Comfort and side effects
Nosebleeds From CPAP: Causes, Fixes and When to Worry
CPAP nosebleeds usually come from dry, irritated nasal lining, and better humidification is the main fix. Most are minor, but a nosebleed that will not stop after 20 minutes, or nosebleeds while on blood thinners, need medical care.
Signs
- Blood on your mask cushion or nasal pillows
- Bloody crusts in the nose in the morning
- Dry, sore nostrils
- Small nosebleeds when you blow your nose
Common causes
- Dry air
- ResMed lists nosebleeds among the problems a CPAP humidifier helps prevent. The Sleep Foundation notes forced air can dry the nose, causing nosebleeds and crusting.
- Pressure or rubbing from nasal pillows
- Pillows that are too big, too small or pushed in at an angle can irritate the inside of the nostril.
- Pressure side effects
- NHLBI lists nosebleeds as a possible PAP side effect. The Sleep Foundation lists nosebleeds among signs pressure may be too high, which only your clinician can assess.
- Medicines and health conditions
- Blood thinners and some health conditions make nosebleeds more likely or harder to stop.
Fixes to try, easiest first
Moisturize the inside of your nose
Use saline spray before bed and a water based nasal gel on the inside of your nostrils. Ask your clinician before using petroleum products near your mask.
Raise humidity and use heated tubing
Heated humidification is the main prevention for dryness related nosebleeds. Increase one step at a time and add heated tubing if you get rainout.
Check your nasal pillow size and angle
If you use nasal pillows, make sure they sit at the nostril without being jammed in. Try a different size if the inside of your nose is sore. Your equipment provider can help.
Try a different mask style
A nasal mask or full face mask does not press inside the nostrils. Ask your provider about trying one while your nose heals.
Stop a nosebleed the usual way
Sit up, lean forward and pinch the soft part of your nose. Let your nose settle before putting the mask back on.
Tell your sleep doctor with your clinician
Tell your sleep clinician about repeated nosebleeds. They can check your settings and data. Do not lower your pressure yourself.
Get medical care if a nosebleed does not stop after 20 minutes, follows a head injury, or happens while you take blood thinners, according to MedlinePlus. Contact your provider if you have frequent nosebleeds or nosebleeds not linked to a cold or minor irritation. Let your sleep doctor know about any repeated bleeding on CPAP.
Supplies that can help
Salt water spray that moistens and clears the nose, a simple aid for the congestion and dryness some people get on CPAP.
A water-based or saline gel applied inside or around the nostrils to soothe dryness and soreness from CPAP airflow.
Tubing with a built-in heating wire that keeps humidified air warm all the way to the mask, which is the main fix for rainout (water droplets …
Distilled water is what most CPAP humidifier chambers are meant to be filled with, because it leaves little or no mineral scale behind.
Retailer links are affiliate links. We may earn a commission at no cost to you.
Mask types this applies to
Frequently asked questions
Can CPAP really cause nosebleeds?
Yes. NHLBI lists nosebleeds as a possible side effect of PAP machines, usually from dry, irritated nasal lining. Humidification is the main fix.
Should I use CPAP during a nosebleed?
Wait until the bleeding has fully stopped before putting your mask back on. If nosebleeds keep happening, call your sleep doctor before your next night.
Are nasal pillows bad for nosebleeds?
They can make a sore nose worse because they sit inside the nostrils. A nasal mask or full face mask may be easier while your nose heals.
Sources
Last reviewed October 11, 2026. How we research · Report an error