This Is How You Stop CPAP Nose Irritation For Good

CPAP mask skin irritation was a big killjoy when I started using CPAP

After waiting for 3 months to receive the CPAP equipment from my medical equipment provider, I was super excited to finally try it out. That night, I set up my sleep apnea machine, fit my mask to prevent any leaks, and drifted into slumber. 

I’d been dreaming about the day when I could eliminate my sleep apnea once and for all, and the day was finally here where I could do that.

Except, it wasn’t.

The next morning, I woke up feeling noticeably better rested. Getting out of bed, I felt a burst of energy I hadn’t felt in a very long time. I was ready to do a million things and have the most productive day I’ve had in years.

I felt like a completely different man; until I looked in the mirror.

When I went to the bathroom for your usual morning routine, I glanced at the mirror to find the worst red spot on the bridge of my nose.

I hadn’t received any warnings from my doctors from this sort of thing and so I thought it must be part of the treatment. But I quickly realized I was wrong after the same thing happened the next morning after using CPAP.

Any skin bruising on the face is a big inconvenience. I looked like Rudolph the red nose reindeer (pic). The occasional itchiness throughout the day was another pain to deal with.

Thankfully, the days of CPAP induced nose bruising are long gone. I no longer wake up with any nose bruising.

Unlike before, no one can tell that I slept wearing a mask for 7 hours.

What Causes CPAP Mask Skin Irritation?

An important part of ending irritation from your CPAP mask is to understand what’s causing it. Irritation can be caused by any of the following:

1. Over-tightened mask.

An overtightened mask causes excessive pressure over your face

This is one of the most common causes of CPAP nose irritation. An over-tightened mask puts too much pressure on the face, especially on the nose bridge. It’s similar to tightly pressing a rubber band against your nose for a few minutes, except an over tightened mask stays on your face for about 7 hours straight per night.

2. Wrong Mask Size.

A mask that is too small adds more pressure against your face as it presses harder on your skin. A mask too big will force you to over-tighten it in order to prevent leaks, thus leading to nose irritation.

3. Mask Allergies.

Bacteria build up stimulates skin irritation

Nowadays, most CPAP masks are made from hypoallergenic materials. However, you can develop allergic reactions to just about anything over time. Though this is one of the more uncommon causes of CPAP skin irritation, it’s possible to have an allergic reaction to polymer that makes up the soft part of the mask. In these cases, you might see irritation around the area of the face that your mask presses against.

4. Dirty Mask.

Keep your equipment clean to prevent bacteria accumulation

If the soft cushion of the mask that presses against your skin is not cleaned regularly, bacteria can build up and causes irritation. The humidity and oils on the face stimulate bacteria growth and can cause serious irritation over time.

5. Old Equipment.

Cracks and other failures can start developing in your CPAP mask over time. Having a weathered CPAP mask or weathered soft cushion is setting yourself up for skin irritation. Check your mask cushion and shell for discoloration and signs that it’s time to replace your mask.

How to Stop CPAP Mask Skin Irritation for Good

On the long road to liberation from CPAP skin bruising, I picked up quite a few tricks that don’t involve compromising mask fit. The following are some of the best ways to end your skin irritation woes:

1. Wash your mask every night

It sounds tedious, but I’ve personally found that this makes a big difference.

I currently use a Resmed Airfit F20. Everything else being the same, when I don’t wash the mask I usually wake up the next day with temporary nose irritation. It generally goes away 5 minutes after I wash my face in the morning. This doesn’t happen when I do wash the mask prior to wearing it for the night.

I wash my CPAP masks by placing them in a bowl of hot water with a bit of detergent a waiting 5 minutes before rinsing it with cold water.

If you have a Dreamstation Respironics or System One sleep apnea machine and you don’t want to go through this cleaning process every night, you can check out SoClean for an automatic and clean way to wash your mask at night.  

2. Always wash your face before bedtime

This is my number one rule of CPAP.

As the day goes by, bacteria, dust, and other impurities build up on your skin. When combined, these particles can form a nasty recipe for skin irritation.

The problem doesn’t stop there, using your CPAP without washing your face also decreases the lifetime of your mask, causes mask leakage, and even itchiness throughout the night.

You can use your favorite face cleanser to wash your face every night. I personally use Noxzema Deep Cleansing Cream because it leaves my face clean and moisturized and has a soothing eucalyptus feel on the skin.

3. Make sure your mask is the right size

Having a wrong sized mask can be the easiest way to guarantee nose bruising. To make sure your mask is the right size, google “(CPAP mask name) sizing guide” without the parentheses. Select the corresponding sizing guide from the searches. Follow the instructions to check if your current mask size is right for you. This is what sizing guides usually look like:

Partial snippet of the Resmed Mirage Quattro mask sizing guide.

In the case that you have a mask that is too small or large, you can talk to your medical equipment provider to get a replacement. If you purchased the mask online, you might be eligible for a refund depending on your purchase date and where you bought it from.

4. You have the wrong mask

No CPAP mask will work for everyone, but there is a CPAP mask out there for each person.

In my case, I tried 4 different masks before finding the one that works best for me. The first CPAP mask I ever had, the Resmed Airfit F10, sealed well but left me with the worst nose bridge irritation I’ve ever had.

I tried a few other masks until I finally found one that fit me well without compromising the seal or causing skin irritation. Ultimately, you want a mask that fits you snug but doesn’t leave any bruising and is leak free.

This is the toughest part of coping with CPAP: finding the right mask that fits your face but doesn’t cause any bruising or leaks. It’s this process of trial and error that causes many people to give up on CPAP and become non-compliant.

5. Try using a mask liner

Mask liners are disposable thin pads that improve mask seal and act as a barrier between the face and skin. The purpose is twofold:

• Increase mask fit: Many people that use mask liners report that their CPAP mask fits better with the mask liner than without it.

• Prevent allergic reactions: Mask liners act as a barrier between the mask and the face which stops any allergic reactions you might be having to the masks soft cushion.

6. It might be time for a replacement

If your mask used to work well, but no matter what you try you can’t stop irritation, it might be time to get a replacement. As small cracks and other imperfections start appearing on the mask, they start affecting the mask’s ability to thwart bacteria build up.

If you received your current mask from a medical equipment provider, you can talk to them to get a replacement for your current mask.

Another option, and my personal preference, is to check out the different online stores that sell CPAP masks. Oftentimes these will actually have lower prices than medical equipment providers. (link)

What if these tips don’t work?

If no matter what you try, you can’t stop CPAP mask irritation, I encourage you to not give up. Many people, myself included, had to try out multiple things before finding one that works for your CPAP therapy needs.

There’s no doubt that this process can be challenging and very annoying. But one thing’s certain for everyone:

Treating sleep apnea and getting it under control is absolutely worth it

There’s not a day that goes by that I don’t feel the difference between having untreated and treated sleep apnea.

However, I’d be lying if I told you that CPAP is the best option for everyone. Depending on your needs, there might be other solutions that that work better for you. Rested Life has a comprehensive list of the most effective sleep apnea treatment options that don’t require a mask. 

If you have any tricks or other tips for stopping CPAP skin irritation problems, feel free to post them below. I’d love to hear about them.

Stay Rested

Juan