Research suggests that CPAP may improve headaches in some people with sleep apnea. But some people may develop headaches if their CPAP mask is too tight, if they develop nasal congestion, or if CPAP disrupts their sleep.

A continuous positive airway pressure (CPAP) machine helps keep your airways open while you’re sleeping. Doctors may recommend CPAP for people with sleep apnea and some other sleep-related breathing conditions.

Headaches seem to be common among people with sleep apnea. Many people with sleep apnea see improvements in their headaches after they start CPAP.

Although CPAP can be beneficial, the machines can be difficult to use, especially in the beginning. Some people may experience headaches indirectly related to CPAP due to underlying causes, such as:

  • disrupted sleep
  • tight straps against their scalp
  • nasal congestion or irritation

Read on to learn more about the connection between CPAP and headaches.

CPAP may contribute to the development of several types of headaches. Headache symptoms can depend on the underlying cause. For example, if your CPAP machine disrupts your sleep, you might develop a tension headache that causes a dull ache or feeling of pressure around your forehead.

Sleep deprivation is also thought to increase your susceptibility to migraine headaches. Migraine headaches can cause throbbing pain on one side of your head. Before your migraine episode, you might have other symptoms, such as:

Researchers believe headaches are common among people with obstructive sleep apnea. According to one 2021 paper, they may occur in anywhere from 15% to 60% of such people.

However, headaches are also common among the general population, and it’s unclear if people with obstructive sleep apnea experience more headaches than people without the condition.

CPAP often seems to improve headaches for people with sleep apnea. However, some people might develop new headaches for indirect reasons.

Trouble sleeping

Some people find their CPAP masks uncomfortable, which may affect their sleep quality. Tension headaches and migraine headaches are highly related to sleep deprivation, with about 50% of people with these types of headaches also experiencing insomnia.

CPAP mask is a bad fit

If the straps on your CPAP mask are too tight, you may develop an external compression headache.

External compression headaches are due to any type of tight headwear. They’re estimated to develop in about 4% of people, potentially due to irritation of nerves like the trigeminal and occipital nerves.

CPAP pressure set too high

If the pressure on your CPAP machine is too high, you might develop nasal irritation or congestion as well as dryness in your mouth or nose. In theory, these symptoms may affect your sleep quality and make you more prone to headaches.

Sinus and nasal problems

CPAP can trigger nasal inflammation and congestion in several ways, such as by:

  • changing air humidity
  • changing air temperature
  • changing airflow rate
  • causing mask odors

Nasal congestion can cause symptoms like:

Nasal congestion and inflammation due to CPAP machines are often secondary to lack of humidity on the CPAP. Many CPAPs have adjustable humidifiers that can be changed to improve dryness leading to nasal congestion and headaches.

Mask or tubing are dirty

If you don’t clean your mask or tubes properly, your equipment may spread infections that can cause headaches and other symptoms. For example, in one 2022 study, researchers reported a case of pneumonia spread by CPAP equipment.

Can CPAP improve headache symptoms?

Treating sleep apnea with CPAP has been shown to reduce symptoms of sleep-related headaches in some people.

For example, in one 2023 study, researchers reported morning headaches in 54.3% of people with obstructive sleep apnea. They found that headaches, especially morning headaches, significantly improved after CPAP.

If you’re developing headaches that you think might be related to CPAP, you might be able to reduce your symptoms by:

  • loosening your mask to help treat headaches caused by tight straps
  • switching your type of mask, if you find it uncomfortable
  • asking your doctor about lowering the pressure of your machine, if you find it difficult to exhale
  • cleaning your mask and tubes regularly to help prevent CPAP-related infections

Here are some frequently asked questions that people have about headaches and CPAP.

Can a dirty CPAP cause headaches?

Not cleaning your CPAP machine properly may spread infections. Many infections can cause headaches, along with other symptoms.

How do I know if my CPAP pressure is too high?

A CPAP machine provides your airways with enough pressure to prevent them from collapsing while you’re sleeping. If the pressure on your machine is too high, you may find it difficult to exhale.

Side effects of CPAP include:

It’s important to contact your doctor if you’re having problems with your CPAP machine, such as waking up with a very dry mouth or having trouble sleeping. Your doctor may recommend:

  • switching the type of mask or tubing connected to your machine
  • adjusting your pressure settings
  • trying a different type of machine, such as an automatic positive airflow pressure machine, which adjusts pressure through the night
  • stopping CPAP

It’s important to communicate with your doctor if you’re having trouble with your CPAP machine. They may be able to recommend ways to manage your headaches, such as changing the pressure on your machine or your mask type.