How To Adjust To High Pressure CPAP Settings

As a patient treating sleep apnea you will find yourself under CPAP pressure. Pressure pushing down on you through your CPAP mask. Your unique pressure setting is dependent upon your apneas, which are the periods when you stop breathing during the night. Apneas vary among individuals based on sleep stages, positions, and more. In severe cases, you may be prescribed a high pressure CPAP setting.

Some patients with high-pressure settings will quit CPAP therapy due to discomfort or the belief that their device isn’t working properly. The air might leak from their CPAP mask or irritate their skin with hurricane-like force. But quitting therapy isn’t the answer to protect your health. Instead, there are a few ways to reduce high CPAP pressure side effects.

How Does A CPAP Machine Work?

CPAP machines operate with an air compressor that generates a specific amount of air pressure. A mask that connects to an individual’s face and a hose transfers the air from the compressor through the mask to hold your airways open during sleep.

The lowest CPAP pressure setting on all machines is typically around 4 to 5 centimeters of water pressure (also referred to as CWP or cm of H2O). Most people require a higher setting than the lowest, but a high setting usually roams toward the maximum machine setting, which ranges from 25 to 30 CWP. 

How To Tell If My CPAP Pressure Needs Adjusting

While adjusting to a CPAP machine takes a little practice, it’s not supposed to be uncomfortable. Your pressure may be too high if you experience the following CPAP side effects: Woman needs to adjust CPAP pressure

  • Your mouth and nose are dry even with the use of CPAP humidification.
  • Your CPAP therapy is uncomfortable.
  • You start breathing through your mouth.
  • You notice significant air leaks through your mask.
  • You swallow air and become bloated.
  • Fluid leaks from your ears.
  • You still feel tired and fatigued during the day.
  • Your AHI (apnea-hypoxia index) is above average per hour.
  • It’s difficult to exhale against the incoming air.
  • You wake up with dry eyes.

What Should My CPAP Pressure Be?

The answer to this question should come from your doctor. A CPAP titration is a type of test to evaluate which pressure setting is optimal for your health and the results are determined by sleep clinicians. They will use this information to calibrate your device. 

If you feel as if your pressure needs to be changed, consult your doctor or clinician. Only they should adjust the pressure to ensure proper treatment and safety. Additionally, you may not need to have more studies performed if you record your CPAP compliance information  and show the results to your doctor. 

Increasing Comfort With High CPAP Pressure

You don’t have to settle for discomfort if your doctor prescribes a high CPAP pressure. There are a variety of ways to increase comfort and enhance your sleep apnea treatment.

1. Try a New CPAP Masks

If your CPAP mask is incorrectly fitted, worn out, or dirty it may lead to leaks and discomfort. You may also have the incorrect type of mask for higher pressure settings. New CPAP masks are continuing to be developed in order to meet the individual needs of a variety of sleep apnea patients. So, instead of sticking to the same old mask, consider your options.

Full Face CPAP Mask - The most comfortable CPAP mask type for high-pressure settings is usually a full face mask. They create a seal around your nose and mouth to distribute the air pressure over a larger area, along with providing oxygen for mouth breathers during the night. 

Man with high CPAP pressure uses nasal mask

Nasal CPAP Mask - Nasal masks only create a seal around the nose. They make less contact with your face, but direct all of the air pressure to your nostrils. While they are great CPAP masks for side sleepers, they might cause nasal irritation if you have a high-pressure setting. 

However, a nasal mask with a foam cushion can provide an airtight, comfortable seal for higher pressure settings. Also, a nasal mask with suction and side straps to secure the nasal mask so it will stay in place can be beneficial.

Nasal Pillow CPAP Mask - Nasal pillow masks have two pillow inserts that rest at the base of your nose, providing minimal contact with your skin. They are ideal for people who toss and turn in their sleep. 

A few of the best CPAP masks for high-pressure settings include:

Woman with high CPAP pressure uses full facemask

ResMed AirFit F30 Full Face Mask - The RedMed F30 is a lightweight full face mask with a minimal design to improve comfort and functionality. By taking up less space it provides an increased field of view making it easier to read and watch TV before bed. Its soft seal reduces pressure and prevents red marks while its QuietAir elbow disperses air over multiple vents for quieter sleep apnea treatment.

Phillips Respironics Dreamwear Full Face mask - This CPAP mask feels like a dream with a soft, weightless feel. The tube is connected at the tube of the frame to allow more freedom during the night. By removing the tubing from the nasal bridge, less pressure is placed on the nose to reduce red marks and discomfort.

Fisher & Paykel Simplus Full Face Mask - The Simplus is a customer favorite. It’s sleek and lightweight design provides freedom and comfort with soft headgear that creates a secure seal. The Simplus has a simple design that maximizes the ability to sleep peacefully. Use the velcro tabs to create a secure fit for stability that lasts the entire night.

ResMed AirFit F30i Full Face Mask - Ideal for those who may feel claustrophobic in other full face masks, the minimal contact design of the AirFit F30i means that users are able to read, use a phone, or watch TV in bed, even if you wear glasses.

ResMed N30i Nasal Mask - The N30i nasal mask has an innovative curved frame to create a secure, yet weightless seal. Because the tube connects at the top of the frame you can enjoy freely sleeping in any position without becoming entangled. Plus, this mask is whisper-quiet, so high-pressure settings won’t disturb you or your partner.

Respironics DreamWisp Nasal Mask - The DreamWisp has a low profile nasal cushion that’s light as a feather to reduce pressure during the night. Take advantage of more liberty as the hose connects at the top of the frame instead of the nasal bridge, allowing you to move freely during your sleep. In addition, the four-point headgear provides a secure fit and increased stability. 

2. Use A Humidifier


You can get a CPAP with humidifier or a humidifier attachment to soften the air passing through your CPAP. Humidifiers add moisture to the air to prevent irritation from dryness. With a heated humidifier or CPAP tube, the air is also warmed. This can prevent chafing and help high-pressure settings become more tolerable. 

Humidifiers are recommended for patients in dry climates and those with allergies because heated humidification can break up congestion in addition to increasing comfort.

3. Try A Different Machine

If you are having trouble adjusting to your CPAP machine you can try an alternative PAP device.

BiPAP - A BiPAP is similar to a CPAP, only it offers Bilevel pressure. Meaning it can be set to two different pressure settings, to assist patients who have trouble exhaling against incoming pressure. The air pressure will be stronger as they inhale and will be lower as they exhale, while CPAP machines can only be set to a single pressure. 

AutoPAP - AutoPAP stands for automatic positive airway pressure because they automatically adjust pressure settings based on the way a patient breathes. If you’re struggling to exhale the pressure will be decreased and if you’re experiencing an apnea the inhalation pressure will increase. They assist patients with high-pressure settings and other respiratory issues.

Still Need Help?

Then contact our dedicated sleep clinicians. We will be more than happy to work with you to solve any discomfort issues. Learn how to comfortably adjust to high CPAP pressure settings to effectively treat sleep apnea and experience the benefits of better rest!