Approximately one of 15 Americans is diagnosed with sleep apnea; and one in 50 is an undiagnosed sufferer.[1]  The treatment for moderate to severe sleep apnea involves using a continuous positive air pressure (CPAP) machine. Technology does not seem to have caught up with this treatment as the machine requires the user to wear a mask that is hooked to the machine. This is the issue with treatment compliance. Depression is just one emotion that can erupt when diagnosed with obstructive sleep apnea (OSA) and prescribed a CPAP machine.

Wearing CPAP Mask can Impact Body Image

Body image is psychological, a learned belief. When individuals have a healthy body image, they have an accurate perception of the shape and size of the body and are comfortable with it. Individuals with negative body image have a distorted perception of shape and size; and that can lead to low self-esteem, dieting, eating disorders, anxiety, and depression.

Body image is not based on fact. It is sensitive to mood changes, physical experiences, and changes in the environment. Individuals with a negative body image will be at a higher risk for noncompliance in wearing a CPAP mask than individuals with a positive body image.

Full Face Mask for Sleep Apnea;  Source: Wikimedia CommonsCredit: Source: Wikimedia Commons

There is no getting around the fact that wearing a CPAP mask alters a person's appearance. Individuals look in the mirror and see a reflection of something that looks like an alien from outer space. The fact that the mask is life-saving does not always eliminate those feelings; but, being aware of it, may lead to acceptance. Focusing on the health aspects of wearing the mask can help reduce the negative feelings of how it makes individuals look.

Fitting the Full Face Mask CPAP Mask


Phobias can be Issue for Some CPAP Mask Wearers

Individuals may feel anxiety when wearing the mask due to a phobia such as claustrophobia which is a fear of tight or enclosed space; or aquaphobia which is the fear of drowning.  Individuals may feel bound or restricted while wearing the mask.  These feelings are most common with wearers of a full-face mask; but can also occur with a partial or a nasal interface.

Individuals may need professional help to overcome the phobia.  Some may overcome the fear by confronting it.  Medical doctors who prescribe the CPAP machine for sleep apnea, advise patients to start wearing the mask for a couple of hours and gradually increase the time until they can tolerate it the entire night’s sleep.  Patients can also use visualization techniques to help.  Patients visualize putting on the head gear, sleeping the entire night, and waking up refreshed.

Feeling Disabled When Wearing A CPAP Mask

Many people feel disabled when using the sleep apnea device.  Although logic tells them something different; emotions tell them they are “less than” and impaired.  However, disability is not a frame of mind; it is a term of reference.  Resolving the feeling of disability entails a bit of self-discovery work.

Individuals need to be realistic and take stock of any actual physical limitations brought about by wearing the CPAP mask.  In the majority of cases, it is more about what the dreaded mask represents rather than actual physical limitations.  The wearer should replace the thoughts of “less than” with thoughts of “what is normal?”

Sleep apnea does not discriminate who it affects.  It is a misconception that only fat or old people get sleep apnea.  It is diagnosed in old, poor, fat, athletic, young, thin, and sedentary people.  What is normal?  The ability to eliminate the feelings of disability will be determined by how well the individual faces reality and refrains from self-pity. 

Guilt can Interfere with Compliance

Guilt can surface when individuals believe they could have prevented sleep apnea by taking better care of themselves; but again, sleep apnea can develop in the fittest individual.  Guilt can also surface when purchasing the equipment.  CPAP machines cost over $200; and the masks cost from $80-$200 depending on the type.  Getting the right one that is comfortable and fits properly can be expensive.  Most masks are non-returnable once the package has been opened.  Insurance may pay for the machine and the first mask.  However, not all insurances cover additional masks; and some do not cover the full cost of the machine.


CPAP Machine and CPAP Mask; Source: Wikimedia CommonsCredit: Source: Wikimedia Commons

Guilt can also crop up when individuals have irrational beliefs or negative self-scripts. They may feel guilty for feeling guilty.  For many individuals, wearing a mask not only affects them; it also affects a spouse or significant other.   The loved one may consider the contraption intimacy killing and can make comments that are unintentionally cruel.   Healthy communication can help in this area.

Some individuals will do well working through the multitude of emotions that come with the diagnosis of OSA and the prescribed treatment of using a CPAP machine and mask.  Others may need assistance.   Support groups are beneficial for some individuals and many sleep clinics offer groups for sleep apnea patients.  Some mask wearers seek professional advice from a psychotherapist.  Others rely on a higher power such as God.  Some use all these strategies to overcome the flood of emotions that can accompany the sleep apnea treatment.  Regardless of which strategy is used; individuals who finally accept the treatment can receive the full health benefits of wearing the CPAP mask.


The copyright of the article Emotional Impact of Wearing a CPAP Mask is owned by Cheryl Weldon and permission to republish in print or online must be granted by the author in writing.

ResMed Quattro FX Full Face Mask Frame System-No Headgear (Large)
Amazon Price: $89.00 Buy Now
(price as of Oct 15, 2013)
This version of the full face mask doesn't use the cumbersome headgear which makes the mask more comfortable.