Every person with obstructive sleep apnea (OSA) experiences different levels of air obstruction. That's why it's important to have your CPAP (continuous positive airway pressure) device set to the right level for your specific needs.
The best way to determine this is with an overnight CPAP titration study where a sleep physician monitors your sleep and adjusts the pressure just enough to prevent air obstructions. Their goal is to find the lowest pressure setting needed. This will ensure you breathe as comfortably as you can throughout the night with a few apneas and hypopneas as possible.
Your CPAP device blows air into your airways to ensure your breathing is not obstructed during sleep. The air pressure delivered is determined by the pressure setting on your device. For most people, this CPAP pressure setting is set between 6 and 14 cmH2O, with an average of 10 cmH2O. Your sleep physician will help you determine what level is right for you.
You may think the pressure level is related to the severity of your sleep apnea, but that's not always the case. People with mild OSA may need high pressure and vice versa. The pressure you need to clear your airways depends more on their anatomy and the nature of your obstructions.
You may feel your CPAP pressure is too high if you experience discomfort in your mouth, nose or airways. This, however, does not necessarily mean the setting is not right for you. You may just need some time or advice to adjust to therapy.
If, after a while, you still find your therapy uncomfortable, having high air pressure may be counter-productive to your therapy. Some people will simply not be able to tolerate high pressures – that's why the settings are adjustable. If you find your pressure too high, it's essential to ask your sleep physician to adjust it for you.
Having the air pressure too high can also cause other side effects beyond discomfort, such as aerophagia, which is when sufferers "swallow" air into their stomachs. This can result in bloating, gas, discomfort, and excessive belching.
As previously mentioned, the ideal CPAP pressure is the lowest pressure needed to treat your sleep apnea. But if it is set too low, you will not have enough air to clear your airways, leading to apneas and hypopneas during sleep.
Those who experience five or more apnea or hypopnea events per hour will typically require an increase in their CPAP pressure setting. And when you’re not getting the therapy you need, you'll continue to experience the symptoms of sleep apnea too, so do go get it checked out!
If you believe your CPAP pressure needs to be adjusted, you should go and see your doctor or sleep physician to discuss your CPAP device settings. Your sleep physician will be able to look at your therapy data to help you determine the settings that are right for you. Changing the CPAP device setting yourself may result in adjusting the pressure too far in either direction, which could make your condition worse.
Some people may benefit from using an Automatic PAP device or APAP, which, unlike a regular CPAP device, can automatically adjust the air pressure as needed to unblock any obstructions that occur. With an AutoSet device, you can rest easy knowing that the pressure will rise and fall as needed to keep the airway open.
If you're struggling with your sleep therapy, even after adjusting your pressure settings, don't give up on sleep therapy just yet. An APAP machine could be the answer.
ResMed is a global leader in sleep technology that has its origins right here in Australia. Our goal is to provide people with the means to awaken their best and enjoy healthier lives by promoting good sleep habits and creating awareness for sleep disorders such as sleep apnea.
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