How to Safely Use Menthol When You Use CPAP

Whether you have a head cold or allergies, or live with chronic congestion, you’ve likely found aromatic products like menthol helpful for clearing your sinus and nasal passages. The bright fragrance and cooling sensation can bring relief, especially if you almost must use positive airway pressure (PAP) therapy for sleep apnea.

What is menthol?

Menthol is naturally derived from plants in the mint family. It can also come from plants with similar aromatic and cooling qualities in their essential oils, such as eucalyptus or citronella.¹

It’s also a compound that’s frequently synthesized. This is because menthol is widely used for all kinds of products besides decongestants, such as pain relief, food flavoring, fragrance, as a cooling agent, and more.²

Menthol has long been considered “generally recognized as safe” (GRAS) by the FDA. However, if you decide to use menthol as a form of aromatherapy during cold and flu season — while using CPAP — you need to do so with care, as some applications are safer than others.³

Types of menthol applications

You can find menthol in all kinds of forms, from lozenges to essential oils to ointments to personal inhalers to bath oils.

If you want to use menthol to help you breathe better while using CPAP, here are some things to keep in mind.

Lozenges

It can be unsafe to suck on a menthol lozenge while reclined. If this therapy appeals to you, enjoy the lozenge before climbing into bed. Its cooling, head-clearing quality will linger quite a while after the lozenge itself has dissolved.

Essential oils

These are the basis for aromatherapy and should be pure and of the highest quality. Those that contain menthol can be safe when used in a diffuser, steam vaporizer, or humidifier following the device manufacturer’s directions.

However, it’s unsafe to place essential oils directly in your CPAP humidifier. Why?^4,5

• CPAP machines deliver pressurized, humidified air that can propel droplets of steam deep into the lungs. If these droplets contain even tiny amounts of essential oil, this can lead to anything from lung irritation to far more dangerous conditions like lipoid pneumonia.≈
• CPAP machines aren’t built to safely deliver essential oils in any amount. They’re only meant to be operated using distilled water. Using essential oils in your machine’s humidifying chamber may void its warranty or lead to machine damage.⁶
• Also, because you use CPAP for several hours overnight, your exposure to concentrated essential oils through the humidifying chamber has the potential to be toxic.⁷

You may have heard of aromatherapy kits sold for use with a CPAP machine. They’re essentially the same thing as other kinds of aromatherapy devices—such as diffusers and vaporizers — already on the market.

Ointments

At bedtime, many people rub menthol petroleum jelly on their feet, their chest, across the top of the lip, on their earlobes, or inside the nostrils to help keep passages clear when they have problems with congestion.

However, please note: If you look at the label on a typical package of menthol petroleum jelly (the most common brand being Vicks® VapoRub), it says quite clearly: “For external use only; avoid contact with eyes. Do not use in nostrils.”⁷

The reason for this is the same as the reason for not inhaling essential oils through your CPAP mask. Recent research shows that long-term internal use of menthol petroleum jelly (including in the nostrils) could lead — if rarely — to lipoid pneumonia.^8,9

However, rubbing the ointment on your feet, your chest, and even on your earlobes, may still give you the decongesting benefits you’re looking for.

Personal inhalers

This is an easy one. Menthol inhalers are made for the safe delivery of menthol products to help ease congestion. Use as directed throughout the day and at bedtime and you should be good to go.

Bath oils, salts, and shower bombs

A warm bath before bedtime can do 3 things at once:

• Relax your body so you fall asleep easier
• Clear your passages so you can breathe easier
• Introduce steam that moistens mucus membranes, providing congestion relief

Lavender, mint, or eucalyptus in the bath right before bed could really bring you a good night’s sleep. Bath oils, salts, and fizzies can all deliver a comforting pre-bedtime soak that clears up your head.

Don’t have a bathtub? Consider a shower bomb. Like bath bombs, these fizzy menthol items work by dissolving in water — in this case, from the spray of the showerhead — releasing aromatherapy into the steam.

Still not sure?

Your safest option is to talk to your sleep physician about over-the-counter products with menthol that can best help you battle congestion while using CPAP.