When starting CPAP therapy one of the main parts of sleep apnea treatment that many take time getting used to is the pressure level. The pressure level of your CPAP machine is prescribed by your physician and set by a CPAP vendor. 

However, it is possible for your pressure levels to be too high or too low. When this happens, the pressure level will need to be adjusted.  

CPAP Pressure: How Does It Work?  

Many new OSA patients are often unaware that there is no single pressure setting for CPAP therapy. Your doctor will carry out a titration study. A titration study will find the pressure required to keep your airway open. This pressure setting is then given to you via a CPAP prescription. 

Once you have received this, you will then take your prescription to a CPAP vendor who will set it to exactly what the prescription provided to you by your doctor says. As continuous positive airway pressure machines are made to keep an OSA patient’s airway open, it is this prescribed pressure level that will make that possible. 

How To Know If Your Pressure Is Too High? 

When it comes to successful CPAP therapy, comfort is key. All OSA patients know that it takes time to adjust to using the equipment but if discomfort persists for a long time then it may be an indication that something is not right. 

People who find that their air pressure setting is too high will notice that the delivery of air through their mask is uncomfortable and disconcerting. Oftentimes, this will make it difficult for them to fall asleep, disrupt their sleep repeatedly through the night and make them feel more fatigued. Everything that CPAP therapy is aimed to treat. 

High-Pressure Side Effects 

If you suspect that the pressure setting on your CPAP therapy is too high, you may experience a number of the following symptoms and side effects. 

• Mask leakage
• Dry mouth and throat
• Aerophagia (Swallowing of air)
• Breathing heavily through the mouth
• Excessive fatigue
• A higher Apnea-hypopnea index (AHI) 

If pressure levels are too high, it is very common to experience air leakage from your mask. A leaky CPAP mask is a serious problem because it means that you are not receiving the proper airflow you require to treat your sleep apnea. 

Aerophagia is another condition that will compromise your CPAP therapy. High CPAP pressures mean that the extra air is not being delivered correctly to the nasal passageway. When this happens, it often travels to the esophagus and stomach causing bloating, stomach discomfort and heartburn. 

Now What? What You Can Do To Fix It   

You should never attempt to adjust the pressure settings on your CPAP device yourself. CPAP pressure is a vital component of your sleep apnea treatment and should always be managed by a professional.

If you are having trouble with your pressure levels, the first step is to go back to your CPAP vendor and ask them to run a normal troubleshoot and a progress report download. The information that you received from this should then be reviewed by your sleep doctor. The doctor can then write a script for a pressure change and your CPAP vendor will monitor the change for a month to see if there are any improvements. 

Additionally, you can talk to your doctor about using an auto-adjusting PAP machine (APAP) option instead. Unlike a CPAP machine which is a fixed pressure machine, an APAP automatically adjusts pressure levels to your needs. 

However, keep in mind that this option may not be available to you depending on where you live in Canada. For example, in Ontario, most titration tests and scripts are made out for fixed pressure PAP machines. Only in very specific cases is it possible to get funding for auto PAP machines. 

Saying that many CPAP machine models now come with an auto-adjustment function allowing airway pressure to adjust during the night. This greatly reduces the chance of high CPAP pressure disrupting the quality of sleep apnea treatment.