Disadvantages
A major issue with CPAP is non-compliance. Studies showed that some users either abandon the use of CPAP, and/or use CPAP for only a fraction of the nights.
Prospective PAP candidates are often reluctant to use this therapy, since the nose mask and hose to the machine look uncomfortable and clumsy. Airflow required for some patients can be vigorous. Some patients will develop nasal congestion while others may experience rhinitis or a runny nose. Some patients adjust to the treatment within a few weeks, others struggle for longer periods, and some discontinue treatment entirely. However, studies show that cognitive behavioral therapy at the beginning of therapy dramatically increases compliance—up to 148%. While PAP side effects are a nuisance, serious side effects such as eustacian tube infection, or pressure build up behind the cochlea are very uncommon. Furthermore, research has shown that PAP side effects are rarely the reason patients stop using PAP. There are reports of dizziness, sinus infections, bronchitis, dry eyes, dry mucosal tissue irritation, ear pain, and nasal congestion secondary to CPAP use.
PAP manufacturers frequently offer different models at different price ranges, and PAP masks have many different sizes and shapes, so that some users need to try several masks before finding a good fit. These different machines may not be comfortable for all users, so proper selection of PAP models may be very important in furthering adherence to therapy.
Beards, mustaches, or facial irregularities may prevent an air-tight seal. Where the mask contacts the skin must be free from dirt and excess chemicals such as skin oils. Shaving before mask-fitting may be necessary.
The CPAP mask can act as an orthodontic headgear and move the teeth and the upper and/or lower jaw backward. This effect can increase over time and may or may not cause TMD disorders in some patients. These facial changes have been dubbed "Smashed Face Syndrome".
Read more about this topic: Positive Airway Pressure