CPAP Dry Mouth: Symptoms, Causes and Solutions

A CPAP machine can revolutionise the way we sleep, improving the quality of life through a good night's sleep and treatment of several existing health conditions. One thing that may not be improved is the sensation of dryness in your mouth come morning once you remove your CPAP mask. In fact, you may be experiencing a higher level of dryness that comes with its own accompanying side effects, ending your sleep on a sour note.

Fortunately, we are aware of this plight of dry mouth from CPAP machines and have some causes and solutions that can help you understand and treat this predicament. After all, the best treatment for obstructive sleep apnea should not come with such hangups.

What is CPAP dry mouth?

CPAP dry mouth is where the influx of air administered from your CPAP machine causes the mucus membrane known as oral mucosa in your mouth and throat to dry out. This can cause a painful sensation, often described as sandpaper, in the throat, especially when swallowing.

It is not entirely uncommon for those undergoing CPAP therapy to experience bouts of dry mouth upon waking, and many find the discomfort a deterrent to continuing treatment, especially when other symptoms arise alongside the quintessential dry mouth.

Despite the aggravation that dry mouth brings, however, it is important to continue using a CPAP machine for successful treatment of obstructive sleep apnea and any other difficulties with nasal passages.

Symptoms of dry mouth with CPAP

Dry mouth symptoms are not just focused on the lack of moisture within the throat and the pain that comes with this. In fact, continuous or chronic dry mouth can lead to additional symptoms that steadily build in severity the longer the issue is not addressed.

Some of the more common examples of dry mouth symptoms include:

• Bad breath
• Metallic taste in mouth
• Dry lips that can crack and bleed
• Tooth decay
• Gum disease
• Skin irritation around the mouth
• Mouth soreness or infection

These symptoms arise due to the lack of saliva in the mouth, which is necessary for various antibacterial and antimicrobial reasons. This includes the prevention of dental cavities, as well as the neutralisation of gastric acids from eating and drinking, which can cause acid reflux if left unaddressed.

Why is CPAP causing dry mouth?

For many, waking up with a dry mouth after a full night's sleep is usually caused due to innocuous reasons. Those who require a CPAP mask every night to prevent sleep apnea, however, experience dry mouth for very different reasons. These reasons may be caused by the CPAP mask, but it is always best to check on your personal habits or conditions first before reaching out to fix or replace your CPAP machine.

Medications or other conditions

There may be another reason why you are waking up with a dry mouth after a night of using the nasal mask that has nothing to do with the CPAP machine itself. It is always best to discuss the potential of these causes with your doctor first before you start pointing fingers at the CPAP device.

Common causes of a dry mouth that is not associated with a CPAP mask include:

• Dehydration
• Oral medications that mention dry mouth as a side-effect
• Drugs used for treating cancer
• The diminishing sense of thirst that comes with ageing
• Inhaling tobacco or methamphetamine
• Nerve damage
• Health conditions such as a stroke, Alzheimer's disease, HIV/AIDS, or Sjogren's syndrome
• Anxiety
• Issues with salivary glands

Always be sure to check in with your body, your medication's side effects, and any existing conditions if you notice that you are dealing with continuous dry mouth. If you are unsure of the cause, your doctor can help you narrow down the causes with an appointment.

Once the cause of dry mouth is discovered as one of these non-CPAP reasons, treatment is generally fairly simple. Making sure to take care of your body can lower your risk of developing a dry mouth overnight, and you can look into training yourself to use only your nose to breathe. Otherwise, your doctor will guide you to possible treatment options that work best for you and your circumstances.

Non-heated air

In the instance where you and your doctor believe that the use of a CPAP mask is causing you to have a dry mouth, then it may be because the device's air is lacking in heat. Without a sufficient level of heat, there is not enough moisture to prevent both your nose and mouth from drying up. Just be sure you do not add too much moisture that you are creating condensation in your air tube.

CPAP mask leak

Mask leaks can sometimes occur in CPAP masks, not only reducing the effectiveness of your sleep apnea treatment but also causing you to regularly experience dry mouth. You are likely to experience a severe mask leak in the case of the following:

• Having an ill-fitting mask, which may also cause facial discomfort and marks, as well as pressure ulcers
• Using nasal or nasal pillow masks as a mouth breather
• Using a CPAP machine that is bilevel

Regularly checking that your CPAP mask is not leaking air can help prevent the likelihood of CPAP dry mouth. It can also alleviate other symptoms of discomfort that come with improper usage of a CPAP machine.

Mouth breathing

When using a CPAP machine, it is advised to breathe in and out through the nose rather than the mouth. This can be difficult for some, however, if they are in the habit of mouth breathing. Continuously exhaling through the mouth, especially when treating sleep apnea, can cause a dry mouth when waking up in the morning.

You may also experience an increase in mouth breathing due to nasal congestion, allergies, or physical obstruction to the nasal passages like a deviated septum. Determining the cause can help you look for possible treatment options or the need to train yourself out of your mouth breathing habit.

How to treat dry mouth from CPAP

Once the CPAP-associated cause of dry mouth is identified, it is fairly easy to make progress towards treatment. It may just be that your CPAP mask needs some repair, or you need to make an adjustment in how you are using the device. Regardless of your chosen treatment, it is likely you will see some improvement in your mouth's dryness within a few nights' rest.

Check for air leaks from your CPAP mask

If you believe your dry mouth is caused by air leaks from your CPAP mask, then you should make the necessary adjustments as soon as possible.

Your mask may be moving out of place during sleep as lying down changes the shape of your face. By refitting your mask when lying down in the sleeping position you like best, you are less likely to have air leakage occurring.

If your face mask is still leaking air after adjustment, this may be an indication it needs replacing. This can be due to the mask frame bending, the headgear stretching, or the mask's cushion wearing down.

Consider using a full face CPAP mask

Those using a nasal mask or pillow for obstructive sleep apnea may have noticed the prevalence of dry mouth in the morning. This may be due to your jaw dropping while you sleep, resulting in a night of mouth breathing and the CPAP pressure escaping from your mouth.

To help alleviate dry mouth and restore the full capacity of your treatment, you can try switching to a full face CPAP mask. This will prevent your jaw from dropping and thus contain the full strength of the CPAP pressure.

Use a CPAP humidifier

If the air from CPAP machines is too cold and dry, it may irritate the nasal passages and cause them to become congested. This often results in mouth breathing, which in turn causes dry mouth.

To resolve such an issue, you can incorporate a CPAP humidifier to introduce warm air and soothe congestion or a sore throat. This, in turn, helps alleviate dry mouth and has accumulated in CPAP users being 43% more likely to continue treatment.

Consider using a CPAP chin strap

A particularly simple solution to persistent mouth breathing is incorporating CPAP chin straps into your nightly routine. Through this additional jaw support, CPAP users are encouraged to breathe only through their noses. The additional positioning of the tongue also guarantees that the mouth remains closed overnight and is not exposed to dry air.

Stay hydrated

Sometimes, preventing dry mouth is as simple as ensuring that you are sufficiently hydrated throughout the day. Drinking plenty of water, especially before bed, can help ensure that you do not wake up with a dry throat when morning comes.

You can also alter your daily habits to prevent greater dehydration. For example, chewing only sugar-free gum and avoiding alcohol, smoking, or too many sugary foods and drinks.

Continuing your CPAP treatment is vital to overcoming obstructive sleep apnea and any other nighttime issues you have with your breathing. That is why you should not let CPAP dry mouth prevent you from making the best of a full night of sleep. With plenty of options available to address the cause of your dry mouth and stop it from continuing, you are sure to wake up feeling refreshed and ready to take on the day!