CPAP Headgear and Neck Nerve Pain: A Case

A 2026 case report describes an 81-year-old man whose one-sided neck and head pain began when he started CPAP. A nerve block took the pain from 6 out of 10 to 0.

PulseOxTracker Team9 October 2026

Infographic summarising a 2026 case report on CPAP headgear and nerve pain. Pain when turning the neck, out of 10: 6 before the nerve block, 0 straight after it. The block numbed one nerve that the lower headgear strap crosses. Who was studied: 1 patient, an 81-year-old man with sleep apnea, using a full-face CPAP mask held on by four-strap headgear, seen at a rehabilitation clinic in Portugal. What the doctors reported. Pain began when he started CPAP: about a year of right-sided neck and head pain. Turning the head right set it off: 0 out of 10 at rest, up to 6 out of 10 at worst. Worn neck joints were blamed first: scans showed heavy wear and narrowed nerve exits. Three therapies gave limited benefit: pregabalin, physiotherapy and mesotherapy. One nerve block stopped the pain: 4 mL of local anaesthetic, guided by ultrasound. Still pain-free at 3 months: neck rotation was no longer limited. What it cannot show: one patient, so the cause is not proven. His worn neck joints may explain part of the pain. Nobody knows how often this happens to CPAP users. Source: Meixedo et al. 2026, Cureus. — A summary of the 2026 case report: one CPAP user, the pain he had, what was tried, and what the report cannot show.

Tight headwear like helmets, swimming goggles and headbands is a known cause of head pain. A case report published in 2026 describes the same kind of problem with a CPAP mask's headgear.

The authors say they couldn't find an earlier published report of it.

Who was the patient?

An 81-year-old man in Portugal with sleep apnea. He used a full-face CPAP mask held on by four straps: two over the top of the head and two around the back at about ear level.

What was the pain like?

Right-sided neck pain that spread to the temple on the same side.
It came on when he turned his head to the right.
He rated it 0 out of 10 at rest and 6 at its worst.
It had lasted about a year when he was referred, and it started around when he began CPAP.
It happened through the day, not only with the mask on.

Why wasn't the headgear suspected sooner?

His scans showed heavy wear in the neck joints and narrowed openings where nerves leave the spine. The doctors blamed that first.

Over the next year he tried pregabalin (a nerve pain medicine, 150 mg twice a day), physiotherapy and mesotherapy. Each gave limited benefit.

Then the doctors went back over his history and noticed the timing with CPAP. Light touch was painful only over the skin supplied by the lesser occipital nerve. That nerve runs up the side of the neck, where the lower straps sit.

What did the nerve block show?

The doctors injected 4 mL of local anaesthetic around that nerve, guided by ultrasound.

Pain on turning went from 6 out of 10 to 0 out of 10 straight away.
At three months he still had no neck pain or headache, and his neck rotation was no longer limited.

The authors think the strap pressed or pulled on the nerve, and that turning the head made it worse. They advised his lung doctor to look at changing the mask.

What can't one case show?

A single case can't establish the cause with certainty.
His worn neck joints may explain some of his neck symptoms.
Nobody knows how common this is among CPAP users.

What can you do with this?

If you use CPAP and have new one-sided neck or head pain, tell your doctor when it started. Any change to your mask or therapy is a decision for you and your doctor.

Not a medical device. Does not diagnose, treat or prevent any condition. Discuss results and changes with a clinician.

References

Meixedo S, Menezes I, Matos Dinis C, Teixeira PM, Martins D. Lesser Occipital Neuralgia Secondary to Continuous Positive Airway Pressure (CPAP) Mask Headgear: A Case Report. Cureus. 2026;18(10):e117419. doi:10.7759/cureus.117419