the need for adjustments to improve comfort. Awakenings can disrupt overall sleep quality, reducing the benefits of CPAP treatment. To avoid this, you should regularly check the fit of your mask and the air pressure, and make any necessary adjustments to minimize interruptions to your sleep.