Pulmonary air leaks (PAL) are probably the most important clinically significant adverse effect associated with CPAP. They tend to occur when the lung compliance starts increasing and the clinical status improves. Overdistention of lung also leads to CO2 retention and increased work of breathing. Use of nasal prongs leads to nasal irritation, damage to nasal septa, skin damage, and nasal bleeding and columellar necrosis (rarely). These complications can be minimized by gentle application of appropriate sized nasal prongs and by giving adequate nasal care.