Following President Biden’s Lead, 5 CPAP Comfort Tips (2025)

“I’m tired of being tired in the morning. My wife kicked me out of the bedroom. My doctor prescribed me the CPAP machine, but I don’t use it. I don’t understand how President Biden wears his CPAP every night,” said Mr. S, a 47-year-old lawyer during our consultation. This sentiment is one that many practitioners in sleep medicine hear often.

Sleep apnea is a serious condition where breathing repeatedly stops and starts during sleep, disrupting oxygen intake and rest. Common symptoms include loud snoring, gasping for air, daytime fatigue, morning headaches, dry mouth, difficulty concentrating and irritability.

It affects around 39 million U.S. adults, yet up to 80% of cases go undiagnosed. Untreated, sleep apnea can lead to cognitive impairments (like memory problems and difficulty concentrating), mental health issues (such as depression and anxiety) and daytime sleepiness. It also increases the risk of cardiovascular diseases (heart disease, stroke, high blood pressure), type 2 diabetes, weakened immunity and sexual dysfunction. Over time, it can cause long-term memory loss, cognitive decline and premature death.

4 Reasons Why Sleep Apnea Often Undiagnosed:

1. Unnoticed Symptoms: Many people gradually become more tired over time and attribute it to aging, not realizing it’s a sign of sleep apnea. Family members may overlook snoring or interruptions in breathing during sleep.
2. Misconception About Weight: Sleep apnea is often associated with overweight individuals, but it can affect people of any weight, especially if they breathe through their mouth due to issues like nasal congestion or allergies.
3. Lack of Screening by Doctors: Primary care doctors rarely ask about sleep patterns or symptoms related to sleep apnea, leading many cases to go undetected.
4. Fear of Treatment: Some people suspect they have sleep apnea but avoid testing because they fear they’ll need to use a CPAP machine, which many find uncomfortable or inconvenient.

Continuous Positive Airway Pressure (CPAP) is a device used to treat obstructive sleep apnea by delivering a constant flow of air through a mask to keep the airway open during sleep. While it’s the gold standard for treatment, many people struggle with compliance due to discomfort. When President Joe Biden was seen with marks on his face from using a CPAP mask, it sparked a national conversation, as millions of people with sleep apnea face the same challenge. Many patients abandon their CPAP machines, leaving them collecting dust in a closet.

5 Comfort Hacks to Make CPAP Use Easier

1. CPAP Comfort Accessories: Specially designed CPAP pillows support the neck, accommodate masks and tubing and enhance overall comfort. “ Items such as aftermarket strap covers prevent marks on the face, while hose covers keep the CPAP hose warm and comfy in bed. Mask liners also help absorb sweat and oil from the skin," said Michael DiDomenico, a compliant CPAP user, publisher of Sleep World Magazine and founder of the Philadelphia Sleep Conference.
2. CPAP Hose Holders: These accessories keep tubing organized and prevent tangling or mask displacement during sleep. By stabilizing the CPAP tubing, they reduce disruptions, making CPAP therapy more tolerable for patients, said Dr. Funke Afolabi-Brown, sleep physician, author of “Beyond Tired”, and founder of The Restful Sleep Place concierge sleep practice.
3. V-Com Device: This accessory softens airflow, reducing pressure and noise, which is particularly helpful for new users or those with higher pressure settings. "I initially tried the V-Com out of curiosity but quickly realized it helped me breathe more comfortably. Now, I use it every night," says Emma Cooksey, author of “The 6-Week CPAP Solutions Workbook”, patient advocate, founder of the podcast “Sleep Apnea Stories” and CPAP user for 17 years.
4. Mouth Tape or Sleep Q+Lip Glue: For users who experience mouth leaks, lip closure encourages nasal breathing, reducing the need for higher pressure settings and preventing air from escaping. While popular on social media, it may be easier to try mouth tape during the day before using it at night. "Mouth breathing while using CPAP is common, but it can significantly reduce therapy effectiveness. Using a nasal breathing support like MyoTape, which encourages lip closure, helps minimize air leaks, improving oxygenation and sleep quality," says Patrick McKeown, internationally acknowledged breathing coach and author of “The Oxygen Advantage”.

5. Behavior Training: Dr. Shelby Harris, a licensed clinical psychologist specializing in behavioral sleep medicine and author of “ The Women's Guide to Overcoming Insomnia”, recommends adjusting expectations. "Many people think using a CPAP is no big deal, but it can be challenging. It's a process that takes time. My tip is to wear the mask during the day while watching TV, then use the ramp function to gradually adjust pressure. More daytime practice helps with night use”

Treatment Options

Sleep apnea is a lifelong, progressive disease and patients need to be educated about all available treatment options besides CPAP to manage their condition effectively.

• Hypoglossal Nerve Stimulation: It’s a treatment for moderate to severe OSA involving a surgically implanted device that stimulates the hypoglossal nerve to move the tongue forward during sleep, helping prevent airway obstruction. “Combining hypoglossal nerve stimulation with an oral appliance reduces the electrical current needed due to the advancement of the mandible. Together, with less voltage required, they provide an ideal, tolerable outcome,” says Dr. Dave Frederici, Board-certified dentist by the American Academy of Dental Sleep Medicine and internationally recognized lecturer.
• Oral Appliance Therapy is a custom-made mouthpiece that repositions the jaw and tongue to keep the airway open during sleep. It can also be used alongside CPAP and hypoglossal nerve stimulation. “As my sleep apnea worsened over time and my CPAP pressure increased, I experienced discomfort while inhaling. I suffered from painful trapped gas due to swallowing air. Adding an oral appliance alongside CPAP allowed my pressure settings to be lowered, making therapy more comfortable,” says Cooksey. Studies show that combining OAT with CPAP improves compliance and has the greatest effect on reducing high blood pressure.
• Surgical Options include tonsil and adenoid removal, correction of a deviated septum and soft palate modifications.

Mini-implant Assisted Rapid Palatal Expansion (MARPE) is a non-invasive orthodontic procedure that widens the upper jaw, increasing nasal passage size and reducing breathing resistance. “MARPE expands the airway, reducing resistance and improving sleep quality,” says Dr. Maria Karpov, an orthodontist in New York City. “It’s particularly helpful for young adults with narrow upper jaws, improving symptoms like snoring, daytime tiredness and low oxygen levels.”

For severe cases, orthognathic surgery may be recommended to reposition the upper and lower jaws, enlarging the airway

“Orthognathic surgery is a game-changer in sleep apnea treatment, offering both a rejuvenated appearance and the chance to eliminate its effects,” explains Dr. David Alfi, MD, a custom double-jaw surgeon. “This procedure addresses the root cause—small jaws.”

• Weight Loss: Obesity is a significant risk factor for sleep apnea. Losing weight through diet, exercise and with help of medications can reduce the severity of sleep apnea or even eliminate it in some cases. The FDA has approved Zepbound (tirzepatide) as the first drug treatment for moderate to severe obstructive sleep apnea (OSA) in adults with obesity. By activating GLP-1 and GIP hormone receptors, it reduces appetite and body weight, which studies show can improve OSA symptoms. Combining weight loss with therapies like CPAP or OAT can enhance treatment effectiveness.
• Myofunctional Therapy: Myofunctional therapy involves exercises to strengthen and retrain the muscles of the tongue and throat. It can improve tongue position and swallowing patterns, reducing airway collapse during sleep. This treatment option can be used in addition to other treatment modalities. It reduces the sleep apnea index by 50% for adults and 62% for children.

Each treatment option works differently for everyone. Working with a sleep doctor to find the right combination is essential to managing sleep apnea effectively.

President Biden has been managing sleep apnea since at least 2008. As his doctor, Kevin O'Connor, noted in a 2019 report released by Biden's presidential campaign team, his symptoms initially improved with nasal and sinus surgeries. However, as his sleep apnea worsened over time, he began using a CPAP machine to improve his sleep quality and daytime well-being. His experience serves as an important example for others, highlighting the importance of CPAP compliance and the need to explore multiple treatment approaches as health needs evolve.