Awake too early after CPAP made my cold worse

CPAP made my cold worse:  How to get sleep while dealing with a sore throat and other symptoms

By Jason Wooden, PhD

Using a CPAP machine while fighting a cold or the flu can be really frustrating.  CPAP made my cold worse and my cold symptoms interfered with my CPAP therapy. 

Fortunately, there’s lots you can do to deal with your symptoms so you can keep using your machine and get the rest you need to recover.

A) How CPAP made my cold worse

A month ago, I had the most awful experience.

It all started with a minor throat cold, something I’ll usually recover from in a couple of days.

What I noticed the first night was that the air blowing from my CPAP machine was really irritating my throat.  When I woke up in the morning, it felt worse.

The next night CPAP aggravated my throat even more.  I was coughing so much I had a hard time staying asleep.

The coughing also made it hard to keep my CPAP mask on for long-periods and things quickly spiraled downward into a full-blown cold with a stuffy nose and all the other fun symptoms.

And then, it hit me – CPAP made my cold worse and my cold was making my sleep worse.

I couldn’t sleep because of the cold and I wasn’t recovering because I couldn’t sleep.

Talk about feeling miserable and stuck.

In desperation, I loaded up at night on decongestants and cough suppressants.  I also reluctantly took sleeping pills (I’m not a big fan of them, but I knew I absolutely had to get sleep).

I started to sleep better and eventually recovered.

However, I was struck by the fact that a minor sore throat had grown into a severe cold that kept me out for weeks because of complications with my CPAP therapy.

B) Can cpap give you a cold?

On average, most adults get 2-4 colds every year, whether they use CPAP or not.

Poor sleep is believed to weaken the immune system’s response to infections.  Studies have linked it to increased susceptibility to colds and other common illnesses.

Sleep apnea patients who sleep more poorly in general may have weakened immune systems making them more vulnerable to colds and the flu.

Furthermore, CPAP may aggravate minor cold symptoms making it harder to sleep.

Bottom line, getting quality rest is important for preventing, fighting, and recovering from colds.  If your CPAP therapy is not working as well as it should, you’re not getting the sleep you need to keep your immune system in top fighting form.

So, while there’s little direct evidence that CPAP can cause a cold, it may hasten the arrival of a full-blown cold and complications with cold symptoms can make it harder to recover.

C) Yes, cold symptoms can interfere with CPAP

When you get a cold or flu, your symptoms can make it harder to use your CPAP machine.

A runny and congested nose can make it harder to breathe, especially if you’re using a nasal mask.  It can also cause you to breathe through your mouth which can compromise the effectiveness of your sleep apnea therapy.

A sore throat can lead to bouts of coughing during the night which is not great for sleep.

In either case, cold and flu symptoms can interfere with your CPAP therapy and keep you from getting deep restorative sleep.

And, if you’re already having a hard time with CPAP, this can certainly make things worse.

D) What to do if CPAP makes a sore throat worse

Viral infections like the ones you get with a cold or flu are the most common cause of sore throats.

The air blowing from your CPAP machine can irritate an already inflamed sore throat and lead to coughing spells which may keep you from getting deep restful sleep

For some, it may get so bad you decide to keep your mask off which is sure to interrupt your sleep apnea therapy.

So, what can you do to keep your throat from getting worse and continue your CPAP therapy so you get the rest you need to recover?

Here are some things to try:

Change position – Try sleeping on your side, lying on your back can worsen the accumulation of excessive mucous in throat.

Drink water – Staying extra hydrated may help get rid of excess mucus in your airways.

Honey – Taking 1 to 2 teaspoons of honey at bedtime is a simple natural remedy that might help with your cough.

Cough suppressants – These meds work by blocking the cough reflex.  They include cough syrup or throat lozenges.  There are many off the shelf options, including organic herbal extracts and more traditional dextromethorphan-based preparations such as Robitussin DM.   If you need something stronger, check with a doctor about getting a prescription for a hydrodone-based cough suppressant.

Expectorants – These cold meds loosen mucus so that its easier to cough up. Guaifenesin, the most common active ingredient, can be found in medications such as Mucinex and Robitussin Chest Congestion.

Combination cold medications – These meds contain a suppressant or expectorant with other ingredients to treat cold symptoms such as a decongestant and pain reliever.

Cold med options I saw at the grocery store after CPAP made my cold worse

Be careful mixing cold meds together and with other meds such as sleeping pills.  They can interact and cause unwanted side effects.

Be careful mixing cold meds together and with other meds such as sleeping pills.  They can interact and cause unwanted side effects.

Be careful mixing cold meds together and with other meds such as sleeping pills.  They can interact and cause unwanted side effects.

E) Using a cpap with a stuffy nose

A stuffy nose is another annoying cold symptom that can wreck your sleep, especially if you’re unable to use your CPAP machine.

Your nose can get stuffy if the nasal lining is irritated when fighting a cold or flu infection.  It can also be triggered by an allergy.

Here are some things to try:

Change your sleep position – Propping your head up with an extra pillow can help the nasal passage to drain. Sleeping on your side instead of your back may also help clear your nose.

Saline spray – Available in drops or a spray, these salt-water solutions can help loosen up mucus, relieve swelling, and help you breathe easier.  The effects may be short-lived.

Nasal Strips – Made of flexible bands with a sticky adhesive, nasal strips such as Breathe Right lift the side of the nose to open nasal passages.  The lifting action can help relieve inflamed passages and make it easier to breathe.

Decongestants – Available as a pill, liquid, or nasal spray, these meds reduce swelling of blood vessels in your nose which helps to open airways. They should be used early enough to take effect by bedtime.  If used too long or often, you can run the risk of rebound congestion.

Combination cold medications –  Many meds for cold and flu symptoms such as Theraflu contain ingredients to help relieve nasal congestion.

Switch to a full-face CPAP mask – If you’re having a hard time using a nasal mask, you may want to try temporarily using a full-face mask.

CPAP with heated humidifier – Humidifying the air in your room can help calm irritated tissues in your nose and sinuses.  Most CPAP machines now can humidify and warm air, so ask your doctor about making adjustments when you are fighting a cold.  In fact, some people find that the warm moist air from their machine actually helps with nasal discomfort.

F) Dealing with headaches

Many people experience headaches as part of a head cold when symptoms are more focused around the head and facial area.

This happens when your immune system releases infection-fighting molecules known as cytokines which can lead to inflammation and headaches.  Headaches can also be caused from swelling and inflammation of the sinus cavities.

Some things to try:

Warm compress – Placing a warm compress or wash cloth on your forehead and nose can help relieve sinus pressure and other head cold symptoms.

Stay hydrated – Drink plenty of warm fluids, it can help clear out the mucus and drain nasal passages.

Decongestants – They help reduce swelling and congestion which can help with the pain and pressure in your sinuses and head.

Pain relievers – Acetaminophen-based meds such as Tylenol work against the area of your brain that receive pain signals.  Non-steroidal anti-inflammatory drugs (NSAIDs) work by reducing the amount a hormone involved with inflammation and pain. Common NSAID meds include aspirin, ibuprofen, and naproxen (Aleve).

G) Making adjustments to your CPAP therapy

So far, we’ve talked about things you can do to deal with cold and flu symptoms.

When fighting a bug, you should also consider making changes to your CPAP therapy:

Keep everything extra clean – Your mask and tubing can get dirty from snot and mucus, so be sure to clean your setup while sick and after you’re recovered.

Switch to full face mask – As mentioned earlier, you may want to give this a try if you’re having a hard time with the nasal mask

CPAP with heated humidifier – Ask your doctor if adjustments such as raising the temperature will help.  If your machine doesn’t have this feature, it’s probably time to make a switch.

Try a CPAP alternative – You may want to plan ahead for the cold and flu season in case things get really bad with your CPAP.  One option is to have an alternative on hand such as an oral appliance.  It might work better since it doesn’t require a clear nasal airway and doesn’t blow air.  Oral appliances may not work as well as CPAP for severe sleep apnea, but you’ll at least be able to get some sleep.

Take a break from CPAP – We’ve talked about how important quality sleep is for recovering, so check with your doctor to see if temporarily stopping CPAP makes sense for your situation.

H) Prevent a cold or the flu before it starts

To avoid complications with your CPAP therapy, your first plan of attack should be to avoid colds and the flu.

Why not keep it from happening in the first place?

Here are some things to do:

Get a flu shot – Discuss with your doctor the benefits an annual flu shot

Regular cleaning – Clean and disinfect touched surfaces at home when someone is ill

Wash your hands – CDC says that regular hand washes with soap and clean running water is one of the most important things you can do to avoid getting sick.  There’s a right way and time to do this, go here for some tips.

Stay away from people who are sick

Avoid touching your eyes, nose or mouth

Get regular rest – As mentioned earlier, sleep is important for keeping your immune system in fighting form.  Sleep experts recommend 7- 9 hours per night.

Eat well – Your body needs nutrients to stay strong and ward off infections, so make sure you’re eating healthy.

Avoid stress – Chronic stress is now known to affect the immune system.  To fight stress, get regular exercise and sleep.  You can also try relaxation exercises such as yoga, meditation, and deep breathing.

Exercise – Light to moderate physical activity is believed to help the immune system by increasing circulation, stimulating infection fighting antibodies and immune cells, raising body temperature, relieving stress, and improving overall general health.  Be sure not to overdo it.  (Learn more about the link between exercise and immunity here.)

Finally, if you get hit with a bug, be sure to get your cold or flu treated as soon as possible.

Do you know the early warning signs?


Fatigue, sore throat, runny nose, coughs and sneezes, watery eyes, headache


Fatigue, body aches and chills, cough, sore throat, ever

Do you know the early warning signs?


Fatigue, sore throat, runny nose, coughs and sneezes, watery eyes, headache


Fatigue, body aches and chills, cough, sore throat, ever

Do you know the early warning signs?


Fatigue, sore throat, runny nose, coughs and sneezes, watery eyes, headache


Fatigue, body aches and chills, cough, sore throat, ever

Summary:  CPAP, colds, and the flu

  • CPAP can make a cold worse, cold & flu symptoms can interfere with CPAP
  • Quality sleep is important for fighting a bug
  • There’s lots you can do for your symptoms so can continue with CPAP
  • Check with your doctor about making adjustments to your CPAP therapy
  • To avoid CPAP complications, try to prevent colds and the flu


1. Behaviorally Assessed Sleep and Susceptibility to the Common Cold, Sleep 2015, 38(9): 1353–1359.

2. Sleep Patterns Are Associated with Common Illness in Adolescents, J Sleep Res. 2014, 23(2): 133–142.

3. The impact of stress on body function: A review, EXCLI J. 2017, 16: 1057–1072.

4. “Show Me the Science – Why Wash Your Hands?”, CDC website.


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