CPAP Therapy Tips

Is Your CPAP Pressure Too High? How to Tell & How to Fix It

Part of getting used to CPAP treatment for Sleep Apnea is finding an air pressure level that is appropriate for you. It can take some adjustment in your CPAP pressure settings to get it right. There is no one setting that is right for everyone. You want a level that is comfortable and also consistent. The side effects of CPAP pressure that is too high can be serious. By finding what the right CPAP pressure is, you can ensure that you are using it in a way that is both safe and effective.

What is the highest pressure on CPAP?

The pressure settings for a CPAP machine are measured in centimeters of water pressure. For instance, if the pressure is set at 10 cm/H2O, this means that the pressure is the same as if you were sucking water through a 10-centimeter straw positioned at the top of the water to your mouth. By contrast, human speech comes in at around 7 cm/H2O pressure as it moves past the vocal cords.

The highest pressure available on your CPAP machine will depend on the model you own. In most cases, CPAP pressure readings max out out at 20 to 25 cm/H2O. However, this rating is too high for most people.

The average pressure for treating sleep apnea is 10 cm/H2O. Typical pressure levels for treating Obstructive Sleep Apnea will range from 6 to 15 cm/H2O. Some people require higher pressures and will use a high-pressure CPAP mask. Others will find that they are more comfortable and that their treatment is more effective at lower levels of pressure.

How to tell if CPAP pressure is too high?

In most cases, it will be uncomfortable to use a CPAP machine where the pressure is too high. This sign alone may be enough to demonstrate that you need to titrate your treatment up or down. However, it is natural to be concerned about whether you are using your machine at the right pressure level. Pay careful attention to how you feel during treatment at night and during the day after to see whether you are using the right level of pressure.

While many people think that the amount of pressure needed is directly correlated to the severity of your Sleep Apnea, this is not always the case. There are many factors that help determine what the proper level of pressure is, which include age, weight, the general level of health, and more. Only through testing for the right pressure can you determine the best level for you. Additionally, that level may change over time. Pay attention to AHIs, side effects and sleep quality to determine whether you are at the right level of treatment, receiving too much pressure or whether you are not getting enough.

What are the side effects of CPAP pressure being too high?

Getting a level of pressure that is enough to hold airways open but not too high for safety is essential. What happens if CPAP setting is too high? CPAP pressure too high symptoms and side effects can include:

  • uncomfortable CPAP therapy
  • significant air leaks from your mask
  • mouth breathing
  • dry mouth and throat, even when you are using heated humidification
  • swallowing air
  • an Apnea-hypopnea index (AHI) above the normal 5 events per hour
  • feelings of tiredness or fatigue during the day

Additionally, some experts worry that setting CPAP pressure too high can lead to pressure-induced central Sleep Apnea. In contrast to Obstructive Sleep Apnea, which is caused by the airways being blocked, Central Sleep Apnea is the result of breathing signals failing to be sent from the brain.

What CPAP masks are best for high pressures?

Mask choice is extremely personal and variable. One that works well for one individual may be a poor fit for someone else. If you have gone through titration of CPAP levels and arrived at a higher than normal pressure, talk to your doctor about the right high-pressure CPAP mask for you. You can choose between a range of models and features that can help you breathe comfortably through the night without risks or side effects.

Which mask will be the right one will also depend on other factors besides your CPAP pressure level. For instance, you may require a full face mask or may be able to use one with nasal cushions. By looking at different models and trying several out, you can see which provides the most effective therapy for you.

How do I adjust my CPAP pressure?

It is not advisable for individuals to adjust CPAP pressure themselves. When you first start using CPAP therapy for Sleep Apnea, your doctor will have you go through a process known as titration to arrive at the proper pressure prescription for you. This means testing different CPAP pressure levels until the proper therapeutic level is reached. If you are having trouble with your pressure levels, you can ask for your doctor to order a new titration study done to evaluate the right level of pressure for you.

Another option is to discuss with your doctor is auto-adjusting CPAP machines (APAPs). APAPs can automatically adjust pressure throughout therapy; this greatly reduces the chances of having a pressure too high interfering with therapy quality.

The more you know about your condition and treatment, the more empowered you are to make the best health decisions for yourself. Sign up for our newsletter to learn more about Sleep Apnea, helpful therapies and solutions to CPAP problems, and to get valuable savings on equipment.

David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.

22 Comments

  1. Frederick Wilhelm Reply

    My pressure at 12 is much too high. The mask leaks no matter how tight the straps. I had my tests done with an online assessment, so I don’t have a local doctor to have the pressure adjusted.
    My solution was to slightly enlarge the diffuser holes until the mask didn’t leak. That did the trick. Wife says I sleep with steady breathing, and I am at last sleeping straight through.

    • Hey Frederick, I am happy to hear that you came up with a solution to your leak issue. If you need assistance with adjusting your pressure, we will be happy to help you. Feel free to reach us at: 1-800-356-5221.

      Have a great week!

    • Hi Susan, congrats on your new CPAP machine. You should always consult with a doctor as to what your settings should be on your machine. If you have your settings, we would be more than happy to assist you.

      Please reach us at: 1-800-356-5221 and we should be able to help you.

      Have a great day!

  2. Pressure at 10 and 14 on resumed auto 10. Continue to have high leaking should pressure be adjusted down if mask and frame gave been changed? Am using dreamwear mask thanks much

    • Hi David, I am sorry to hear that you are having problems with a high leak rate. You shouldn’t have to adjust your pressure to avoid leaks. Have you confirmed if maybe you have a leak from your hose? Also, please make certain that you are using the correct size cushion. If you continue to receive a high leak rate, I would recommend, you maybe try using a different mask, if possible.

      If you would like us to try troubleshooting the issue over the phone, please feel free to reach us at: 1-800-356-5221.

      We wish you the best!

  3. Kathy Koenig Reply

    My husband has been using a CPAP mask for approximately 5 years. From time to time I hear his mask making noises that wake me up. Lately, the noises seem to come more frequently–usually two to three times a night. Over the years I’ve heard a trombone, a motorcycle, a trumpet and even a calliope sleeping next to me. My husband wears hearing aids, which are, of course, removed at night so he doesn’t hear what I am hearing. I do catch him sleeping on his stomach and lying on the hose which causes noises. Other times, he is lying on his back when I hear them. Sleeping on his side seems to minimize them–sometimes. I’m at wit’s end having my sleep disturbed and I’m searching for answers. Any help would be appreciated. Thank you.

    • Hey Kathy, Oh goodness, that is a symphony of sounds! – mask leaks happen for a few reasons – most commonly, its time to change the cushion – the oils in our faces deposit onto the cushion, which is a porous material, and over time, it becomes harder and harder to get and keep a seal – so if you notice that these leaks are happening more and more, my first suggestion would be to replace the cushion – cushions should be washed daily, and replaced every 3-6months. Second most common is mask fit – does your husband use a full face or a nasal mask? Is the sound coming from the mask itself not having a good seal, or is it air escaping from his mouth (like his mouth falling open)?

      For questions, or concerns, please feel free to reach us at: 1-800-356-5221.

      Enjoy your day!

  4. I have the pillow mask and wonder exactly what is suppose to do. It lets air out and i have it covering my nostrils. Is it suppose to blow air up my nose or exactly what? My husband says air coming out is to high of pressure. When i have it on i can’t close my mouth or i have a hard time breathing. With my mouth slightly open it is ok, but then i get dry mouth and throat real bad. What are your recommendations?

    • Hi Katrina, I am sorry to hear that you are having some problems with your therapy. The nasal pillow mask does blow air in your nostrils. Since you feel like the pressure you are receiving is too high, I would recommend that you speak with your doctor for a lower pressure.

      Also, opening your mouth during therapy will definitely, result in dry mouth. You may consider switching to a full face, or a nasal mask instead of the pillow mask that you are currently using.

      If you would like to speak with us further regarding the problems you are having with your mask, pressure, or anything else, please feel free to reach us at: 1-800-356-5221, or e-mail us at: cpap@cpap.com.

      We wish you the best!

  5. Patrisha Mai Reply

    Without a doctor’s order can you purchase the automatic adjusting cpap machine

    • Hi Patrisha, in order to purchase any CPAP/APAP machine, we will require a valid prescription per FDA guidelines. If you have an older prescription which is still valid, we can accept it, or we would be more than happy to submit a prescription request form to your doctor’s office on your behalf.

      Please feel free to reach us at: 1-800-356-5221, or you may e-mail us at: cpap@cpap.com.

      Have a great day!

  6. I have had my current Cpap for 7 years and recently have not been happy with how I am feeling. My doctor has increased my pressure twice in the last 3 months ( 23 episodes 3 months ago and 9 today) When I asked for a new machine he would not prescribe a new machine. Is this reasonable? I am a 70 year old woman and am feeling terrible.
    Thanks

    • Hi Sherry, I am very sorry to hear that you haven’t been feeling well while using your CPAP Machine. What’s wrong? Do you feel like you are not getting enough pressure/too much pressure? If your doctor refuses to prescribe a new machine, it could be because they have an understanding of the data from your therapy, that shows your machine is helping you.

      I would recommend, that you continue speaking with your doctor to express your feelings and symptoms, this will ensure that you are receiving the best therapy possible. If you feel like you are not receiving the service you need from your doctor, it may help that you get a second opinion.

      Also, if you have questions, or concerns, want to go through some troubleshooting over the phone to see if it will help you get better sleep, we will be more than happy to assist you. You may call 800-356-5221.

      I hope you start feeling better, have a wonderful weekend!

  7. Dee Dee Gilbert Reply

    I just got my chap a week ago and have not slept longer then an hour at a time. I feel my pressure is too high. I wake up feeling like i have a shop vac on my nose. But my biggest concern is the shortness of breath I am now having all day long. I have been told by one person it’s not normal and another person it’s totally normal. No leaking issues. But just a sine note I have a nasal mask and I have never breathed through my nose. Have always been a mouth breather is this normal or not?

    • Hi Dee Dee, I am sorry that you haven’t been able to get any sleep with your CPAP machine. I have spoken with patients that feel like they are experiencing shortness of breath. Please speak with your doctor regarding the symptoms that you are having. Your doctor may feel that your pressure should be lowered.

      Since you are a mouth breather, the only way a nasal mask will be effective is if there is some way to be certain that your mouth is not falling open during the night. You should consider using the nasal mask in conjunction with a chin strap. I would recommend that you try using a full face mask also, as this will ensure that both your nose and mouth are covered.

      If you have further questions/concerns, or would like to speak with us regarding switching to a full face mask, please feel free to reach us at: 1-800-356-5221.

      Have a wonderful day!

  8. Marty Maggiora Reply

    I’ve been using a cpap for a year now with no relief. My Dr has it set 8 to 12. Just did another sleep study and no they want me to use a bicpap machine and the settings will be 21 to 25. Isn’t that high for people to use?. Thanks…Marty

    • Hi Marty, i’m sorry to hear that you haven’t had any relief with using your CPAP Therapy. Ordinarily, a pressure of 25/21 is considered high for most folks. However, with your doctor prescribing this pressure based upon a recent sleep study, it most likely means this is the pressure required for you to receive some relief.

      You definitely want to follow your doctor’s orders, but if you feel uncomfortable with the setting, this is something that I would encourage you to enter into a dialogue with your doctor about. I am sure he/she would be more than willing to explain the reasoning behind the high pressure setting. If you find that the prescribed setting doesn’t work for you, your doctor can easily lower the pressure setting.

      For further questions, or concerns, please fee free to reach us at: 1-800-356-5221, or e-mail us: cpap@cpap.com.

      We wish you the best!

    • Hi Priscilla, I am sorry to hear about the noise that you are experiencing. Where is the popping sound coming from? (Machine, Mask, etc.)

      It’s really hard to answer your question without further information. Please feel free to contact our customer service department for over the phone troubleshooting at: 1-800-356-5221.

  9. I’ve only been on the Cpap for a month and the first few nights I had it I woke up feeling great. Now I’m noticing constant leaking from where the hose connects to the face mask ( I use a dreamwear nose mask) and I wake up with a headache and groggy again. I’ve done the pressure test on the machine and it says the pressure delivered is fine. I don’t know if the pressure is too high or not high enough. It’s set at 12.

    • Hi Elysia, i’m sorry to hear that you are having some trouble with your CPAP Therapy. Have you tried any other masks? It could be that the DreamWear Nasal, is not the mask for you. We would be more than happy to go over some troubleshooting steps with you over the phone and, or assist you with selecting a different mask that may be a better fit for you.

      Also, I would recommend that you speak with your doctor, or sleep specialist about the way you are feeling. Your doctor, may make a decision to adjust the settings on your machine to a level which is more ideal for you.

      Please feel free to reach us at: 1-800-356-5221, or e-mail us at: cpap@cpap.com with any questions, or concerns.

      We wish you the best!

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