Having Sex When You Have a CPAP Machine

Falling asleep with someone after having sex is the height of romance, right? Well, not always. Both the act of sex and the act of sleep are fraught with conceivable hazards—one of which can be dealing with continuous positive airway pressure (CPAP) therapy, which is used to treat Obstructive Sleep Apnea (OSA).

OSA occurs when the throat and tongue muscles relax during sleep, blocking the airway. This leads to snoring, choking, gasping and repeated awakenings. OSA is involuntary, meaning you can't control it, and OSA happens so rapidly that you often don't even know about it. But in the morning, patients wake up exhausted and/or with a headache.

Treatment for OSA includes a continuous positive airway pressure therapy (CPAP) machine that forces air through a tube and into a mask that is worn all night long over the mouth, nose or both. "The air acts almost as if it were a splint that you would use on a broken finger to keep it straight for healing," said Shelby Harris, PsyD, CBSM, a sleep psychologist in New York City. "The CPAP pressurized air at night keeps the airway nice and rigid, helping to prevent collapse."

(Not) too sexy for your PJs?

Modeling a CPAP machine might not be your definition of seductive. But you don't strap on a CPAP like a sex toy during the act. You add it afterward before you go to sleep.

Nevertheless, you don't have to lose sexual spontaneity. Relatively new CPAP user Caridad Moro-Gronlier, based in Miami, said she and her wife will generally have sex before she dons the mask. But if they get the urge after it's on, "it's pretty easy to take off."

Harris confirmed that it's "totally okay to ask for you to take the machine off in the middle of the night or in the morning if you desire to have sex."

Still, simply having the machine by the bedside alludes to the less alluring side of life. Plus, "if you like to sleep all tangled up with someone, yeah, the hose and especially the exhaust blowing in their face are likely to be disruptive," noted Adrienne Dellwo, a Washington State-based medical writer who writes about fibromyalgia and ME/CFS (aka chronic fatigue syndrome).

"Spooning and intimacy can be an issue if the machine is on," said Harris, who also authored "The Women's Guide to Overcoming Insomnia" in 2019. "Instead, have the PAP wearer be the little spoon in this instance so there's less to worry about."

Overcome shame

Too embarrassed to bring out the machine in front of someone? This is what Harris called "the biggest disruptor overall." Conquering self-consciousness is crucial, so to alleviate any mortification, Harris recommended bringing your partner along to appointments. Frequently, a partner was the one to bring snoring and breathing issues to your attention anyway. Value them in return by including them in the process.

For those who fear judgment from new lovers, Dellwo said it helps if you don't have unrealistic expectations about sex. A fibromyalgia and ME/CFS educator-advocate, she once advised a younger woman who "adored romance and glamor" and was devastated when she was diagnosed with OSA.

In that case, cultivate a sense of humor. Also, keep in mind that what feels cringe-worthy in your 20s won't matter so much a couple of decades later when potential partners also develop lifestyle quirks.

Dellwo had given birth twice with a longtime partner when she first started on the CPAP 15 years ago. But she has since moved on to other sexual partners. "It's a little weird, sure," she said. "But would you rather they saw you with a goofy thing strapped to your face or had to listen to you snore and gasp all night? 'Cause, that's certainly not sexy, and neither is sleep deprivation. If it really bothers you, turn the light off before you put it on."

Hold on, there are some positives.

Even though Moro-Gronlier is still adjusting to the CPAP, she said she already sees benefits: "Now that I'm sleeping, my libido is much improved!"

Dellwo noticed the same advantage. "I became so much better rested that I had more energy to devote to my partner, in and out of bed," she said. "So, in that way, it contributed to our intimacy."

The benefits of using CPAP machines to treat OSA can include improved libido and energy as well as mood, Harris confirmed. In addition, she said, it "even helps with erectile dysfunction in some men." Now that's an upside indeed.