ASK APRIA

Today's Clinician

Kathlene McDonald

Kathlene McDonald is a dedicated Respiratory Therapist with 14 years of experience and a strong commitment to patient care and clinical excellence. She has been a proud member of the Apria team since 2018, where she continues to make a meaningful impact in respiratory health. Outside of work, Kathlene loves spending time at the beach, taking walks with her two Great Pyrenees, and keeping up with her energetic 6-year-old son.

Q. Why do I produce so much mucus when using my CPAP machine?

A. Excessive mucus production while using a CPAP machine is often related to airflow or humidifier settings. High airflow can irritate the nasal passages, and both insufficient and excessive humidity may increase mucus. In many cases, low humidity is the primary cause. A common misconception is that humidity should be turned down when mucus appears, but in reality, increasing the humidity often helps. When the air is really dry, it can irritate the nasal passages, and the body's response is to produce mucus to help moisturize the passage. Higher moisture levels thin out secretions and reduce mucus buildup.

Using ClimateLine tubing (RX only) and setting the device to “Auto” can help maintain consistent, appropriate humidity. It’s also important to keep your CPAP machine clean—bacteria and other organisms can grow on unclean parts, potentially leading to respiratory infections, congestion, and phlegm.

Q. I use my CPAP every night for 7-8 hours but still wake up tired. Why?

A. Waking up tired despite regular CPAP use can occur for several reasons, including mask leaks from an improper fit, incorrect pressure settings, or underlying medical conditions. It may also be related to the severity of your original sleep apnea or other co-existing sleep disorders. Reviewing your CPAP data—such as your AHI (Apnea-Hypopnea Index)—with your healthcare provider is essential to ensure proper fit and function.

A high AHI or frequent events during therapy may indicate the need for pressure adjustments, which must be prescribed by your physician. Your provider may also identify complex sleep apnea that was not previously detected. Mask leaks reduce therapy effectiveness, and pressure settings that are too high or too low can leave apnea events untreated. Always confirm mask fit and consult your healthcare provider to review your therapy data and optimize treatment.

Q. Can my CPAP cause stomach bloating, and how can I prevent it?

A. Yes, stomach bloating, or aerophagia, can happen if you swallow air. This is more common with higher pressure settings or significant mask leaks. CPAP can cause aerophagia, leading to bloating, gas, and discomfort. It occurs when pressurized air enters the stomach instead of the lungs, often due to high pressure, mouth leaks, or sleeping on your back.

To help prevent this, make sure your mask fits properly and consider discussing pressure adjustments with your doctor. You can also try sleeping on your side and tucking in your chin. A clinician can enable or adjust EPR (expiratory pressure relief) if it is not already active. If the issue persists, reach out to your physician.

Q. I'm getting water in my CPAP tubing, and it rattles when I breathe. Why?

A. Water in the tubing, also called “rainout,” often sounds like popcorn popping. It occurs when humidified air in the hose cools and condenses into water droplets, which then pool at the opening of the tubing near the back of the machine. The rattling sound comes from this water moving around. Using ClimateLine tubing (RX only) can help prevent the air from cooling and condensing, and it also regulates the room’s ambient temperature when set to “Auto.” If you only have standard tubing, you can try lowering the humidity setting on your machine or placing the CPAP machine on a surface lower than your head.

You can also use a zip-up tubing cover to insulate the hose or simply cover it with a blanket while sleeping. Avoid having a fan blowing directly on your tubing, and consider slightly increasing your room temperature if it is below 70 degrees. Lowering the humidifier setting, using heated tubing, and keeping the tubing elevated so water drains back into the humidifier can help. Also avoid drastic room temperature changes, and if you sleep with the windows open, keep in mind that weather swings and temperature shifts can increase condensation.

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