CPAP Allergies: Top 5 Tips and Tricks for Using CPAP with Seasonal Allergies While Treating Sleep Apnea

As a whole, allergies are a sniffly, sneezy, itchy, watery, no-good time that virtually everybody can agree is one of the worst things to lose sleep over. And if you’re one of the tens of millions of people living with Obstructive Sleep Apnea, using CPAP with allergies can be a complicated experience.

Treating allergy symptoms at their root is always the best course of action, even if you’re treating sleep apnea with a CPAP machine. While there are some comfort features like Ramp and heated humidification that can make CPAP with allergies more tolerable, you may want to consider an antihistamine, nasal spray, or nasal rinse to combat allergy symptoms first and foremost. Keeping your CPAP and sleeping environment clean is a useful preventative measure for reducing the potential number of allergens you’re exposed to inside your home. Banning any pets from your bed (but not your bedroom) can further reduce allergens in your immediate sleeping area.

In this article, we’ll discuss several methods for reducing the presence of allergens in your home, bedroom, and equipment to make CPAP with allergies much more manageable. But first, we’ll talk about how allergies affect sleep apnea and why sticking to CPAP is worth it, even if your allergies have you down.

If you experience seasonal allergies, you’re likely familiar with sneezing, coughing, itchy or watery eyes, sinus headaches, congestion, and/or the whistling sound of your one barely functioning nostril doing its best to keep you supplied with enough oxygen to function. While it may seem like blowing your nose enough should clear your nasal passages enough for CPAP to work, the swelling and inflammation of the nasal passages is what’s actually creating the blockage.

During the day, gravity helps your sinuses drain naturally, but when you lie down for bed, the mucus builds up in the back of your throat, bringing further obstruction to an already obstructed airway. This drainage is your body’s natural way of removing allergens from your respiratory tract, but it can present enough of a problem to make many people want to shelve their CPAP until their allergies subside.

When your nose gets stuffy, you may have a tendency to breathe through your mouth instead, but by doing so, you’re actually bypassing a large part of your body’s natural humidification process which occurs largely in the nasal passages. When you breathe through your mouth to avoid nasal congestion, you’re actually more likely to dry yourself out faster and create an environment for an even more severe allergic reaction.

Allergic Rhinitis; Hay Fever; Seasonal Allergies—regardless of what you call them, allergy symptoms are something most people would probably prefer to never experience. When you can barely breathe through your nose because of inflammation and congestion, the thought of using your CPAP machine can sound like an impossible task. You may even be tempted to skip your therapy for a night, week, or however long it takes for your allergies to pass.

It can’t be understated: skipping even a night or two of CPAP therapy can have both short and long-term consequences including the disruption of your sleep schedule, mild cognitive impairment, fatigue, high blood pressure, difficulty regulating your appetite, and memory and concentration problems, to name a few. In the long term, untreated sleep apnea increases your risk for stroke, cardiovascular disease, diabetes, and even Alzheimer’s.

Adding continuous air pressure to your allergy symptoms may seem counterintuitive, but a 2017 study found that people with allergic rhinitis actually enjoyed an improvement in both nasal symptoms and quality of life after CPAP therapy. The study didn’t even include humidifier usage, which has been found to decrease inflammation in the nasal passages and reduce breathing resistance caused by inflammation.

So how do you maintain your CPAP therapy with allergies? The first thing you’ll want to do is limit your exposure to allergens:

1. Keep Your CPAP Clean

While it isn’t the most revolutionary idea, regularly cleaning your CPAP equipment will remove allergens in your tubing, humidifier chamber, and mask. If you’re dealing with allergies, you’ll want to rinse your hose, mask, and humidifier chamber daily to prevent your equipment from harboring allergens. Regularly cleaning (if it's reusable) or replacing (if it's disposable) your air filter will keep the incoming air cleaner and the inside of your machine free of dust and debris, though there’s something to be said about your sleeping environment, too…

2. Keep Your Bedroom Clean

Keeping your sleeping area clean with fresh bed sheets and pillowcases is hugely important in combatting allergens regardless of the time of year. Your bedding will constantly trap allergens like dust, dead skin cells, pet dander, and pollen each night. Changing your sheets and pillowcases one to two times a month can reduce the presence of allergens.

Taking it a step further, wrapping your box spring, mattress, and pillows with a plastic cover will prevent allergens from becoming trapped in deeper layers of fabric and pillow stuffing. By wrapping different parts of your bed in plastic, you’ll only have to worry about changing sheets and pillowcases and you’ll benefit from better air quality while sleeping. You’ll also want to keep your windows closed, especially during heavy allergy seasons.

3. Shower Before Bed

If you’ve been outside or exposed to allergens during the day, it’s a great idea to shower before bed to remove allergens from both your body and hair and can also help to remove allergens circulating in your personal microbial cloud. Pollen, dust, and other allergens easily get caught in the hair, which can be problematic for women and men with long hair. Thoroughly washing your hair will remove allergens that might be hanging around your face while you sleep, further limiting your exposure.

4. Don’t Sleep in Outdoor Clothes

Similarly to showering before bed, you’ll also want to make sure to change your clothes before bed if you wore them out of the house that day. Fabric will trap and carry dust, pollen, and other allergens, so you’ll be removing potential allergens from your sleeping environment by wearing clean clothes to bed.

5. Keep Pets Out

If you sleep with pets, and especially if those pets spend time outdoors on a daily basis, it’s a good idea to remove them from your sleeping environment. At the very least, reclaiming your bed is a must because it will further remove airborne allergens from your immediate sleeping area. While some argue that removing pets from the bedroom entirely is conducive to better sleep quality, a 2018 study actually found that the presence of a dog has many lifestyle benefits that actually create a net improvement in sleep quality in dog owners.

Many CPAP machines also have some onboard features geared towards making therapy more comfortable and tolerable, which can be very useful if you’re dealing with allergy symptoms:

Adding humidification to your therapy greatly increases comfort and can help to loosen up irritated airways and even thin out mucus for easier drainage. The nose is responsible for humidifying air on its way to the lungs with moisture it retains during exhalation. When breathing through your mouth, you won’t enjoy the same natural humidification, so using humidification with your CPAP therapy can help to soothe the airway and keep it functioning more naturally if you opt for a full face mask. Most modern CPAP machines come with an integrated humidifier or attachable one, and heated hoses can help to further humidifier functionality for a more consistent experience.

If you find it difficult to tolerate the continuous airflow of your CPAP because of allergies, try turning on the Ramp feature if your machine has one. Ramp allows you to start the night at a much lower and more tolerable pressure level, allowing you to ease into sleep. After a period of 15, 30, or 45 minutes, your machine will deliver your prescribed therapy pressure. Depending on the machine, it may slowly ramp the pressure up over time or even wait to turn the pressure up until it detects that you're asleep.

Most modern machines also feature some form of pressure relief, which reduces your therapy pressure during exhalation to make it easier for you to exhale. Since nasal exhalation is already difficult with allergies and congestion, enabling the maximum level of pressure relief that your machine allows may make CPAP therapy with allergies a bit more approachable.

Where a CPAP machine provides continuous pressure, an APAP machine automatically adjusts to your needs on a breath-by-breath basis. An APAP machine will be able to adapt to a more tolerable pressure when you aren’t feeling your best instead of needing your healthcare provider to change your pressure setting entirely. A new machine purchase isn’t something we take lightly, however, and we understand that it isn’t a realistic solution for making allergies more tolerable. If you do find yourself in a position to buy a new machine and want one that can adapt to your needs, APAP machines can bring a whole new level of comfort to your therapy.

If you want a CPAP machine that takes allergies even more seriously, look for machines that support the addition of a PM 2.5 filter, such as the Luna G3 CPAP Machine, or those with a hypoallergenic filter option like the AirSense 10 AutoSet.

Congestion and inflammation can make it very difficult to use your CPAP with allergies, especially if you use a nasal or nasal pillow mask. Switching to a full face mask will allow you to breathe through your mouth while your nose and sinuses are stuffy. Due to the way a traditional full face mask rests and puts pressure on the sinuses, we recommend a hybrid design like the DreamWear Full Face CPAP Mask or ResMed AirFit F30i.

Allergens caught in the nasal passages may also be removed with a saline rinse or spray. Using a saline sinus rinse to clear the nasal passages in the morning can help you experience less congestion during the day, and doing another rinse before bed will remove anything that built up over the course of the day, ideally leaving you with less irritated airways that are free of allergens.

Sometimes, allergy symptoms will need to be kept at bay with medication. Always consult your healthcare provider before switching or introducing new medications, as they will be able to determine how it will interact with any existing medications you might be taking.

Some find solace in antihistamines and decongestants while others prefer over-the-counter nasal sprays or even prescription-strength steroid sprays. Ultimately, you and your healthcare provider should determine the best course of action for you if you decide to use an allergy medication.

Bolstering your health with supplements and vitamins—especially vitamin C, which is a natural antihistamine—can also be very helpful in regulating your allergy response for a more manageable reaction.

If you feel like you’re having an allergic reaction to your CPAP mask, you should stop using it immediately and consult your healthcare provider. While latex masks were more common in the past, virtually every modern CPAP mask is made with silicone or gel. Still, you should verify that your mask isn’t an older model that was made with latex.

We often find that symptoms that appear to be ‘CPAP allergies’ are remedied by a more diligent cleaning routine, as the oils, dirt, and skin cells will build up and irritate your face where the mask seals. Think back to the first time you wore your mask; did you have a reaction the first time you wore it overnight? If so, you may have genuine cause for concern, but if not, CPAP mask wipes are an effective solution for keeping your mask cushion clear of debris to better protect you from further irritation.

Using CPAP with allergies doesn’t have to be an unpleasant experience. Thanks to advancements in technology, the ramp and pressure relief features on most machines can make your therapy more tolerable, especially when combined with a heated humidifier.

Preventative measures to remove allergens from your sleeping environment will have the largest impact, though, so be sure to keep clean sheets, wrap your mattress and pillows if you have to, shower and change clothes before bed, and do your best to keep pets out of the bed with you. Treating allergies with medication is a perfectly reasonable option as well, just be sure to consult your healthcare provider first if you’re combining medications. Saline rinses are also very effective for removing allergens from the nasal passages when used in the morning and evening.

We hope the tips in this article will help you get back to sleep so you can enjoy the increased energy levels, alertness, and improved mood you get from successful CPAP therapy. Our customer service team is ready to answer any questions you may have about using CPAP with allergies or any other questions or concerns you have, wherever you’re at in your therapy journey. Reach us at 1-800-356-5221 from Monday to Friday 8 a.m. to 8 p.m. and Saturday from 8 a.m. to 5 p.m., or reach out via the live chat option on our website.