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 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 the 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 five 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 (APAP). 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.
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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.