Save 45% on a Home Sleep Test –Shop Now
/ CPAP: Continuous Positive Airway Pressure / CPAP Pressure Settings
Jay Summer Staff Writer
Jay Summer
Staff Writer
Jay Summer is a health content writer and editor. She holds a B.S. in psychology and master's degrees in writing and public policy.
Want to read more about all our experts in the field?
Dr. Abhinav Singh Sleep Medicine Physician
Dr. Abhinav Singh
Sleep Medicine Physician
Dr. Singh is the Medical Director of the Indiana Sleep Center. His research and clinical practice focuses on the entire myriad of sleep disorders.
Want to read more about all our experts in the field?
Fact-Checked
Sleep Foundation
Fact-Checking: Our Process
The Sleep Foundation editorial team is dedicated to providing content that meets the highest standards for accuracy and objectivity. Our editors and medical experts rigorously evaluate every article and guide to ensure the information is factual, up-to-date, and free of bias.
The Sleep Foundation fact-checking guidelines are as follows:
- We only cite reputable sources when researching our guides and articles. These include peer-reviewed journals, government reports, academic and medical associations, and interviews with credentialed medical experts and practitioners.
- All scientific data and information must be backed up by at least one reputable source. Each guide and article includes a comprehensive bibliography with full citations and links to the original sources.
- Some guides and articles feature links to other relevant Sleep Foundation pages. These internal links are intended to improve ease of navigation across the site, and are never used as original sources for scientific data or information.
- A member of our medical expert team provides a final review of the content and sources cited for every guide, article, and product review concerning medical- and health-related topics. Inaccurate or unverifiable information will be removed prior to publication.
- Plagiarism is never tolerated. Writers and editors caught stealing content or improperly citing sources are immediately terminated, and we will work to rectify the situation with the original publisher(s)
- Although Sleep Foundation maintains affiliate partnerships with brands and e-commerce portals, these relationships never have any bearing on our product reviews or recommendations. Read our full Advertising Disclosure for more information.
Up-to-Date
Table of Contents
Table of Contents
- How to Determine the Proper Pressure Setting for a CPAP Machine
- Factors That Affect the Pressure Setting of a CPAP Device
- How to Tell if Your CPAP Pressure Is Properly Set
- Frequently Asked Questions
Key Takeaways
- CPAP pressure levels, as determined by a sleep specialist, are typically the lowest amount of pressure needed to to keep the airway open.
- The pressure setting is crucial to treating sleep apnea and reducing symptoms.
- Anatomy and sleep habits factor into the appropriate pressure level.
- Speak to your doctor about recalibration if you experience discomfort, breathing difficulties, and a lack of symptom improvement.
People with obstructive sleep apnea (OSA) stop breathing for brief intervals during sleep due to a blocked or collapsed airway. Continuous positive airway pressure (CPAP) machines are commonly prescribed to treat the condition. The devices deliver pressurized air to help normalize breathing. The right amount of pressure is critical to effective CPAP therapy, as pressure that is too low or too high can create adverse side effects.
We discuss how CPAP pressure is measured, the various factors that determine pressure needs, and the signs and symptoms that suggest your pressure level might need adjusting. It is important to contact your doctor if you believe your CPAP machine settings need to be adjusted. Pressure settings should only be changed under the guidance of a medical professional.
How to Determine the Proper Pressure Setting for a CPAP Machine
Pressure in a CPAP machine is measured in centimeters of water pressure (cm H2O). Settings vary based on the device, but most CPAP machines have a pressure range of 4 cm H2O to 20 cm H2O. The average pressure setting for people with OSA is around 9 cm H2O Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source .
A CPAP titration study is the most common method used to determine an appropriate pressure level. Similar to a sleep study, the assessment is usually done overnight at a sleep center or hospital. Sensors are attached to the sleeper’s body to monitor oxygen levels, breathing, heart rate, brain waves, and body movements. A physician or sleep specialist calibrates CPAP pressure levels until the lowest amount of pressure needed to keep the airway open is determined.
The apnea-hypopnea index (AHI) assesses how many times a person stops breathing or breathes shallowly while asleep, which helps medical professionals determine CPAP pressure settings. Most modern CPAP machines keep track of the sleeper’s AHI, which lets the doctor know if the pressure level needs to be modified.
The sleeper is also fitted for a CPAP mask during the study, which is crucial for effective treatment. CPAP masks come in a variety of styles, including full-face masks, nasal masks, and nasal pillows.After the study, the doctor establishes the optimal pressure range. They can also make recommendations about how to use a CPAP machine.
Take Our Quiz to Know Your Sleep Apnea Risk
To understand if you could have sleep apnea, take our short quiz below to see if you exhibit any signs.
Factors That Affect the Pressure Setting of a CPAP Device
A number of factors determine the severity of OSA and a person’s appropriate CPAP pressure setting. Some are anatomical, while others relate to lifestyle and sleep habits.
- Anatomical factors: People with craniofacial or upper airway characteristics such as a small lower jaw, a large tongue or tonsils, or a neck circumference greater than 17 inches may be at greater risk of developing OSA Trusted Source Merck ManualFirst published in 1899 as a small reference book for physicians and pharmacists, the Manual grew in size and scope to become one of the most widely used comprehensive medical resources for professionals and consumers.View Source and may require higher CPAP pressure levels.
- Deviated septum: A deviated septum Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source limits airflow through the nose, so a higher amount of pressure may be needed to keep the upper airway open.
- Body mass index (BMI): People with obesity are more likely to have extra throat tissue that restricts airflow to the lungs. Pressure requirements tend to increase with a person’s weight Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source , so people who lose a significant amount of weight usually need to lower their pressure setting.
- Nasal allergies: Allergies and nasal congestion can make breathing more difficult, thereby reducing oxygen intake. In addition to calibrating pressure settings, a CPAP machine with a humidifier can sometimes help people with allergies. Regularly cleaning filters can also reduce allergen triggers.
- Sleep position: Back sleeping is generally the least favored sleep position for sleep apnea Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source because the pull of gravity puts pressure on the airway. Back sleepers therefore usually require higher pressure settings. Experts recommend side sleeping Trusted Source UpToDateMore than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights.View Source for people with OSA because it puts less weight on the upper airway.
How to Tell if Your CPAP Pressure Is Properly Set
Proper CPAP pressure levels help alleviate conditions associated with sleep apnea, such as snoring and sleep disturbances. If you are not experiencing better sleep quality after CPAP therapy, you will probably need to consult with your doctor about adjusting your pressure settings.
Signs Your CPAP Pressure Is Too Low
If you still wake up feeling groggy or unrefreshed after using a CPAP machine, your airway might not be getting enough oxygen to stay open. Heavy snoring, feeling like you are choking, or a lack of improvement in high blood pressure Trusted Source National Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.View Source may be signs that your CPAP pressure is too low. If your AHI does not improve once you have fully integrated CPAP therapy into your sleep routine, it may also be an indication that the settings should be adjusted.
Signs Your CPAP Pressure Is Too High
Discomfort is the strongest clue that your pressure setting is too high. Struggling to exhale, nose and mouth dryness, or a burning sensation in the throat are common symptoms of excessive pressure. Some people also experience mask leaks, fluid in the ears, and gas or belching from swallowing air.
APAP Machines
If you continue to have issues with pressure settings on your device, your doctor might prescribe an auto-adjusting positive airway pressure (APAP) machine. This device automatically changes pressure levels based on a user’s breathing patterns. The machine starts at a low setting and then increases according to changes in breathing and airway resistance.
Even though APAP machines automatically adjust pressure levels, a physician still needs to prescribe an ideal pressure range suited to your needs. If the range is off, you may experience adverse side effects.
Frequently Asked Questions
How Do I Know If My CPAP Pressure Needs Adjusting?
If you consistently experience discomfort during CPAP therapy, or you are not noticing any improvements in your sleep or health, then your CPAP pressure settings probably need to be adjusted. Persistent fatigue, loud snoring, mask leaks, and difficulty exhaling all indicate suboptimal pressure levels. An above-average AHI level suggests that your pressure setting may be too low.
What Pressure Should My CPAP Be Set At?
A physician determines proper pressure settings based on your CPAP titration study and AHI. Your pressure might need to be adjusted later if you lose or gain significant weight, change your sleep position, or start taking certain medications. Always speak with your doctor if you suspect your pressure level needs fine-tuning.
How Do I Adjust My CPAP Pressure?
If you think your pressure level needs adjusting, contact your doctor’s office and bring your CPAP machine to the appointment. Your doctor will evaluate data from the device and make changes as needed. Pressure settings should only be changed under medical supervision.
Medical Disclaimer: The content on this page should not be taken as medical advice or used as a recommendation for any specific treatment or medication. Always consult your doctor before taking a new medication or changing your current treatment.
Written By
Jay Summer,Staff Writer
Jay Summer is a health content writer and editor. She holds a B.S. in psychology and master's degrees in writing and public policy.
Medically Reviewed by
Dr. Abhinav Singh,Sleep Medicine PhysicianMD
Dr. Singh is the Medical Director of the Indiana Sleep Center. His research and clinical practice focuses on the entire myriad of sleep disorders.
References
7 Sources
Farré, R., Gozal, D., & Montserrat, J. M. (2021). Alternative procedure to individual nasal pressure titration for sleep apnea. Journal of Clinical Medicine, 10(7), 1453.
https://pubmed.ncbi.nlm.nih.gov/33916282/Strohl, K. P. (2022, October). Obstructive sleep apnea. Merck Manual Professional Version., Retrieved February 8, 2023, from
https://www.merckmanuals.com/professional/pulmonary-disorders/sleep-apnea/obstructive-sleep-apneaYeom, S.W., Kim, M.G., Lee, E.J., Chung, S.K., Kim, D.H., Noh, S.J., Lee, M.H., Yang, Y.N., Lee, C.M., & Kim, J.S. (2021). Association between septal deviation and OSA diagnoses: A nationwide 9-year follow-up cohort study. Journal of Clinical Sleep Medicine. 17(10), 2099–2106.
https://pubmed.ncbi.nlm.nih.gov/34606442/Lankford, D. A., Proctor, C. D., & Richard, R. (2005). Continuous positive airway pressure (CPAP) changes in bariatric surgery patients undergoing rapid weight loss. Obesity Surgery, 15(3), 336–341.
https://pubmed.ncbi.nlm.nih.gov/15826465/Menon, A., & Kumar, M. (2013). Influence of body position on severity of obstructive sleep apnea: A systematic review. ISRN Otolaryngology, Article e670381, 1–7.
https://pubmed.ncbi.nlm.nih.gov/24223313/Kryger, M.H., & Malhotra, A. (2022, August 11). Management of obstructive sleep apnea in adults. In N. Collop (Ed.). UpToDate., Retrieved February 8, 2023, from
https://www.uptodate.com/contents/management-of-obstructive-sleep-apnea-in-adultsShafazand, S., & Patel, S. R. (2014). Effect of CPAP on blood pressure in patients with obstructive sleep apnea and resistant hypertension. Journal of Clinical Sleep Medicine, 10(03), 341–343.
https://pubmed.ncbi.nlm.nih.gov/24634635/
Learn More About CPAP
Online CPAP Stores That Take Insurance
ByLogan Foley May 31, 2024
Is It Safe to Buy and Use a Used CPAP Machine?
ByLogan Foley May 31, 2024
Can You Get a CPAP Machine Without Insurance?
ByLogan Foley May 24, 2024
Can You Buy a CPAP Machine Online?
ByLogan Foley May 22, 2024
Can You Buy CPAP Supplies In Store?
ByLogan Foley May 20, 2024
Can You Buy a CPAP Machine in Store?
ByLogan Foley May 20, 2024
Should You Use Distilled Water for a CPAP Machine?
ByAustin Meadows May 7, 2024
What Is a BiPAP Machine?
ByEric Suni April 30, 2024
What Is a CPAP Machine?
ByLucy Bryan April 29, 2024
CPAP Recalls: What You Need To Know
ByLucy Bryan April 11, 2024
What is CPAP Compliance?
ByJay Summer April 2, 2024
EPAP Therapy As A CPAP Alternative
ByJay Summer April 2, 2024
Aerophagia: Symptoms, Causes, and Treatment
ByDanielle Pacheco April 2, 2024
CPAP Dry Mouth: How to Stop It
ByJay Summer April 2, 2024
Common Side Effects of CPAP
ByJay Summer February 27, 2024
Sleep Apnea Treatments Without CPAP
ByDanielle Pacheco January 10, 2024
Does Insurance Cover CPAP?
ByDaniel Noyed January 10, 2024
Before and After CPAP Machine Effects: How Your Body Changes
ByJay Summer January 10, 2024
Do You Need a Prescription For a CPAP Machine?
ByLogan Foley January 10, 2024
What Are Micro CPAP Devices and Do They Work?
ByLogan Foley December 21, 2023
CPAP and COVID-19
ByJay Summer December 21, 2023
How Do I Purchase a CPAP Machine?
ByDaniel Noyed December 21, 2023
The Link Between Sleep Apnea and Teeth Grinding
ByEric Suni November 16, 2023
CPAP: Continuous Positive Airway Pressure
ByJay Summer November 14, 2023
BiPAP vs. CPAP Machines: Breaking Down the Differences
ByJay Summer November 6, 2023
How to Use a CPAP Machine for Better Sleep
ByEric Suni November 3, 2023
What Are the Different Types of CPAP Machines?
ByJay Summer November 3, 2023
CPAP Benefits
ByJay Summer November 3, 2023
If I Snore Do I Need CPAP?
ByJay Summer October 16, 2023
APAP Machines: A Guide to Treatment
ByJenna Tidd October 16, 2023
How Much Do CPAP Machines Cost?
ByLogan Foley June 16, 2023
CPAP Mask Types
ByDaniel Noyed May 25, 2023
What Does CPAP Stand For? And Other PAP Acronyms
ByLauren Fountain April 12, 2023
How to Choose a CPAP Mask Based On Your Sleep Position
ByJay Summer March 10, 2023
APAP vs CPAP
ByJay Summer March 2, 2023
How to Clean a CPAP Machine
ByLauren Fountain February 16, 2023
Load More Articles