With sleep apnea affecting almost 20 million Americans, it is no wonder why so many people turn to CPAP therapy. The CPAP (Continuous Positive Airway Pressure) machine is the most popular form of treatment for the sleep disorder, as it delivers a constant flow of air via a breathing apparatus during sleep. However, the effectiveness of the machine, depends on the pressure setting matching the irregularity of a person's breaths. It's important to know how to tell if your CPAP pressure needs adjusting.
Finding the balance between comfort and consistency is key. If you, like many others, suffer from sleep apnea, you may have trouble with your pressure levels and find it unclear how to tell if your CPAP pressure needs adjusting. If that's the case, look no further! We have gathered all the information you need to know, including a simple guide on assessing your pressure levels.
What Is the Optimal CPAP Pressure?
A frequently asked question amongst sleep apnea patients is how to find the optimal level for effective treatment. Since every human body is unique and every person experiences sleep apnea slightly differently, there is no one pressure setting that fits all. Knowing how to tell if your CPAP pressure needs adjusting will depend on your body's needs and what your sleep doctor has seen fit to prescribe.
Usually, CPAP levels should be adjusted to a pressure strong enough that it can hold your airway open, and the pressure is measured in centimeters of water pressure. For example, a 10cm/H2O setting means that the pressure is equivalent to an average person sucking water through a 10cm long straw that is positioned at the water's surface. By comparison, human speech, as it moves past the vocal cords, is roughly 7cm/H2O.
Your CPAP machine's highest pressure setting will depend on the model you have, but most max out at 20 to 25cm/H2O, which is far too high for most patients. A setting anywhere between 6cm to 14cm/H2O will treat most sleep apnea cases with the average pressure setting being about 10cm/H2O. This can vary further when considering patients with Obstructive Sleep Apnea (OSA) who may require an even higher-pressure setting or prefer their treatment to be at lower levels of pressure for added comfort.
Ultimately, the anatomy of your upper airway and the specific nature of your airway obstruction are the biggest factors in determining the optimal CPAP pressure setting. Sleep apnea can occur from a variety of different blockages, ranging from a blocked nose, a collapsing soft palate, or a tongue that falls back into the airway, and each once requires a specific pressure to push these tissues out of the way.
Being overweight or obese can change your settings further, and patients who have lost significant amounts of weight may find they need to lower their CPAP settings. Besides all this, alcohol, medications and even sleeping on your back may add to your pressure needs.
You may notice specific signs or symptoms that suggest your pressure needs adjustment, and if that's the case, be sure to consult your sleep doctor immediately as an inaccurate CPAP pressure can have unwanted side effects.
What Are the Risks of an Inaccurate CPAP Pressure?
As mentioned previously, having an accurate CPAP setting is paramount to gaining effective treatment against the array of sleep apnea conditions. Having an inaccurate CPAP pressure will negate any effectiveness of the treatment and leave you susceptible to various side effects and symptoms of sleep apnea that can bring significant health risks.
Many patients will experience an inaccurate CPAP pressure as this is normal, especially when patients are first trialing the treatment or as individual needs change. These adjustments in pressure only cause minor side effects and symptoms, such as snoring or a dry throat. However, if inaccurate settings go unadjusted for extended periods of time, then patients can find themselves exposed to the more serious side effects and symptoms of sleep apnea.
For instance, a pressure that is too high can lead to pressure-induced Central Sleep Apnea (CSA) which, in contrast to Obstructive Sleep Apnea (OSA), is the result of the brain failing to send the correct breathing signals to the nose, throat and lungs. This, over long periods of time, can eventually lead to severe health problems, which include:
High Blood Pressure
A lack of oxygen can lead to higher stress levels as you sleep, making your hormone systems boost your blood pressure levels.
A disruption in oxygen can also mean a disruption in blood flow. This can lead to potential strokes or atrial fibrillation.
Type 2 Diabetes
While this is uncommon, lack of proper sleep can affect your body's ability to produce sufficient insulin, and the risks increase if the patient is overweight or obese.
Accidents or Injuries
An inaccurate CPAP pressure will affect proper sleep patterns, which can cause grogginess and fatigue. Patients with busy work days or long commutes may be at risk of dozing off in dangerous situations.
The risks associated with incorrect (too high or too low) CPAP pressure can be serious, so knowing how to tell if your CPAP pressure needs adjusting is important for your general health and safety.
How to Tell If Your CPAP Pressure Needs Adjusting
When being treated from sleep apnea with CPAP, your doctor will prescribe the pressure of your machine, based on a process known as titration. You will undergo a series of tests with different pressure levels until you reach the right therapeutic level. Doctors and specialists do not recommend adjusting your CPAP machine yourself, but understanding the impact of its pressure will empower you to make the best health decisions.
The primary indicator of whether your air pressure needs adjusting is you. You will be the first step in identifying if you need to titrate your treatment up or down. Below is a list of things to consider when assessing yourself:
A common misconception is that the severity of your Sleep Apnea dictates the amount of pressure you require. Every case is different and there are multiple factors that contribute to determining the right air pressure level. These include: age, weight, general fitness level, lifestyle choices (smoking, drinking alcohol) and even the various medications and supplements you take.
If Your CPAP Pressure Is Too Low
Without a strong enough amount of pressure, the air flow is unable hold the airways open or regulate breath. Below are several indicators that your CPAP pressure is too low:
If Your CPAP Pressure Is Too High
The number of times a person experiences the partial (hypopnea) or complete collapse (apnea) of their airways in an hour of sleep is measured on the Apnea-hypopnea index (AHI). The 'normal' amount is anywhere from 1 to 5 events per hour. If you experience over 5 events in an hour, this could indicate the pressure setting on your CPAP is too high. If the setting is too high, it can aggravate the severity of your condition and impact the effectiveness of your treatment.
Other symptoms and side effects include:
It is important to note that your level may change over time, so to ensure you continue to receive the right level of treatment, pay attention to your AHIs, the quality of your sleep and side effects.
Ways to Optimize Your Pressure
If you believe that your CPAP pressure needs to be increased or decreased, speak with your doctor about changing the settings of your treatment. An alternative is to consult your doctor about automatic CPAP systems, known as APAPs. APAPs automatically adjust the pressure throughout the therapy session, which significantly reduces the chances of high pressure interfering with therapy quality.
You may also want to consider avoiding or limiting the following things, when testing the pressure levels on your CPAP machine:
These variables can worsen your sleep apnea during treatment, along with suffering from the common cold, hay fever or sinus allergies.
Understanding how to tell if your CPAP pressure needs adjusting can be the difference between a good night's sleep and serious side effects that influence your health and peace of mind. By continually monitoring your experiences with the CPAP machine and notifying your doctor when you believe the pressure needs to be changed, you will increase the success of your treatment and improve your overall energy, alertness and happiness. If you have further questions about CPAP pressure or sleep apnea, consult your local physician or the specialists at Apnea Treatment Center.