How to Know If My CPAP Pressure Needs Adjusting

If you have sleep apnea, you know it can be quite a change to get used to continuous positive airway pressure (CPAP) treatment.

In fact, studies suggest that from one-third to more than 50% of patients stop using their CPAP machines. This is for a variety of reasons but is usually due to discomfort.

Having the right CPAP pressure is essential for effective treatment, but it is key for a comfortable night’s sleep. Because our bodies are unique, there isn’t a single pressure setting that will work best for everyone.

While we don’t suggest changing your pressure yourself, you should be active in your treatment plan. Here are some signs to discuss with your doctor if you think you need an adjustment.

If Your Pressure Is Too High

If your CPAP device has too high pressure for your needs, you are likely to experience discomfort.

Difficulty breathing is the most common sign that your pressure setting is up too high. If you are struggling against the pressure from your device, you are likely to wake up often during the night.

Excess pressure is not only uncomfortable, but it can also be harmful. Forced air can enter the ears and cause fluid buildup and leaking. You can also swallow it, leading to gas and bloating.

If you notice any of the following symptoms, your pressure settings are likely too high:

  • difficulty exhaling against the pressure while sleeping
  • chronic aerophagia, or swallowing air
  • burning or dry sensations in the nose or throat
  • hearing issues or fluid leaking from the ears
  • daytime fatigue from frequent waking

Unfortunately, this variety of discomfort often makes users abandon their machines.

If Your Pressure Is Too Low

The purpose of CPAP therapy is to provide the least amount of air pressure needed to keep your airway open while you’re sleeping. If your CPAP pressure settings aren’t high enough, you won’t get enough air to meet the requirements.

If your CPAP device is failing to keep your airway open, treatment becomes ineffective.

You will begin to experience the same symptoms of sleep apnea you had before you started treatment. These include:

  • difficulty breathing while sleeping
  • snoring, gasping, or choking during sleep
  • not feeling refreshed after a full night’s sleep
  • sleepiness while driving
  • daytime fatigue from frequent waking

If you have been wearing your CPAP all night every night and begin to experience symptoms, this is a sign that your pressure settings are too low.

Helping You Find the Right CPAP Pressure

We hope these signs help you recognize when it might be time for a CPAP pressure adjustment.

Remember, you shouldn’t decide your new pressure settings for yourself. Reach out to your doctor to discuss your concerns.

Your sleep doctor may suggest a CPAP titration study to determine the correct amount of air pressure you need. If your machine has it, they may also recommend using a timed “ramp” feature. This setting starts airflow at lower levels then slowly rises as you fall asleep.

If you are struggling with your CPAP pressure settings, contact us today. We are here to help answer any questions about your CPAP machine.

About the Author


Jason Smith is recognized by the board of polysomnographic technologists (BRPT) as a registered polysomnographic technologist (RPSGT) since 2003. He is also Director of Clinical Operations for 6 multi-state sleep diagnostic facilities including the nation’s largest 20 bed sleep disorder testing center. Jason has also been a Co-Author with two research publications featured in Journal of Clinical Sleep Medicine.