CPAP Therapy Tips

CPAP Pressure Setting 101: CPAP vs APAP vs BiPAP

What’s the average CPAP pressure setting? What pressure setting should you be using What should you do if you snore while using a CPAP machine? The answer to these questions can be found by looking at the pressure settings for your CPAP machine. If the pressure is too low, you may experience some of the issues listed above. Find out everything you ever wanted to know about pressure settings in this article!

What is CPAP Therapy?

Every human body is unique, and every person with sleep apnea experiences it in a slightly different way. Because of this, sleep apnea therapy is not a one-size-fits-all treatment. sleep apnea machines come equipped with settings that sleep doctors can change to fit each patient’s needs.

Continuous Positive Airway Pressure (CPAP) therapy uses the power of positive air pressure to treat sleep apnea, a condition that causes your breathing to stop for a time while you sleep. If you have one type of sleep apnea, known as Obstructive Sleep Apnea (OSA), your airway collapses when you sleep, and this prevents you from breathing. Positive Airway Pressure (PAP) therapy involves the use of various machines that pump out air at a pressure high enough to keep your airway open.

CPAPS, APAPs, BiPAPs – What’s the Difference?

There are several types of PAP machines available, and each works in a different way to open your airway. Each type of PAP machine also produces a different amount of air pressure. Furthermore, medical professionals will suggest different CPAP settings for different patients, depending on the patient’s needs.ResMed AirMini Giveaway

CPAP Pressure Settings

As its name implies, Continuous Positive Airway Pressure machines produce a continuous stream of air pressure to keep the airway open. For many patients, CPAP is the only treatment they need for sleep apnea.

BiPAP Pressure Settings

A Bilevel Positive Airway Pressure (BiPAP) machine delivers two different air pressures to hold your airway open as you sleep. The machine senses when you inhale and exhale, and produces different pressures when you breathe in and when you breathe out. The BiPAP machine produces a high enough pressure to hold your airway open when you inhale and then produces a lower pressure when you exhale.

APAP Pressure Settings

Auto Positive Airway Pressure (APAP) machines automatically adjust themselves to your changing breathing patterns throughout the night. If you are like many people with sleep apnea, you tend to have more frequent bouts of paused breathing at some times of night than at others. APAP automatically adjusts air pressure to fit your changing breathing patterns.

Sleep doctors use sleep studies to diagnose sleep apnea. These sleep specialists may prescribe CPAP, APAP, or BiPAP machines to patients, depending on the patient’s individual needs. Sleep doctors will also prescribe the pressure settings depending on patient needs.

Only trained professionals should adjust PAP pressures, as the measurements for these pressures can be a bit confusing. Health care professionals measure PAP pressure in centimeters of water or cmH2O. Scientists use cmH2O as a standard measure of pressure because it is easy – they measure how much pressure a column of water exerts against its container. Most people think of pressure in terms of pounds per square inch, or PSI. One centimeter (cm) of water is 0.0142233 PSI. While the differences may seem small, confusing, the two can have a significant effect.

What is the Average CPAP Pressure?

Most people with sleep apnea require CPAP pressure between 6 and 14 cmH2O. The average CPAP pressure is 10 cmH2O. At the advice of your sleep doctor, though, you may change the settings on your CPAP, APAP or BiPAP.

What Should My CPAP Pressure Be?

One of the most frequently asked questions sleep professionals hear is, “What should my CPAP pressure be?”

In general, your CPAP pressure settings should be just high enough to hold your airway open. When the pressure is too low, you may suffer symptoms of sleep apnea. If the pressure is too high, you may struggle with the device, have nasal congestion, and experience choppy or fragmented sleep.

Your CPAP, APAP, or BiPAP pressure needs may change over time. If your pressure needs do change, you may notice certain signs and symptoms. Contact your sleep doctor if you notice any of the following signs and symptoms that suggest your pressure needs adjustment.

If someone witnesses pauses in your breathing as you sleep while you wear your CPAP, APAP, or BiPAP device, your pressure may not be high enough.

Snoring

Snoring should never occur if your CPAP, APAP, or BiPap pressure is adequate. Significantly insufficient air pressure from the sleep apnea machine allows the airway to collapse to cause snoring. Low air pressure can also allow tissue in your airway to vibrate, which causes snoring.

Be aware, though, that a leaky mask can cause snoring. A leaky mask allows some of the air to escape, which lowers the air pressure. Before having your CPAP, APAP or BiPAP pressure adjusted, check your mask for leaks.

Waking up choking or gasping

Waking up choking or gasping is another sign of sleep apnea that should not appear with the use of a CPAP, APAP, or BiPAP machine.

AHI readings greater than 5

sleep apnea professionals use the apnea-hypopnea index (AHI) to indicate how many times you stop breathing over the course of an hour of sleep. You should have your PAP pressure increase if your AHI readings are five or higher.

If you are experiencing any of these signs or symptoms, speak with your sleep doctor about having the CPAP pressure settings adjusted.

To help make sense of the different styles and features of CPAP machines, we’ve put together this comprehensive guide to CPAP machines to help you on your journey to CPAP success!

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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.

44 Comments

  1. Hmmmmmmmmm – – – keeps talking about one’s specialist. What does one do when their apnea specialist is a turkey?

  2. How do I change the pressure of my CPAP? It is set at 8 and like to change it to 9 or perhaps 10

  3. Daniel Kanouse Reply

    If your machine is linked via a modem to the supplier like mine is they know the settings at all times I monitored. That is a same way to know you are doing ok pressure wise an equipment. I have Respirionics Equipment.

  4. on bipap machine resently went for overnight test and given printouts
    where do i find the measurements for high and low numbers

  5. You forgot about AutoSV for people who have mixed central and obstructive apnea.

  6. Excellent and very pertinent information. Thank you for providing the information and data.

  7. My old CPAP unit was stolen a week ago. It is difficult to get to a specialist in some countries (I live in Mexico). I’ve been searching online for a new CPAP machine but I can’t find anything related to pressure settings when I read the descriptions for the machines. Can I just buy any of them and adjust the pressure all by myself? Is any software needed to do that or the new machines have a way for the user to change the settings?

    • When you buy a new CPAP machine, you will need to have a prescription on file, and that prescription will have your pressure setting on it. We will set the pressure before sending it to you. If you need help tracking down the old prescription you can reach out to us at our number for international customers: +1 713-351-3414. Perhaps we can help you work out a solution to your problem that will get you back into CPAP therapy.

    • John Kovacs Reply

      Buy one asap and use Google to find instructions to adjust settings.

  8. I am from India Tamil nadu I have been using CPAP machine but my nasal Mask and head gear has got lost stipness , the agency I bought is not getting it for me. Where else can I get it.

    • Hi Thomas,

      Some manufacturers of CPAP equipment prohibit sales to countries other than the US, so keep that in mind as you look for replacements. I think your best bet is to give CPAP.com a call at our international number of +1 713-351-3414. Keep in mind our CPAP experts are in the Central US time zone. When it’s 8 AM for CPAP.com, it’s 6:30 PM in India. Our CPAP experts can help you get the replacements you need. They’re friendly and knowledgeable.

  9. I have trouble with mask leakage. If I adjustthe headstraps to stop air leakage I have to cinch it up until it hurts. I get new masks every 3 months. I mask usually last a month. This is very uncomfortable and makes me not to use my BIPAP but I have frequent long period of not breathing without my BIPAP.
    Thank you for helping

    • You might want to consider using a mask liner, as an inexpensive way to reduce the amount of leakage from your mask. Mask liners are great at improving the seal and making the mask more comfortable too.

  10. Barry Kaechele Reply

    I asked my supplier to increase my pressure a bit as I don’t seem to be getting enough air. They only turned off the pressure delay but until I take off the nose piece, it feels as though I have to pull with my diaphragm in order to feel there’s enough air coming in. When I open my mouth, there’s lots of air that escapes under pressure. I tried using a Breath Right and it helped a bit but it’s uncomfortable and expensive over the long term. Any thoughts?

    • Hey Barry!

      I’d recommend calling one of our CPAP experts with your question. They can be reached at 1-800-356-5221.

  11. Dave Scott Reply

    Some machines have optional exhalation relief. The machine automatically senses when the user is exhaling and reduces the pressure. For example DeVilbiss calls this feature smartflex. Do you know what the difference is between Smartflex and a Bi-pap machine?

    • So a BiPAP machine is going to deliver therapy air at two distinctly different pressures, and can also be used to treat Central Sleep Apnea. SmartFlex is exhalation relief (and many modern machines have it). Exhalation relief makes it easier to exhale, but it’s not a BiPAP machine. If your doctor wants you to get a BiPAP machine, there’s no other device that can substitute for one.

  12. I have a Resmed AirSense 10 autoset cpap machine. This machine automatically adjusts pressure in real time as your pressure needs change. So, with that said, why would I need a Dr. to “prescribe” a setting if the machine automatically adjusts? Can’t I just set it to the “average” setting of 10 and let the machine adjust as need be?

    • Hey Dave! Yes, you can. However, the machine would have to be set to a high and a low pressure. For example, if you know that you need at least a 10 pressure, but don’t need your pressure to go over 15, your pressure would be set to 10-15. If your doctor has no idea what your pressure is, you also have the option to have your pressure set at the default settings which is a minimum pressure of 4 and a maximum pressure of 20. Since it is an auto-titrating machine, you should only receive the amount of pressure you need on a breath by breath basis.

      I hope this information helps.

      Enjoy your day!

  13. Sharon Maginnis Reply

    My doctor gave me a pressure of 4. I had to buy the CPAP out of my own pocket and pay cash, because it was a percentage point above where Medicare would pay for it. My doctor has his own sleep study center set up in his own office. My doctor also said he would do a stem cell treatment for $1000 below another well experienced physician. My doctor had only done 10. I say this because it was obvious that my doctor was seriously worried about not making it financially. My doctor quit earlier this year by way of an email. He went to work for the VA. Do you think I need a CPAP machine?

    • Hi Sharon, I am not medically able to determine if you need a CPAP Machine, or not. If you would like a second opinion, you may want to have another sleep study with a different doctor, or at least speak with a Sleep Specialist to confirm if you need a CPAP Machine.

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

      Have a great day!

  14. I’ve had my cpap for 7 months. Recently I’ve had trouble with a constantly runny nose (all clear liquid), sneezing & stuffy head. Is this common?

    • Hey Sharln, I am sorry to hear that you are having some problems with your CPAP Therapy. It is not uncommon for you to have a runny nose, or the other symptoms that you mentioned. The symptoms could be unrelated to the CPAP Therapy, so please be sure to speak with your doctor. If you are not using a heated humidifier with your CPAP Therapy, you may benefit from adding one. If you are currently using a heated humidifier, you may try increasing the temperature just a little bit to see if this will provide some relief to you.

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

      We wish you the best!

    • Hello, I have been unable to locate any information to support any claim that CPAP Therapy causes changes to the nostrils, or the shape of the nose. I would encourage you to direct your question to either your sleep clinic, or your doctor.

      Please feel free to contact us at: 1-800-356-5221, or email us at: cpap@cpap.com with further questions, or concerns.

      Enjoy your day!

  15. Dennis A Toon Reply

    Can someone help please.
    My air pressure has gone up in the last week from an average of 10-11 to 14. I’m waking up it sounds like I have leak but my machine is telling me i have an 100% mask fit???

    • Hi Dennis, how long has it been since you changed your cushion? If it has been more than 3 months, you may try changing your cushion, or if it has been longer than 6 months, you should change out your entire mask. Also, I would encourage you to make sure your hose is not leaking. You can do a test on your hose by removing your mask from the hose and covering the end of the hose with your hand while the machine is on to see if you hear the leak. If not, this will mean the leak is with your mask. However, if you hear the leak with the mask off, please replace your hose.

      If you are not able to pinpoint where the leak noise is coming from, please feel free to reach us at: 1-800-356-5221 and we will be more than happy to assist you via phone.

      We wish you the best!

  16. My original prescription was set at CPAP 14. After a few years and due to a change in machine to an auto device the prescription settings were altered to A Flex minimum 10 maximum 15. I now have been offered a new Auto machine with full setup manual. Is there any reason why I couldn’t set this up myself to my current setting?

    • Hi Joe, as long as you have access to the Clinical Settings, you should not have any issues with setting the machine to match your current prescription. We do suggest you speaking with your doctor before changing any of your settings.

      If you have questions, or need assistance with setting your machine, please feel free to reach us at: 1-800-356-5221, or you may e-mail: cpap@cpap.com.

      Enjoy your day!

  17. Susan Pilla Reply

    Is a 0.5 events per hour reading on my CPAP machine considered not even 1?

  18. Hello. I use an auto cpap machine settings 4-20 with a full face mask. Is it normal to feel air coming out from where the hose connects to the mask. And what does it mean if my pressure stays at 18-20 when I wake up in the morning

    • Hi Angela, which mask are you currently using? Each mask has exhalation ports and it is very normal for air to come from the mask, but in order for me to confirm where it should be coming from, I must know the name of the mask. Also, it could be that you are experiencing a mask leak. Have you changed your mask cushion within the last 3 months, your entire mask within the last 6 months, or your hose within the last 6-12 months? I would recommend you confirm that you do not have a leak from your hose also. You can check this by turning your machine on and running your hand up and down the hose to see if air is seeping from it.

      What pressure setting is your machine set to? If it remains at a setting of 18-20, it could be the setting that your machine is listed at, or again, you may have a leak which will cause the machine to blow more pressure to compensate for the leak.

      We would be more than happy to go through some troubleshooting steps with you over the phone. If you are interested, please reach us at: 1-800-356-5221.

      We wish you the best!

  19. I have been using a CPAP since 2009. I recently had to do another sleep test and my settings have got to go from a 6 to a 9. I use a Phillip Resporonic machine. The Dr is writing order for new machine with increased settings. Where it is set on 6 inside my nose stays very dry and my mouth and throat are very dry and scratchy when I wake up and have a very dry cough. Could this be coming from because setting is to low at 6. Plus it has humidifier on it one day I may use all the water next day it won’t look like it’s used any water. Could something be wrong with machine cause they tell meu Medicare won’t pay for one but every ,5 years.

    • Hi Mildred, i’m sorry to hear about the dryness that you have been experiencing. More than likely, the pressure setting has nothing to do with the dryness that you are experiencing.

      There is an explanation, as to why some nights, you may empty your water chamber and others, it’s as if you haven’t used the humidifier. It’s possible that your Phillips Respironics machine, may be using an ambient temperature. When the humidifier automatically adjusts to moisture in the room, it will not provide more moisture from the unit. (Some regions have a drier/humid climate, which can factor into this)

      You can go to your comfort settings and change from auto to manual. If you would like assistance with the setting adjustment, please feel free to contact our customer service department at 1-800-356-5221.

      Please see the link below of a moisture cream, that may provide you some relief as well.

      https://www.cpap.com/productpage/CPAP-Moisture-Therapy-Cream-1-oz-Tube

      Also, keep in mind that waking with a really dry mouth/throat, is an indication that your mouth is falling open during the night. Are you currently using a full face mask? If not, I would recommend, you trying one to see if that helps.

      Please feel free to reach us for any further questions, or concerns.

      Have a great weekend!

  20. Lau Teow Leong Reply

    Lately I bought an APEX XT auto from CPAP .com invoice no M2609904.
    The past 18 days my AI is 0-1,HI is 6-13,SI is 4-12. My prescription was informed as 13cm H2O changed to 12 on my last CPAP and my AHI was less than 4.
    Now this new unit, the min pressure set is 4cm H2O while max is 20 set by CPAP.com.
    Please advice how to increase min pressure setting on this machine.

    • Hi Lau, we have sent you an e-mail that contains further information regarding your pressure adjustment request.

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

      Thank you for being a valued customer, have a great day!

    • Hi Willie, i’m not fully understanding your question. Are you trying to increase/decrease the pressure on your machine?

      If so, we always recommend that you speak with your doctor before you adjust your pressure. If you’ve already spoken with your doctor and it has been determined that your pressure needs adjusting and you have the correct pressure setting, please give us a call with your machine near you and we’ll be happy to assist you.

      We can be reached at: 1-800-356-5221.

      Have a great day!

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