Sore on the bridge of the nose from CPAP mask

by Soreness

I have used a CPAP for 6 years now and in the last 6 months I have had 2 different nose sores. It takes forever to heal and they are so ugly and they hurt.

After the first one I discovered a comfort pad and it helped heal the first sore quickly. Now I have gotten another one and it is not healing well.

I am wondering if the tissue on the bridge of my nose is getting broken down after 6 years of a mask on it.

Can you give me any advice on healing this one and what are my alternatives? I like the CPAP and do not want to discontinue use...but I can't go this route either.

Answer


Sore on the bridge of the nose from the use of CPAP mask is a very common problem in patients with CPAP.

This sore nose problem really ticks many CPAP users off. We cannot understand why the companies that manufacture these masks do not address these issues.

All the CPAP masks have to be worn for at least 6 hours every night by persons that have enough difficulty trying to learn how to sleep with these CPAP problems. And we cannot accept that there is no technology that cannot address these issues and at least make it a little easier.

Fortunately, there are methods to resolve the mask problems, including the sore nose, thanks to many CPAP users who tried everything to make their sleep and life easier.

Causes of Sore on the Bridge of the Nose


If you're developing a sore, there are three main possible causes:

  1. an allergy with the material of the CPAP mask,

  2. a rubbing-related sore caused by a wrong adjustment of the CPAP mask,

  3. you may have the wrong CPAP mask for your face structure.

Alternatives for the Sore Nose Problem


  • Cause: Contact Allergy with the CPAP Mask - if you have a reaction to latex or a similar material, changing to a non-latex mask can resolve this issue.


  • Furthermore, many CPAP users change their mask with nasal pillows, which can be extremely comfortable and also eliminate the sore nose discomfort and claustrophobia problems.

    The nasal pillows doesn't touch your bridge of the nose, and I can't think of any other way you're going to be able to continue to use your CPAP while you wait for your nose to heal.

  • Cause: CPAP Mask Misadjustment - You might have your CPAP mask too tight or too loose on your face, or not adjusted properly.

    I don't know the type of your mask, but many masks have the forehead connector with more than one position. Your mask can be pulled too tight at the top and you should experiment with adjustments until you get it right.

    If you try a different position, the sore nose problem can be solved right away. There are 3 or 4 settings to allow for a recessed forehead or protruding forehead.

    Do you have your straps too tight? Many CPAP users tighten the straps to prevent the air leaks, but this is not the right way to do it.

    The CPAP mask is designed to form a bubble when you turn on the CPAP machine. The straps shouldn't be too tight or too loose to maintain this bubble. You can learn more about mask fitting here or in one issue of Sleep Apnea Newsletter.

  • Cause: Wrong mask for your face - If these methods don't work, you should contact your supplier as there is a possibility that you were incorrectly fitted.

New Method to Avoid Sore on the Bridge of the Nose


If you want to keep your CPAP mask, this method can help you avoid sore nose in the future without changing the mask. I found this tip in a forum about sleep apnea and sore nose, and the method is also called "Peke's silicone ear plug tip", after the person who shared it.

You just have to find a way to let the nose heal, and then try this method:

  • Firstly, you need silicone ear plugs, like Mack's Pillow Soft Silicone Earplugs. You can use them several times before you have to throw them away.

  • version 1: roll the earplug and squeeze it into a rope and placed it under your mask where it's rubbing your nose, or where you have leaks,

  • version 2: or you can attach the earplug to the silicone liner like this "/\" (use as many earplugs as you need to do this), and press it gently all around until it's flattened and even with the inside edge. Then, when you put on the mask, it will flatten even more and it stay in place.

  • with Peke's silicone ear plug tip, you may discover that you have an incredible seal, and no soreness and bruising in the morning.

  • If your nose is still sore from previous wearing, I suggest you protect the bridge with a small sized Band-Aid with all but quarter inch of adhesive cut off on each side or something like that to protect your nose even under the putty.

  • Be careful of that sore spot if it has broken skin. Keep it clean and pad it when you wear the mask. Moleskin is good.

I think it is very sad that we have to resort to earplugs, comfort pads, Band-Aid, latex, etc. to make these masks wearable. Until the companies that make them care enough to try to improve their designs, I guess we'll keep on having to use our own ingenuity.

But why should they care? As long as we are uncomfortable, we'll keep on buying masks to try to find the right one. Sounds like a win-win situation for them.

I hope it helps. Don't be afraid to comment back.

Remy Thierry
Founder of Sleep Apnea Guide


Comments for Sore on the bridge of the nose from CPAP mask

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Jun 25, 2011
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Sore nose
by: Anonymous

Even the nasal pillow design has it's problems. Only after 2 nights of using it, because of the even just enough pressure from strapping it on needed to keep it from leaking, I now have a permanent horizontal wrinkle across my nose!

I have tried 2 full face masks. I can not tolerate the one with the forehead piece, and have only fair results with the one with out it. I have been hoping eventually I will finally get used to all of this but it has been a year now.

I STILL have daytime fatigue, and feel like crap in general,and issues from the c-pap causing dry eyes, nose and throat, in spite of using a c-pap machine and oxygen compressor with humidifiers.

Jun 11, 2013
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Ear Plugs
by: Anonymous

Great idea about using an ear plug! Thanks for sharing.

Jul 10, 2016
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Sore nose.
by: Gwil

I have been on a cpap machine for around 12-13 years and had a sore nose problem often, resulting in a puss-infected area. It usually happens (though not always),wh en the mask is new and very 'grippy'.

You can get silicone gel rolls from your Dr but, they do tend to be a little on the thick side, which pushes the mask away from your face and leaking out air.

Personally, I put a little medical plaster on it while it healed then a little petroleum jelly after, just for a week or two-your nose becomes hardened to it after that.

Best Regards,
Gwil

Nov 08, 2016
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Sore Nosse
by: Anonymous

Water based silicone jelly may do the trick. The SleepWeaver from Advance is a soft cloth inflatable that might work.

Jan 06, 2017
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sore nose
by: Anonymous

I went from nasal canal mask to full mask First night I got up next morning with a sore on bridge of my nose and very red. Day two its still sore and red beginning to think I made a very big mistake.Think I will trade back to nasal mask with chin strap to keep my mouth closed.

Mar 28, 2017
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CPAPs a racket?
by: New to CPAP

I'll admit I'm new to CPAP life and trying to adjust. Nasal pillows/straps are lost cause for anyone who moves at all during the night. I tried all of the "benign" nostril solutions. Leaky and noisy, or painful and noisy. What is benefit if you're awake most of the night??

Masks too have issues. Using my new mask, the bridge of my nose and nostrils are sore today, but otherwise things have gone better. Have some ideas in mind. I also have an overarching question, after reading up on CPAP technology and usage, and talking with a number of therapists.

What did people do BEFORE there were CPAPs? Did they all just get heart disease and die? Uh, no. I'll continue to work on adapting to CPAP usage, but if at some point the lack of sleep and aggravation outweigh the benefit, I'll just go back to sleeping on my side or elevated, and not worry about the sky falling.

Oct 27, 2017
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A solution that helped me might help you
by: Dr MK

Im a dermatologist and after recently starting CPAP myself with a full face mask hit the stubborn obstacle of sores, blistering, redness and ulceration on the bridge of the nose.

The issue is that the nasal bridge is one of the least supported structures on your face due to its thinness, sparse tissue under the skin and reduced collateral blood supply. I have seen this area to result in breakdown and poor healing to any insult such as pressure, laser treatment or even black head removal with a comedone extractor.

The surest way to avoid these issues is to avoid the causative factor altogether. I tried various plasters, Vaseline, gauze, cotton , ear pads and even the Resmed Gecko silicone nasal pad specifically designed for this issue - and not cheap - to no avail.

The pressure relief was not enough to avoid the nasal bridge sore and it always took ages to heal between trials of the next option. The resulting hyperpigmentation after healing of my blisters/ulcers was also difficult to improve. Mask fitting and adjustment were not the issues and had been checked by the CPAP techs. Even at the loosest fitting that would retain air and not allow it to escape I still faced the issue.

My solution was to replace the full face mask with a hybrid oral+nasal mask. It delivers air to your nose by nasal pillows and covers the mouth without touching the rest of the nose so you can breath through either orifice. I didnt face the issue with the nasal pillows as mentioned by someone. It has smartly adjustable nasal pillows with independent height settings for each side. Perhaps that helps.

The mouth piece supports your chin too and you dont need a separate chin strap. The package includes mouth pieces and nasal pillows of all sizes so you don't have to worry about trialling different sizes. My CPAP machine is of a different brand but no connectors were needed and it fit the existing hose.

I suppose all acceasories use universal sizes now. I had to get it shipped from the US to UAE but the total price was not that much and certainly improved my compliance with CPAP. Not sure if sharing brands is allowed by I got the hybrid from cpap.com. i have no affiliation.

Nov 03, 2017
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Issues with Full Face Mask
by: Dramagal

After one week, I am also getting a sore at the bridge of my nose that looks like I have been punched. Although I don't mind a FFM, I definitely do mind waking up to a very sore nose. This seems like such a simple issue to fix, yet surprisingly the manufacturers of these masks haven't come up with a good solution.

Btw: to the person who wrote, "What did people used to do before CPAP?" They just annoyed others around them and often slept in separate rooms from their partner. Now that I am on CPAP therapy, the quality of my sleep has greatly improved. I don't mind a mask, but I do mind wearing the marks the next morning.

I have been using the DreamWear nasal mask (for a year), but thought I would try a FFM since the store assistant tells me I have many leaks. However, with my sore nose issues, maybe I need a hybrid mask instead.

Mar 05, 2018
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protecting bridge of nose
by: Anonymous

I buy Visco-Gel Silicone Moleskin Protective Padding that is made by Pedifix to protect sores on your feet. But I cut off a piece just to fit the bridge of my nose and it works. After a few days, I have to use a new piece. But my new Resmed Machine gives me a smiley face for mask fit so I know I don't have too many leaks. The doctor's sleep report sent to her from my cpap machine said things looked good.

The sleep therapist at my doctor's office told me to go to cpap.com and buy something there but I will have to take a look.

Mar 17, 2018
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Help
by: Tracey

After 2 weeks 1st week faulty mask now got another mask resulted to really bad sores on my nose so sore really don’t think I can put mask on till healed what do I do ??

Apr 08, 2018
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Thanks
by: Caryn

Appreciate this information as my husband just started using his CPAP and he is swelling up and in pain. Your information helped us to quickly understand what may be happening.

Thanks!

Apr 09, 2018
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CPAP mask fit
by: Al

I am difficult to fit, those that have tried probably have nightmares.

Finally, after 20 years, I had to take matters into my own hands-and the journey is long and has been difficult.

I had sores on the bridge of my nose, just as many here have reported. I had red marks and irritation on the sides of the face just below the bridge of the nose. The nose hurt quite a bit-an understatement. Soon the bruises turned black and blue and appeared to be permanent.

Here's what I learned:

The fitting is everything. Rather than let the medical supply house do the fitting, you need to start it correctly (yourself), otherwise you end up leaving with a mask fit that is doomed to failure.

Take the suggested masks and throw out all the 'crap' selections (WISP and similar full floating types where the mask is free to flop around as the patient rolls over during sleep). A proper fitting mask needs to have a forehead bracket-otherwise the mask isn't anchored properly and the thing will leak during the night. A bare nosecone with no forehead rest and one that only has 2 straps connected to the nose piece itself (such as the WISP) is crap.

Next, move to a horizontal position and place each silicone nose piece (without straps) onto your nose until you find one that almost seals, just from it's own weight. If the silicone nose cone needs to have excessive pressure exerted in order to make a reasonable seal-keep searching. THIS IS IMPORTANT!!! As the nose piece is placed over the nose, note how the perimeter touches the skin all around the outer edges. A good candidate is found when the mask simultaneously touches all the skin at the same time! Older mask models have stiff silicone that is thick in the areas that seal against the skin. The mask you're looking for is one that has super thin and flexible silicone sealing flaps.

In other words, you're looking for a mask that won't require excessive tightness on the straps to create a seal!! You find this mask as described in the previous paragraph. Don't be afraid to try off brands. And, a bigger mask size isn't necessarily better!

Excessive tightness of the straps causes bruising, sores and at one time, I could see the bone due to my sores on the bridge of my nose. Excessive strap tightness is the enemy-having to over tighten the straps in order to compensate for a silicone nose piece that isn't quite right to begin with can only lead to failure.

So, finding the proper fit in the silicone nose piece is the critical first step! Don't try to do a mask fitting while sitting-when you use your mask, you won't be sitting!!!

For me, my story continues though. There was a properly fitting nose piece with extremely compliant thin silicone sealing surfaces. But, the mask frame didn't support the silicone nose piece correctly. Before I reached a proper solution, I took pieces from 2 different masks and modified them into one mask. It fits like a glove! And, it works GREAT-for the first time in 20 years, I can now sleep well!!

For those that might need to do a 'frame-ectomy....use medical grade UV hardening clear epoxy to combine the parts from the 2 (or 3) different masks. Beware industrial 2 part epoxy as it does have some chemicals that aren't safe. There is also a relatively new technique that that uses a hot air stream and a spool of plastic 'welding rod' to connect 2 plastic pieces. Shops that do plastic canoe repairs tend to have these plastic welding machines.

My mask ended up being a now obsolete Resmed Mirage Micro (used only for its frame and straps). The frame is the size L frame, which supports the Large and Wide-Large nose pieces. To that frame, I mated it to a size small F and P Eson nose piece. And, it is flawless!

Finally, I had to modify the straps on the Mirage Micro because they were to stretchy and the frame wouldn't consistently anchor the nose piece in the same spot when rolling from side to side. It's important to make sure the nose piece doesn't move as the patient rolls from side to side during sleep.

Hope this helps someone!

PS:Save you old masks, If I hadn't done so, I would have had a ton of $$ to find the right frame/nose piece combo!

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