Should You Use a CPAP With a Stuffy Nose?

A stuffy nose can make using your CPAP machine more challenging, but it’s possible and might even help ease congestion. With a few adjustments like using a humidifier, taking over-the-counter medications, and keeping your machine clean, you can breathe easier and maintain your sleep apnea therapy.

Does CPAP Help or Hinder Nasal Congestion?

CPAP machines provide a pressurized stream of air to prevent airway obstruction in your lungs.

However, CPAP may be less effective if you have a respiratory illness that makes breathing difficult. Conditions like the common cold or flu can lead to a congested and runny nose, complicating CPAP use, especially with a nasal mask.

Mucus discharge can contaminate the CPAP mask, especially if you use nasal pillows. Studies suggest a risk of secondary infection if bacteria grow on a contaminated mask.

Airflow might also irritate a sore throat and cause coughing. When you cough, opening your mouth may make the pressure more uncomfortable.

Is It Okay to Temporarily Stop Using Your CPAP?

It’s usually okay to take a short break from using your CPAP if you have a cold or stuffy nose. There are typically no major side effects from stopping suddenly. However, for your safety, it’s a good idea to talk with your healthcare provider first if you plan to not use your machine, even for a couple of nights.

You might still experience some benefits from the treatment, even several days after stopping, because it takes time for the swelling in your airways to return.

Consider pausing CPAP use for reasons such as:

• Ear pressure
• Ear pain
• Persistent nasal congestion
• Runny nose
• Nosebleeds
• Sore throat
• Coughing
• Shortness of breath
• Nausea and vomiting

Ear Infections

People often worry that frequent ear infections may be worsened by CPAP use. CPAP air pressure doesn’t move from the throat to the inner ear through the Eustachian tube.

You might notice minor pressure changes, but mucus isn’t usually forced into these tubes where it can worsen ear infections.

If you decide that your symptoms require a break from CPAP use, this is OK. Try to get back to treatment soon as you recover from the cold.

Managing a Stuffy Nose While Using CPAP

If you choose to continue using your CPAP while you have a stuffy nose, consider treatments that can make it more comfortable.

Many people prefer using CPAP during a cold, as heated and humidified air can provide relief, especially when there’s minimal nasal discharge.

The pressurized air can help clear mucus and reduce congestion, making it easier to breathe after a few minutes. Decongestants and cold and flu remedies can also ease symptoms while using CPAP.

Saline Spray or Rinse

Saline spray is inexpensive and effective. Use it as needed to moisten the nose lining. Consider rinsing nasal sinuses with a neti pot during a cold.

Nasal Decongestants​

Afrin (oxymetazoline) spray spray can relieve symptoms but avoid frequent use to prevent rebound congestion. Prescription nasal steroid sprays such as Flonase, Nasacort, Rhinocort, Nasonex, and Astelin may help with chronic congestion from allergies.

Cold and Flu Medications

Consider the use of medications that target cold and flu symptoms. In particular, antihistamines like Benadryl (diphenhydramine) may provide relief and improve sleep.

Mucinex (guaifenesin) might thin mucus, making it easier to clear. For coughs, consider using cough syrup or throat lozenges for additional relief.

Heated Humidifier and Tubing

Use the CPAP humidifier when you have a cold or nasal congestion to reduce irritation and inflammation. Studies show that a heated humidifier can lower the risk of infections and shorten their duration. Opt for heated tubing to minimize condensation and bacteria build-up.

Full-Face Mask

Sometimes, you can’t use a nasal mask due to congestion or a deviated nasal septum. In these cases, consider using a full-face mask.

A full-face mask allows breathing to occur via either the nose or mouth. In some cases, the full-face mask can be used temporarily. As nasal breathing improves, it is possible to switch back to a nasal or nasal pillow mask.

Positional Therapy

To improve breathing during sleep, try lying on your side or stomach. You can also raise your head using a wedge pillow or a few stacked pillows for more comfort, even without CPAP.

Pressure Changes or Auto-CPAP

When the nose is more obstructed, additional CPAP pressure may be required. This airflow may open things up. Consider reaching out to your healthcare provider to have the pressure adjusted, if needed.

Auto-CPAP therapy, in which a range of pressures can be delivered, may also be a helpful option. Unfortunately, CPAP devices are typically only replaced every five years by insurance, so you may have to wait to get one.

Keeping Your CPAP Machine Germ-Free

During and after your cold, it is important to be diligent about cleaning the CPAP mask, tubing, and humidifier tank:

1. Give everything a thorough cleaning with dish soap and hot water.
2. Let the mask, tubing, and humidifier sit in a sink of soapy water for 20 to 30 minutes.
3. Rinse the equipment with water until the soap is thoroughly removed.
4. Let it hang to air dry.
5. Replace the filter on the machine.​

You don’t have to worry about reinfecting yourself with a cold or flu virus when using CPAP; the chance of reinfection is unlikely. In most cases, it’s unnecessary to use a CPAP sanitizer (such as the SoClean device, which retails for $299). 

With that said, unsanitized CPAP equipment can cause infections unrelated to a cold or flu. This is especially true with respect to bacterial infections like acute bacterial rhinosinusitis or bacterial pneumonia, particularly in people with compromised immune systems.