Obstructive sleep apnea is a health-wrecking sleep disorder that causes breathing to stop multiple times a night, depriving the body of oxygen and putting the sufferer at risk of everything from heart disease to depression. An estimated 18 million Americans have obstructive sleep apnea and many turns to continuous positive airway pressure (CPAP) machines for relief.

CPAP devices work by delivering steady air pressure into the nose and/or mouth via a mask to keep the airway open during sleep. The technology helps millions of users breathe better and live healthier. Increased oxygen benefits every system of the body, including your eyes. Unless…

Leaks in a CPAP mask contribute to dry eye syndrome for many patients. These things happen for a variety of reasons that we’ll address shortly, but first you must determine if you have dry eye syndrome. The most common symptoms include:

  • Blurry vision
  • Eye burning and itching
  • Redness
  • Sensation of dust or debris in eyes
  • Light sensitivity
  • Eye discharge
  • Tired eyes
  • Watery eyes

Why is my CPAP causing dry eyes?

When a CPAP mask is fitted and functioning properly, the air pressure from the mask helps maintain an open airway while you sleep. However, some conditions can cause the air to leak from around the mask and blow into your eyes, causing dryness.

Improper fit

A mask that’s too big, too small or the incorrect shape for your facial structure can result in leaks. It can be difficult to strike the right balance. In fact, new CPAP users could go through several styles of masks before they find the one that works best for them.

The Fix: Schedule an in-person visit with a technician to get fitted for a mask. Your tech can recommend a style and size based on your facial anatomy, the CPAP pressure prescribed to you and your sleeping habits (side sleeping or supine, or example).

Pressure that’s too high

It’s possible your sleep specialist has set the air pressure on your device higher than is necessary to maintain your open airway. 

The Fix: Discuss your experience with CPAP use with your doctor to see if a lower air setting might achieve the same results without leakage.

A buildup of dirt

Natural skin oils and ambient dust can build up on your mask over time, interfering with proper mask seal.

The Fix: Thoroughly clean your mask, hose, water tank and head straps on the schedule recommended by the manufacturer. Avoid oily moisturizers on your face at bedtime, particularly around the mouth and nose where your mask must seal. Use special CPAP mask wipes to remove dust and natural oils from your mask each night.


A built-in humidifier on your CPAP device will help keep the airflow from drying out your mouth overnight. However, too much humidity can create moisture buildup around the mask and break the tight seal.

The Fix: Start at the lowest humidity setting and slowly increase the level to find a comfortable setting. Your face shouldn’t feel wet after CPAP use. It also helps to keep your bedroom cool so you don’t perspire.

Replacement is overdue

The plastics that make up your mask and hose break down over time and lose their ability to properly shape to the face.

The Fix: Replace the soft, flexible face mask cushion or nasal pillow that directly contacts your skin every 2-4 weeks, and replace the hard mask that holds it every 1-3 months.

It’s also helpful to know that your eyes aren’t necessarily completely closed while you sleep, leaving them exposed to airflow. This can just be an individual quirk, but it can also be a consequence of certain health conditions, such as eye swelling from diabetes or floppy eyelid syndrome. Even without ambient airflow, your eyes would dry out under these conditions.

Prevent dry eyes by using a thick, lubricating eye gel at bedtime. If dry eye syndrome persists, talk to your ophthalmologist about other treatments.

Matossian Eye Associates performs a number of treatments for dry eye, visual disturbances and refractive errors that cause eye discomfort. Schedule an appointment with an eye doctor at your convenience by calling us at (800) 708-8800 or through our website at MatossianEye.com.