CPAP with a cold, stuffy nose, or cough: what to do tonight.
Key Takeaways
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Most people can keep using CPAP with a cold, but comfort changes are often needed. Doctors generally recommend staying on therapy because it helps keep the airways open and supports better sleep for recovery.
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If you can’t breathe through your nose, switch strategy tonight. Nasal congestion is the biggest blocker. Try using a full face mask if you have one, or use a saline rinse before bed to clear the blockage.
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Adjust humidification settings one step at a time. Increasing humidity or tube temperature can soothe a sore throat and reduce dryness, but go slowly to avoid rainout (water in the hose).
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Clean and dry your equipment daily while sick. Viruses cling to moisture. Wash your mask and tubing every morning and never leave old water sitting in the humidifier chamber.
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When to pause and contact a clinician. Stop using CPAP and call your provider if you experience difficulty breathing, chest pain, severe ear pressure, sinus pain, or a persistent high fever.
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If CPAP is not tolerable tonight, have a backup plan. Sleep on your side with your head elevated to keep airways open, avoid alcohol or sedatives, and try again tomorrow.
Source: Cleveland Clinic (using CPAP when sick) and ResMed (using CPAP with colds/flu).
Tip 1: Switch Mask Strategy When Your Nose Is Blocked
If nasal congestion makes breathing through your nose impossible, switching to a full face mask is usually the simplest workaround because it allows you to breathe through your mouth. This is not about finding a "better" mask permanently; it is a temporary strategy for sick nights to keep your therapy going.
When this tip applies:
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My nose is fully blocked, and sprays aren't helping.
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I keep ripping the mask off.
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I’m mouth-breathing and cannot maintain a seal with my current mask.
Practical setup notes: When you swap masks, focus on fitting it gently rather than cranking the straps tight. Over-tightening often worsens leaks and leaves red marks on your face. A loose, evenly distributed fit usually seals better than a strangled one.
The tradeoff: Be aware that full face masks can leak more if the cushion isn't seated perfectly, and breathing through your mouth can still cause significant dryness. If you wake up with a parched throat, try adjusting your humidification settings gradually instead of just tightening the mask further.
Options to consider: If you need a backup for congested nights, the ResMed AirTouch F30i Full Face CPAP Mask offers a minimal-contact style that sits under the nose, which can feel less bulky when you are already feeling stuffy. For a more traditional fit, the ResMed AirTouch F20 Complete Mask System provides a reliable seal with memory foam that is gentle on sensitive skin. If you want to compare styles first, check out our guide to the Best Full Face CPAP Masks.
ResMed AirTouch F30i Clear Full Face CPAP Mask
ResMed AirTouch F20 Full Face CPAP Mask
Tip 2: Start With Saline, Then Use Medicated Sprays With Caution
Saline spray or a saline rinse is usually the safest first step to ease stuffiness before CPAP. If you need medicated options, check with a clinician or pharmacist, especially if you have heart or blood pressure concerns.
Saline first: Try using a rinse right before bed or before putting your mask on. This simple step helps clear out mucus and keeps your nasal passages moist, so the air pressure feels less irritating.
NeilMed NasoGEL Moisturizing Nasal Gel Spray
Options to consider: Two saline rinse options (if you prefer a rinse over a spray):
All in One Saline Nasal Spray by NeilMed NasaMist
Safety note: Always use distilled, sterile, or boiled-then-cooled water for nasal irrigation to avoid infection risks. You can stock up on Snugell Distilled Water for CPAP to ensure you have a safe, travel-friendly supply ready for your sinuses and your humidifier.
Tip 3: Use Humidification (and Adjust It the Smart Way)
Humidification can ease dry nose and throat irritation during a cold and may make CPAP airflow feel less harsh. The golden rule is to change one setting at a time in small steps and re-check how you feel after a night.
What to adjust first:
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If you feel dry or scratchy, raise the humidity setting one level, then evaluate the next morning.
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If the air feels too wet or heavy to breathe, drop the humidity one level rather than turning it off completely.
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If water enters the hose or mask, focus on keeping the hose warmer by using a heated tube or by improving routing.
Heated tubing makes a difference: It helps keep humid air warm as it travels through the hose, reducing condensation and making higher humidity settings easier to tolerate in a cool room. This simple upgrade is often the key to making CPAP humidifiers actually usable when you are fighting a cold.
Heated tube options (match your machine):
How to avoid rainout: If you notice gurgling or see water droplets, first raise the tube temperature (if available), then lower the humidity by one step if needed. Also, fix your hose routing so it does not sag and collect water in a low dip near the floor.
If nasal breathing remains obstructed despite humidity and saline, consider switching to a full-face mask. That would likely be the easiest CPAP workaround for that night.
AirSense 11 & AirCurve 11 ClimateLineAir Heated Tube
ResMed AirSense 11 AutoSet CPAP Machine
ResMed AirCurve 11 VAuto with HumidAir
ResMed ClimateLineAir Heated Tube for Airsense 10 and Aircurve 10 CPAP Machine
ResMed AirSense 10 AutoSet CPAP Machine with HumidAir Heated Humidifier
ResMed AirCurve 10 VAuto BiPAP Machine with HumidAir Heated Humidifier
Tip 4: Vapor Rub for Comfort (Use It Carefully With CPAP)
A topical vapor rub can make it feel easier to breathe and may reduce nighttime cough discomfort for some people. However, it does not open your nasal passages, as noted by Mayo Clinic, so use it for comfort support rather than your primary intervention.
How to use it without messing up CPAP: Apply it where the label allows, typically on your chest or neck, and keep it away from anywhere the mask cushion seals against your skin. If you notice leaks or a slipping mask, skip it for that night or move the application lower on the chest.
Safety note: Follow label directions, do not apply it inside the nose, and never heat the product. Avoid using it on young children and keep it out of reach.
If congestion is the real blocker, saline plus humidification and a full face mask usually do more for CPAP tolerance than vapor rub.
Tip 5: Sleep Propped Up and on Your Side (When You’re Congested)
Sleeping with your head elevated can reduce the post-nasal drip feeling and make breathing feel easier when you are sick. Side sleeping is often the simplest fallback position on congested nights, especially if lying flat makes you feel worse.
Do this tonight:
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Prop up your upper body: Aim for keeping your head higher than your heart using two pillows or a wedge.
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Pick a side and commit: If you keep rolling onto your back, use a pillow behind your back to block the rollover.
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Protect your mask seal: Adjust the cushion once you are in position and avoid burying the mask into a pillow edge where leaks start.
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If coughing wakes you up: Stay propped up rather than flattening out, then re-seat the mask and resume therapy.
The main downside of side sleeping is mask leaks from pillow pressure or strap shifts. If leaks spike, reduce pillow contact with the mask area, re-seat the cushion, and only tighten straps slightly because over-tightening often makes leaks worse.
If head elevation and side sleeping still don't make CPAP tolerable for several nights, check in with your clinician or DME for troubleshooting.
Cleaning Your CPAP When You’re Sick (and Basic Illness Precautions)
When you are sick, keeping your mask and humidifier clean can reduce irritation and help your setup feel usable night to night. Follow the manufacturer’s cleaning instructions, as most CPAP parts are intended to be cleaned with mild soap and water and then fully air-dried.
Daily basics:
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Wash the mask cushion daily with mild soap and warm water, then air dry because oil buildup can break the seal and worsen leaks.
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Empty the humidifier tub every morning and let it dry out rather than leaving water sitting all day.
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Use distilled water if you can to minimize mineral buildup in the chamber.
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Wash your hands before and after handling your gear, especially when you are sick.
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Optional quick clean: A CPAP cleaner spray can help remove oils and residue between washes, but it does not replace a thorough soap-and-water cleaning.
Weekly basics:
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Wash the tubing, mask frame, headgear, and humidifier tub weekly, then rinse thoroughly and air-dry completely.
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Consider a soak: For a thorough clean, you can use specialized cleaning tablets or a dedicated solution like RediClean to break down grime.
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Avoid harsh chemicals like bleach or alcohol that can damage parts or leave residue.
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Check and replace filters on schedule because reduced airflow can make CPAP feel harder when you are congested.
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Scrub the hose: For deep tubing cleaning, a hose brush is a practical add-on to ensure the inside is spotless.
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If you think you’re contagious (cold/flu/COVID), keep it simple:
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Follow the same manufacturer cleaning routine and wash hands before and after touching the mask, hose, or filters.
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Sleep in a separate bedroom if possible while using CPAP to reduce exposure risk for a bed partner, especially for COVID-type concerns.
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Replace disposable filters and any disposable accessories after you are well, per guidance.
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If you can’t isolate and are concerned about transmitting illness, contact your clinician for short-term alternatives.
You generally don't need a specialized machine to clean CPAP equipment, as soap and water, along with thorough drying, are the standard baseline. The FDA warns that some ozone or UV devices may carry risks and are unnecessary. If you are looking for more details on maintaining your equipment, check our guide on the Best CPAP Cleaners.
When to Contact a Clinician or Provider
Most colds can be managed with simple comfort measures, but certain symptoms indicate that you should pause troubleshooting and contact a clinician.
When to reach out:
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Trouble breathing or chest pain that feels new or worsening.
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Severe wheezing or shortness of breath, especially when you are lying down.
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High fever that persists or does not improve after a few days.
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Severe sinus or ear pain and pressure, which can sometimes worsen with CPAP airflow.
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Repeated nights where CPAP feels intolerable despite trying mask, humidity, and position adjustments.
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Any symptom that feels out of proportion to a typical cold or is getting worse instead of better.
Standard guidance from sleep medicine groups like the American Academy of Sleep Medicine (AASM) and the Cleveland Clinic suggests following up whenever therapy side effects or illness start to interfere with your ability to use the machine safely.
FAQs: CPAP with a Cold
Can I use CPAP with a cold or flu?
Yes, most doctors encourage you to keep using your machine because sleep is essential for fighting off the flu virus. However, you might need to adjust your settings or switch masks to make it tolerable. If you feel too miserable to sleep with it, a short break is usually safe, but try to stick with it if you can to aid your recovery.
What do I do if my nose is completely blocked on CPAP?
If nasal sprays and saline rinses do not clear the blockage, a nasal mask probably won't work for the night. Your best move is to switch to a full face mask that lets you breathe through your mouth comfortably. If you do not have one, sleeping on your side with your head propped up can help keep your airway open without the machine.
Should I switch to a full face mask when I’m congested?
Yes, switching to a full face mask is often the easiest way to keep using CPAP when your nose is stuffed. It allows you to breathe through your mouth without losing therapy pressure or breaking the seal. Just keep an eye on leaks, as facial stubble or jaw movement can sometimes make them trickier to seal than nasal masks.
Will higher humidity help congestion, and how do I avoid rainout?
Higher humidity is great for loosening mucus and soothing irritated passages, but if the room is cold, that moisture can turn into water droplets in the CPAP hose. To avoid this "rainout," use heated tubing to keep the air warm all the way to your mask. If you do not have a heated tube, you can try wrapping the hose in a cover or lowering the humidity slightly.
Why does CPAP make my throat feel worse when I’m sick?
The rapid airflow from CPAP can dry out your throat quickly, especially if you are congested and unconsciously opening your mouth to breathe. This mouth breathing bypasses your nose's natural humidification. Cranking up your machine's humidity level and using a full face mask can help keep your throat moist and comfortable.
What if I’m coughing with CPAP? When is a short break OK?
If coughing keeps waking you up, try sleeping with your head elevated on a wedge pillow to reduce the post-nasal drip that triggers the tickle. If the cough is severe or you are vomiting, it is okay to take a break from CPAP for a night or two. Just return to therapy as soon as your symptoms become manageable again.
How should I clean my CPAP equipment when I’m sick?
Viruses love moisture, so you need to be diligent about hygiene. Wash your mask cushion and water chamber every single morning with warm water and mild soap to wash away germs and oils. Let everything air dry completely before using it again, and never let old water sit in the humidifier tank all day.
When should I stop CPAP and contact a clinician?
You should pause therapy and call your doctor if you experience severe ear pressure, sinus pain, chest pain, or difficulty breathing that feels different from your normal cold symptoms. Also, reach out if you have a high fever that won't go away or if you simply cannot tolerate the pressure despite making comfort adjustments.
References
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Admin-Resmed, & Resmed. (2023, December 5). Using your CPAP machine with a cold or flu. ResMed UK.
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Clinic, C. (2025, January 20). Should you keep using a CPAP machine while sick? Cleveland Clinic.
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CPAP machines: Tips for avoiding 10 common problems. (n.d.). Mayo Clinic.
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How to clean CPAP supplies. (2024, July 3). Mayo Clinic Store.
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Vicks VapoRub: An effective nasal decongestant? (n.d.). Mayo Clinic.
Lilly Perez, Certified Respiratory Therapist
17 Feb 2026•11 min read
