A man shown from behind with a hand placed on his tilted neck where the vertebrae glow with pain beneath the strap of his CPAP mask.

Using a CPAP Mask While Having Neck Issues

Having sleep apnea and using a continuous positive airway pressure (CPAP) machine with a mask is hard enough for the average person to get used to. Having other issues in your neck can make CPAP therapy much more difficult.

Existing neck issues before CPAP therapy

I personally have several different issues with my neck. The 1 that causes more problems with the sleep mask is Chiari malformation (CM). A simple CM explanation is when the brain herniates into the spinal column.

But on top of that, I also have myasthenia gravis. For me, this causes weak neck muscles, along with a whole host of other problems.

I also have degenerative disc disease, arthritis, some stenosis, bone spurs, and other fun things.

My husband, Jeff, also has sleep apnea and uses a CPAP machine with a mask. A few years back, he had to have an emergency spinal fusion in his neck. He also has arthritis in his neck. We both have existing neck issues.

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More neck issues using CPAP therapy

Strap pressure increases neck pain

I have used a CPAP machine for a few years longer than Jeff. Also, I have used a few different types of masks. However, my husband is still on his first mask.

What we have both noticed is that all the masks, or at least the ones we have used, have a strap that goes in the space of the back of the head right between your ears. Or, somewhere in that area.

Well… it’s not that these masks are strapped down really tight. But we're finding when you have neck issues, even having that slight pressure in that area causes pain and problems using the CPAP.

Slight pressure affects neck alignment

Even with that slight pressure, both of us have noticed that it seems to pull the neck out of alignment just a little bit. There again, this pressure would cause some neck pain for the average CPAP mask user. But when you already have neck issues causing some sort of instability, it doesn't take much pressure to create other problems.

CPAP strap causes headaches

At times for both of us, pressure from the strap causes full-blown headaches right there at the base of the skull. Not fun at all when you're trying to sleep.

Adjustments to strap interrupt sleep

While it's not an every night occurrence for either of us, we do tend to have our sprees – days, or weeks at a time – where our sleep is interrupted trying to adjust the mask there at the base of the skull (in between the ears.) Either trying to get that strap higher or lower interrupts our sleep.

After getting it adjusted, it stays for a while. But then slowly creeps back to the base of our skull. The strap applies a slight pressure, just enough to cause the neck issues to act up.

Helpful solutions

On top of sporadically adjusting the back strap of the CPAP mask at the back of our heads, we have several different pillows of different densities. We will switch out the pillows depending on what kind of support we feel our neck is needing at the time. And yes, there have been times we've used more than 1 pillow.

My personal favorite is a very soft pillow that I can roll up and squish to best fit my next need for that night. I also took 1 pillow and squashed most of the filling to 1 end. Then, I sewed it, so that on the other end there's a slight bit of padding. With this, the back of my head can rest in between the 2 bumps of filling.

Incidentally… that pillow is used a lot too, by both of us.

Do you have neck issues from using CPAP? Please share a comment and solutions that help.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The SleepApnea.Sleep-Disorders.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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