How to Determine Whether Your CPAP Pressure Needs Adjusting

October 20, 2020 | CPAP Tips & Tutorials |
How to Determine Whether Your CPAP Pressure Needs Adjusting

CPAP, or continuous positive airway pressure, therapy is the most effective form of treatment for obstructive sleep apnea. A small, bedside machine produces pressurized air that flows through a tube to a mask worn by the patient. The air pressure helps to keep the airway from collapsing, allowing patients to breathe throughout the night and sleep restfully. CPAP machines require a valid prescription from a licensed physician, and the air pressure setting is determined by your prescription. So how do you know if your CPAP pressure needs adjusting?

What Are the Signs That Your CPAP Pressure Is Too Low?

CPAP therapy provides the minimum amount of air pressure needed to keep your airway open. When your CPAP pressure is too low, you will have difficulty breathing while sleeping. To determine this, check your sleep reports to see your AHI score. AHI determines the severity of your sleep apnea – the lower the score, the less severe the sleep apnea. If your CPAP pressure is too low, the AHI score will most likely be higher.

What Are the Signs That Your CPAP Pressure Is Too High?

One of the main indicators that your CPAP pressure may be too high is difficulty breathing. If you have a hard time exhaling against your prescribed pressure, it may need to be lowered. You may also experience chronic dry/sore mouth and throat, excess bloating and gas, or even fluid in the ears. 

Which Factors Affect CPAP Pressure Setting?

AHI score is the main factor when prescribing CPAP pressure settings. The higher the AHI score, the higher the severity and the higher the prescribed setting.

  • AHI of 5-15 (events per hour) is considered mild sleep apnea
  • 15-30 (events per hour) is considered moderate sleep apnea
  • > 30 (events per hour) is considered severe sleep apnea

Of course, there are a number of outside factors that can affect your AHI score. 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.

What Should I Do If My CPAP Pressure Settings Need Adjustments?

If you feel that your pressure settings require adjustment, speak to your doctor. Do not try to adjust your CPAP machine yourself. Calibrating your CPAP machine is part of the process of getting the most out of your CPAP therapy and needs to be done by a professional. If you are unable to see your doctor, online services, such as Sleep Care Online, offer prescription renewal programs with board-certified sleep physicians.

Other options include switching to an auto CPAP machine. Auto CPAPs adjust the air pressure you receive automatically, starting with lower pressure to help you fall asleep and then increasing pressure once you are in a deep sleep. By self-adjusting, your auto CPAP machine uses a range of air pressure to keep you comfortable all night along. 

The CPAP Shop offers a wide variety of CPAP and auto CPAP machines. If you need help selecting the right CPAP machine for you, speak to our knowledgeable customer care team. Call 866-414-9700 or email us at questions@thecpapshop.com for additional information.

Chris Vasta CPAP Expert & President at The CPAP Shop

Author

Chris Vasta

Over a 10+ year career at PHH Mortgage managing a $100 million portfolio, Chris Vasta learned the ins and outs of the business world. He learned how to establish business relationships, lead a multi-prong team, and implement strategies for long-term growth. In 2007, Vasta used that experience to transition his role into president of The CPAP Shop. Over his tenure, Vasta has been involved in everything from website design to warehouse layout. His hands-on approach with customers has evolved into an in-depth understanding of the challenges of beginning and adhering to sleep therapy. He often provides his insights on product…


16 Comments Leave new

  • Carma Lea Sundquist

    I do not feel like I am getting enough air breathing in what could be the problem, it appears to be worse after cleaning my hoses and mask

    • Chris Vasta

      Hi Carma, if you feel as if you are not getting air, it is important you speak to your doctor so that they can help you with your pressure setting. Do not try to adjust your CPAP machine yourself.

  • Melinda Southard Willford

    I have been using my Resmed AirSense 10 with Heated Humidifier (P10 Nasal) for 7 months and have just begun not being able to fall asleep even when very tired. My max pressure setting was on 16 but researched settings this morning and found that a normal setting once stabilized is from 8-14. I am planning on lowering my setting to 12 to see if this helps. Any ideas? My PCP did my initial test, and I bought the machine on my own so I don’t have a clinical person to monitor my settings. I am doing it on my own.

    • Chris Vasta

      Hi Melinda! Are you noticing any leaks from the mask when you’re trying to fall asleep? It’s highly possible it’s the mask that’s the issue – not your machine. If your mask needs new pillows, it will leak and you won’t be getting the required pressure. This can lead to poor sleep and feeling very tired in the morning.

  • Thomas Zace

    I constantly wake up around five or six in the morning with sinus headaches. I never had problems before but this has been going on for quite awhile. I’ve tried different headgear and make sure my equipment is clean. I’ve read that it may be caused by the pressure being too high. Any ideas?

    • BB

      Are you using the water chamber? Are you also waking up dry? Dryness can cause dry sinuses, leading to sinus headaches. Your humidity level may need to be turned up so you breath in more moisture, which lubricates those sinus membranes.

  • Brian Clancy

    I’m using a ResMed Airsense 10 with P10 mask. I process SD card data using OSCAR. On a night with 0 (as in ZERO) AHI, the machine increased pressure from 6.0 to 6.6, mild snoring then began for a brief period but the pressure continued to increase over the next six minutes to 14.65, at which point I developed a large leak. Does my machine (over two years old) need an adjustment? OSCAR definitely sees pressure increase without apnea events ahead of snoring, and continues to increase until I have enough pressure to cause a large leak and wake me up. It’s happening a lot. Thanks for a quick opinion on this issue.

    • Andrew Rivenbark

      Hi Brian, the AirFit P10 Nasal Mask is rated to handle pressures up to 25, so we would first recommend ensuring your mask is secure – not too tight that it is pressing into your face causing red marks, but not too loose that the seal won’t hold. You can also check with your doctor to see if you need an updated prescription for your CPAP settings. If those don’t alleviate the problems you are experiencing, then you may need to take additional steps. Feel free to give us a call at 866-414-9700 with any additional questions!

  • Monica

    I’ve recently started getting throbbing morning headaches as described online. I used to sleep great with my cpap so I’m concerned. Recommendations?

  • Ronald Copeland

    i seem to totally run out of water each night… what should or should not do?

    • Chris Vasta

      The higher the humidifier temperature is set, the more water is going to be used. Therefore, it will help to adjust the humidifier and lower the heated tube temperature if a heated tube is being used. Depending on CPAP/BiPAP you are using, you may be able to change the humidifier setting from adaptive to fixed. If you have non-heated tubing incorporating a tube buddy will help insulate the hose and reduce excess condensation.

    • Lisa

      This was happening to me as well. I had to buy a small humidifier for my bedroom. When the humidity in the bedroom was higher, I used less water from my cpap humidifier. Hope this helps.

  • Reg Sissons

    I am trying to get used to a p30i. It seems like there is no exhaust air being expelled when I breath out. The pressure builds up and I have to open my mouth to get rid of it and this repeats over and over. When I breath out it seems to cause a pressure build up and there is no air coming out from the mask. Is this the way this mask should be working?

    • Chris Vasta

      Hi Reg, do you know how high your CPAP pressure is? If you have a high pressure setting, it may be difficult to exhale especially when using nasal pillows. Do you know if you have ‘C-Flex’ or ‘EPR’ turning on for your machine? This option lower the pressure upon exhalation making it much easier to breathe even with a very high pressure setting. You should not be having difficulty exhaling with any mask. I would check your machine settings. If you continue to have issues, it’s possible the P30i, or pillow masks in general, just aren’t the right type for you and a Nasal or Full Face mask may be required instead.

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