A blocked or runny nose is a common reason people struggle in their first weeks of CPAP. If your nose is blocked, you may end up breathing through your mouth, which brings its own problems: dry mouth and, on a nasal mask, mouth leak.
What the guidance recommends
| Fix | AASM | ATS | MedlinePlus | ResMed |
|---|---|---|---|---|
| Increase humidification | ✓ | ✓ (raise heat setting) | ✓ (use a humidifier) | ✓ (raise Humidity Level) |
| Heated tubing | ✓ | ✓ (Climate Control) | ||
| Saline nasal spray | ✓ | |||
| Non-petroleum cream in nostrils before PAP | ✓ | |||
| Talk to your provider about prescription nasal spray | ✓ | ✓ | ||
| Full face mask | ✓ | |||
| See an ENT specialist if it persists | ✓ |
Sources: AASM PAP troubleshooting FAQ, American Thoracic Society tip sheet, MedlinePlus, ResMed AirSense 11 user guide.
Step 1: humidity and heated tubing
On the ResMed AirSense 11, the user guide links a dry or blocked nose to a humidity level that’s set too low: “Increase the Humidity Level.” Humidity runs from Off and 1 (lowest) to 8 (highest). With ClimateLineAir 11 heated tubing and the HumidAir 11 tub, Climate Control Auto aims for a constant 85% relative humidity, which ResMed says is designed “to prevent dryness in the nose and mouth” (ResMed AirSense 11 user guide).
If more humidity leaves water droplets in your mask or tube, see CPAP rainout.
Step 2: nasal care
- Saline spray before bed (MedlinePlus).
- Non-petroleum cream in the nostrils before using PAP (AASM PAP troubleshooting FAQ).
- Prescription nasal sprays: the AASM and ATS both say to discuss these with your healthcare provider.
Step 3: check your mask
Leaks can dry the nose. The ResMed troubleshooting guide’s checks for dryness start with “Are there any leaks?” and the humidity setting (ResMed troubleshooting guide). See mask leaks.
If your nose stays blocked, the AASM lists a full face mask covering the nose and mouth as an option. Ask your supplier to compare options (mask guide).
Step 4: when to see a specialist
If congestion persists despite these steps, the AASM suggests consultation with an ear, nose and throat (ENT) specialist. MedlinePlus also lists nosebleeds among the problems some people have when starting PAP. Tell your provider if you get them.
Verdict
Turn the humidity up first, and use heated tubing if your machine supports it. Add saline spray or a non-petroleum nasal cream, check for leaks, and ask your provider about prescription sprays if it doesn’t settle. If your nose stays blocked, a full face mask and an ENT review are the next steps.