# CPAP Troubleshooting: 12 Common Fixes Diagnose CPAP side effects. Fix dry mouth, aerophagia, mask leaks, claustrophobia, and nasal congestion with a free symptom-based tool. Source: https://cpapclarity.com/learn/cpap-troubleshooting-guide Published: 2026-04-08 Updated: 2026-04-08 Author: Brian C. Informational, not medical advice. Talk to your sleep physician before changing your therapy, pressure, mask, or medications. Most people who quit CPAP therapy don't quit because the diagnosis was wrong. They quit because a fixable side effect turned every night into a small war, and nobody explained the fix. Dry mouth, stomach bloating, a leaky seal that wakes you up at 3am: these are all solvable problems with known fixes, and you don't need to be a sleep doctor to work through them. If you'd rather have the tool walk you through it, use the [**CPAP Troubleshooter**](https://cpapclarity.com/tools/cpap-troubleshooter) to pick your symptoms and get a ranked list of fixes. Otherwise, this guide covers the 12 most common CPAP problems and what resolves each of them, from the cheapest fix to the "call your doctor" last resort. ## 1. Dry mouth or throat This is the #1 complaint and usually the easiest fix. Dry mouth happens when air escapes through your mouth at night: either because you sleep with your mouth open, or because your mask leaks around the seal. **The fix, in order:** 1. **Turn up the humidifier.** Most machines ship with humidity set to 3 or 4 out of 8. Crank it to 5 or 6. If your climate is very dry (desert, winter in a heated house) go to 7. Make sure you have a fresh humidifier chamber and clean it weekly. 2. **Try a chin strap.** If you're a mouth breather, no amount of humidity will save you; the air escapes faster than your mouth can stay wet. A basic chin strap is inexpensive and is the single most effective fix for mouth-breathing-induced dry mouth. 3. **Switch to a full face mask.** If a chin strap doesn't work or is uncomfortable, a full face mask seals over your mouth and nose, which eliminates the problem entirely. ## 2. Bloated stomach (aerophagia) Aerophagia is swallowing air during therapy. You wake up bloated, burping, or with gas that wasn't there before CPAP. Pressure is often part of the picture: when the air arriving is more than your breathing needs in that moment, some of it can go down your esophagus instead of into your lungs. **The fix:** 1. **Talk to your provider about your EPR setting.** Expiratory Pressure Relief changes the pressure you breathe against when you exhale. Its effect on air swallowing varies from person to person, so adjusting it is a change to make with your sleep doctor rather than on your own. Our guide to [CPAP aerophagia](https://cpapclarity.com/learn/cpap-aerophagia) walks through reading your own data for the cause. 2. **Ask your sleep doctor to review your pressure.** If the bloating continues, your sleep doctor can check whether your prescribed pressure or range suits you, for example with a titration review. Don't change pressure yourself. It is a prescription setting, and changing it can leave your airway undertreated. 3. **Sleep on your side.** Side sleeping reduces the amount of air swallowed because your airway stays more open, so you need less CPAP pressure to achieve the same result. ## 3. Mask leaks at the top (air blowing into your eyes) This is always a fit problem, and it almost always starts with an old cushion. **The fix, in order:** 1. **Check the cushion age.** Silicone cushions harden after 4-6 weeks of nightly use. A hardened cushion can't form a seal at the top of your nose, so air blows upward. Replace with a fresh OEM cushion. They're cheap and make a bigger difference than you'd expect. 2. **Tighten the bottom straps, not the top.** Most people tighten the top straps when they get a leak, which just makes it worse. Loosen the top, tighten the bottom, and let the cushion seat itself under the pressure. 3. **Switch to a nasal pillow mask.** If you've been fighting leaks for months, the mask type is probably wrong for your face shape. A nasal pillow mask has almost no top-seal area and is much easier to fit. ## 4. Mask leaks at the side Side leaks are usually a jaw problem: your mouth falls open at night, which drops your jaw and breaks the side seal. **The fix:** 1. **Try a chin strap.** Same one mentioned above: inexpensive and it fixes side leaks in most users. 2. **Replace the cushion.** As with top leaks, an old cushion is the first thing to rule out. 3. **Switch to a full face mask** if the chin strap is uncomfortable. Full face masks are designed for mouth breathers and handle jaw drop without losing the seal. ## 5. Nose stuffiness or congestion CPAP dries out your nasal passages, which triggers a rebound inflammation that presents as stuffiness. This is basically a mild nasal irritation, not an allergy. **The fix:** 1. **Turn up the humidifier** and use a heated tube if you have one. The heated tube prevents "rainout" (condensation in the hose) and keeps air moist all the way to your nose. 2. **Saline spray at bedtime.** Over-the-counter saline spray before you put the mask on reduces rebound inflammation within a week. 3. **Ask about nasal steroids.** If humidifier + saline don't fix it within two weeks, a course of nasal steroid from your doctor is the next step. This is common enough that most sleep doctors prescribe it without a separate visit. ## 6. Sore spot on nose bridge Red mark, soreness, or skin breakdown where the mask sits on your nose bridge. This is a pressure-point problem and it gets worse the longer you ignore it. **The fix:** 1. **Loosen the top straps.** Most users over-tighten to prevent leaks. Back off until the mask barely stays on your face, then see if the leak is actually a problem or if you were fighting a ghost. 2. **Switch to a nasal pillow mask.** Nasal pillows don't touch the nose bridge at all. Problem solved in one swap. 3. **Nose bridge pads.** If you can't switch masks, gel pads or cloth pads protect the skin while you figure out the longer-term fix. ## 7. Claustrophobia / mask anxiety The mask feels suffocating. You wake up tearing it off, or you can't even get to sleep with it on. This is common in the first few weeks, and for many people it eases as the mask becomes familiar. **The fix:** 1. **Check your ramp comfort setting.** Ramp starts therapy at a gentle starting pressure and builds up to your prescribed level, so you can fall asleep first. Your provider or equipment supplier can show you how yours is set and whether a different ramp time is right for you. 2. **Wear the mask daytime.** Put the mask on while watching TV or reading for 30 minutes a day for a week. This decouples the mask from the anxiety of trying to sleep. 3. **Consider a nasal pillow mask.** Pillows touch less of your face, and many people who feel closed in by a nasal or full-face mask find them easier to wear. 4. **Read the [CPAP adjustment period guide](https://cpapclarity.com/learn/cpap-adjustment-period)** for more on getting used to the mask, including short daytime practice sessions. ## 8. Mouth breathing Your mouth falls open and pressure escapes through it. Same root cause as dry mouth, but worth calling out separately because the fix is identical. **The fix:** 1. **Chin strap.** Inexpensive, and many people on a nasal mask find it helps. Only use one if you can breathe easily through your nose. 2. **Full face mask.** If the chin strap is uncomfortable, switch to a mask that covers your mouth. 3. **Mouth tape.** This is a last-resort option: discuss with a doctor first to make sure you don't have a nasal obstruction that would make taping dangerous. ## 9. Noisy machine or mask Modern CPAPs are quiet: the AirSense 11 runs around 27 dB. If yours is noticeably loud, the problem is usually an aging machine, a leaking connection, or a worn-out mask diffuser. **The fix:** 1. **Check every connection.** Pull the hose off the mask and off the machine, inspect both ends for cracks or deformation, and reseat them firmly. 2. **Replace the mask diffuser.** The diffuser is the little mesh piece where exhaled air vents out. When it clogs or tears, the mask gets loud. A replacement diffuser is cheap. 3. **Consider a quieter machine.** If your machine is more than 5 years old, a refurbished AirSense 10 or 11 runs several dB quieter than legacy models. ## 10. Hard to exhale (the "wall" feeling) Exhaling against CPAP pressure feels like pushing back on a strong wind. **The fix:** 1. **Check your exhale-relief comfort setting** (EPR on ResMed, Flex on Philips). It lowers the pressure as you breathe out, which many people find makes exhaling easier. Ask your provider or equipment supplier how yours is set and whether a different level is right for you. See [understanding EPR](https://cpapclarity.com/learn/understanding-epr). 2. **Ask your sleep doctor about APAP mode.** APAP (auto-adjusting) modes vary the pressure through the night instead of holding one fixed level. It's a prescription change, so the doctor has to sign off. 3. **Ask your sleep doctor to review your pressure** if you're on a fixed pressure. Pressure is a prescription setting, so any change is theirs to make. ## 11. Can't fall asleep with the mask on Related to claustrophobia but narrower: you can tolerate the mask, but the pressure makes you too aware of your breathing to relax. **The fix:** 1. **Check your ramp comfort setting.** Ramp lets you fall asleep before the full prescribed pressure arrives. On ResMed machines the ramp time can be set from 5 to 45 minutes or to Auto, which waits until you fall asleep. Your provider or equipment supplier can show you how yours is set. 2. **Use the [Sleep Cycle Calculator](https://cpapclarity.com/tools/sleep-cycle-calculator)** to align your bedtime with your natural 90-minute sleep cycles. Falling asleep is easier when you time it to the start of a cycle. 3. **Read a book.** Boring, but effective: forcing your brain to focus on narrative pulls attention away from your breathing and the mask fades into the background. ## 12. Pressure feels too strong overall The prescribed pressure feels overwhelming the moment you lie down. This is often a question about your prescription, which is for your sleep doctor. **The fix:** 1. **Check your ramp comfort setting** for a gentler start, as above. 2. **Talk to your sleep doctor about your pressure.** Bring your recent AHI, leak and usage from the [CPAP Clarity dashboard](https://cpapclarity.com/) so they can see how your therapy is going and decide whether your prescription should change. 3. **Ask about APAP mode.** Auto-adjusting machines vary the pressure through the night; whether that fits you is your sleep doctor's call. ## What if none of these fixes work? If you've worked through the relevant fixes above and nothing helps, the problem is almost always upstream of the mask or supplies: either your prescription is wrong, or there's a secondary condition (such as central apnea, UARS, or nasal obstruction) that CPAP alone can't address. Book a follow-up with your sleep doctor and bring your [compliance data](https://cpapclarity.com/tools/compliance-calculator) so the conversation is grounded in numbers instead of vibes. ## Try the Troubleshooter [Run the Troubleshooter](https://cpapclarity.com/tools/cpap-troubleshooter) for a ranked-fix list based on your specific symptom combination. It's free, your answers never leave your browser, and it takes under a minute. Pair it with the [Cost Calculator](https://cpapclarity.com/tools/cpap-cost-calculator) if you're also trying to decide whether to change masks or switch from insurance to cash-pay supplies. ## FAQs **How long should I try each fix before giving up?** Give each fix at least 3 nights. Gear changes and pressure changes both take a few nights to stabilize. **My DME supplier wants me to come in. Is that necessary?** Only if you're within the 90-day Medicare compliance window. Outside that window, most fixes can be applied at home. The DME visit is sometimes required for pressure changes because the doctor has to sign off on the new prescription. **Is it safe to adjust pressure myself?** No. Pressure changes require a new prescription for billing purposes and may mask a deeper problem (central apneas, complex sleep apnea) that needs different treatment. Always go through your sleep doctor. **Should I use a smart CPAP cleaner?** Not necessary and possibly counterproductive. ResMed and most manufacturers advise against ozone cleaners; hand washing with CPAP-safe cleaners is what the manuals recommend.