CPAP usage and claustrophobia

Does your CPAP mask bother you? If it does, you should not feel alone. Simply put, a mask is just not meant to be worn on the face when you sleep. That being said, CPAP is the gold standard treatment for sleep apnea, and it works miraculously well! What’s more, some people have no problem putting on their mask and sticking to it. So why do some people feel more uncomfortable than others? Might there be some other sort of factors at play? Perhaps claustrophobia?

To answer this question, a group of researchers in the United States implemented a survey-based analysis. They recruited participants who entered the sleep clinic and had suspected sleep apnea. In order to be eligible for the study, the participants had to be prescribed to have an overnight “titration,” which is basically a CPAP fitting session. During the morning after the titration night, the participants completed a questionnaire called the CPAP-adapted Fear and Avoidance Scale. This scale assesses situational fear and includes a few questions about claustrophobia. Subsequently, all participants went home with their fancy, new CPAP, and their adherence (usage) to the CPAP was monitored via a microchip in the CPAP base.

How claustrophobic were the participants overall? After the titration night, 63% reported feeling claustrophobic. Interestingly, the researchers broke it down by mask type, finding that “…of full-face mask users, 85% had claustrophobic tendencies; for nasal pillows users, 63% had claustrophobic tendencies; and among nasal mask users, 52% had claustrophobic tendencies.” This may not be surprising, as it is logical that a full-face mask would feel the most claustrophobic. And did claustrophobia predict CPAP adherence? It sure did. Those with claustrophobic tendencies were about 5 times higher to wear their mask for only a few hours per night, which is not ideal.

It seems that, in addition to the discomfort that comes with having a mask on your face, claustrophobia makes the issue worse! This was shown in the current study when, at 1-week follow-up, the claustrophobic individuals were less likely to stick to their treatment. If this is the case for you, you might need to switch to a more tailor-made treatment. Alternatively, it may be that switching to a different mask type is the easy remedy. Overall, it is important that you do not give up if you struggle with your mask. There are more options out there – it’s worth it for your health!

Janna Mantua


Janna is a PhD Student / Graduate Research Assistant at University of Massachusetts Amherst with a background in clinical sleep research and psychology. Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.

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