Every person with obstructive sleep apnea (OSA) experiences different levels of air obstruction. That's why it's important to have your CPAP (continuous positive airway pressure) device set to the right level for your specific needs.
The best way to determine this is with an overnight CPAP titration study where a sleep physician monitors your sleep and adjusts the pressure just enough to prevent air obstructions. Their goal is to find the lowest pressure setting needed. This will ensure you breathe as comfortably as you can throughout the night with a few apneas and hypopneas as possible.
What do CPAP pressure settings mean?
Your CPAP device blows air into your airways to ensure your breathing is not obstructed during sleep. The air pressure delivered is determined by the pressure setting on your device. For most people, this CPAP pressure setting is set between 6 and 14 cmH2O, with an average of 10 cmH2O. Your sleep physician will help you determine what level is right for you.
You may think the pressure level is related to the severity of your sleep apnea, but that's not always the case. People with mild OSA may need high pressure and vice versa. The pressure you need to clear your airways depends more on their anatomy and the nature of your obstructions.
Is my CPAP pressure too high?
You may feel your CPAP pressure is too high if you experience discomfort in your mouth, nose or airways. This, however, does not necessarily mean the setting is not right for you. You may just need some time or advice to adjust to therapy.
If, after a while, you still find your therapy uncomfortable, having high air pressure may be counter-productive to your therapy. Some people will simply not be able to tolerate high pressures – that's why the settings are adjustable. If you find your pressure too high, it's essential to ask your sleep physician to adjust it for you.
Having the air pressure too high can also cause other side effects beyond discomfort, such as aerophagia, which is when sufferers "swallow" air into their stomachs. This can result in bloating, gas, discomfort, and excessive belching.
Is my CPAP pressure too low?
As previously mentioned, the ideal CPAP pressure is the lowest pressure needed to treat your sleep apnea. But if it is set too low, you will not have enough air to clear your airways, leading to apneas and hypopneas during sleep.
Those who experience five or more apnea or hypopnea events per hour will typically require an increase in their CPAP pressure setting. And when you’re not getting the therapy you need, you'll continue to experience the symptoms of sleep apnea too, so do go get it checked out!
Should you change CPAP pressure yourself?
If you believe your CPAP pressure needs to be adjusted, you should go and see your doctor or sleep physician to discuss your CPAP device settings. Your sleep physician will be able to look at your therapy data to help you determine the settings that are right for you. Changing the CPAP device setting yourself may result in adjusting the pressure too far in either direction, which could make your condition worse.
Consider an AutoSet Device
Some people may benefit from using an Automatic PAP device or APAP, which, unlike a regular CPAP device, can automatically adjust the air pressure as needed to unblock any obstructions that occur. With an AutoSet device, you can rest easy knowing that the pressure will rise and fall as needed to keep the airway open.
If you're struggling with your sleep therapy, even after adjusting your pressure settings, don't give up on sleep therapy just yet. An APAP machine could be the answer.
FAQs
Your CPAP device blows air into your airways to ensure your breathing is not obstructed during sleep. The air pressure delivered is determined by the pressure setting on your device. For most people, this CPAP pressure setting is set between 6 and 14 cmH2O, with an average of 10 cmH2O.
What should my CPAP pressure be set at? ›
For most people, an appropriate CPAP pressure is between 6 and 14 cmH2O, with an average of 10 cmH2O. Your sleep specialist can help you determine what specific level is right for you. Over time, your CPAP device pressure may require adjusting.
What does 90% pressure mean on CPAP? ›
This is relevant when your device is an Auto-CPAP. During any given night, the device recognizes the 90% Pressure achieved by the Auto Algorithm. 90% Pressure is defined as the pressure at which the device spent 90% of the session time at or below.
What should my CPAP score be? ›
According to the American Academy of Sleep Medicine, CPAP therapy should aim to reduce the AHI score to below five if possible.
What is a high pressure on CPAP? ›
The lowest CPAP pressure setting on all machines is typically around 4 to 5 centimeters of water pressure (also referred to as CWP or cm of H2O). Most people require something higher than the lowest setting, but a high setting usually roams toward the maximum machine setting, which ranges from 25 to 30 CWP.
What are good readings on CPAP machine? ›
An events per hour score below five is considered normal and indicates healthy breathing. Generally, the lower the number, the better. Your AHI may vary depending on disruptions. These disruptions could include mask leaks or turning and knocking your mask out of place throughout the night.
Why do I wake up after 4 hours on my CPAP machine? ›
You may not get the full benefit of treatment if your CPAP settings are incorrect. These settings regulate the pressure of air delivered to your mask. If the setting is too high, you may struggle to exhale and find yourself waking in the middle of the night.
What are signs your CPAP pressure is too high? ›
Signs Your CPAP Pressure 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.
How to tell if CPAP is working properly? ›
Signs Your CPAP Therapy is Working Correctly
- Your snoring eases up.
- You don't wake up gasping for breath.
- You wake up feeling rested.
- You don't have morning headaches.
- You can better focus on work.
Chest and nasal congestion, enlarged tonsils, a deviated septum and more can increase your AHI score and therefore, your pressure setting. Weight loss, reduced alcohol consumption, smoking cessation and more can improve your AHI and lower your prescribed pressure.
Severe obstructive sleep apnea means that your AHI is greater than 30. You have more than 30 episodes per hour. Moderate obstructive sleep apnea means that your AHI is between 15 and 30. Mild obstructive sleep apnea means that your AHI is between 5 and 15.
What is a good CPAP report? ›
The apnea hypopnea index (AHI) is calculated by dividing the number of apneas and hypopneas by the time spent asleep. Some physicians consider CPAP therapy adequate if a person achieves an AHI reading of fewer than 10 respiratory events per hour.
How does a CPAP know when you stop breathing? ›
A CPAP machine works by both monitoring your breathing and providing air pressure. By measuring resistance, oxygen levels and breathing patterns, this device can detect any changes in sleep quality that may occur throughout the night.
What is a good average CPAP pressure? ›
Your CPAP device blows air into your airways to ensure your breathing is not obstructed during sleep. The air pressure delivered is determined by the pressure setting on your device. For most people, this CPAP pressure setting is set between 6 and 14 cmH2O, with an average of 10 cmH2O.
What is the life expectancy of a person with sleep apnea? ›
Life Expectancy of People Sleep Apnea
People with severe sleep apnea under 50 can expect to live between eight to 18 years if they receive treatment with oral appliance therapy or the CPAP machine.
What is a normal CPAP event per hour? ›
CPAP, oral appliances and other sleep apnea treatment options are designed to reduce your AHI, but not necessarily eliminate them. That's because it's considered normal for everyone to have up to four apneas an hour.
How does a CPAP machine know when you stop breathing? ›
Autotitrating CPAP machines use pressure sensors and computer algorithms to work out the correct pressure a person needs throughout the night to prevent lapses in breathing.
Does using a CPAP cause weight gain? ›
Overall, the majority of large-scale, high quality research indicates CPAP use is more likely to cause weight gain, but that doesn't mean you can't lose weight during CPAP treatment. If you feel more alert and energized after CPAP therapy, it can be a great opportunity to increase your activity levels.
Can a CPAP machine tell if you're asleep? ›
Your AirSense 10 will know you're asleep no more than three minutes after.
