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Still Snoring With a CPAP Machine?
- CPAP pressure settings are important – switching from your prescribed settings can interfere with your therapy and increase snoring.
- Check your machine, mask, and connection points to make sure air is not leaking.
- Mouth breathing can cause snoring. Focus on clearing your nasal passages if you’re congested, and consider a chinstrap or full-face mask if you usually breathe through your mouth.
- Avoid alcohol within 2 hours of your bedtime, and don’t use benzodiazepines or other sedatives without a doctor’s directive.
For people with obstructive sleep apnea (OSA), continuous positive airway pressure (CPAP) therapy can be effective at reducing how much they snore . Unfortunately for those with OSA and their partners, certain circumstances can still cause snoring – even if they’re using their CPAP machine as directed.
We’ll explain why you could be snoring with a CPAP and offer troubleshooting tips to get back to a quiet night’s sleep.
Snoring? It Could be a Sign of Sleep Apnea
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Why Am I Still Snoring With CPAP?
Most people still snore while using CPAP because their airway is too narrow, whether due to equipment-related or anatomical reasons. Pressure settings, mask issues, and airway blockages are common culprits. We’ll explain how to figure out what could be causing your snoring.
CPAP Pressure Is Too Low
CPAP machines support your breathing passages with pressurized air . During an initial titration test, healthcare providers determine which pressure levels will be most beneficial for your specific needs. If pressure is too high, sleeping can be uncomfortable. If pressure is too low, there’s not enough force keeping your airway from collapsing – this can lead to snoring and other side effects.
Mask Leak or Poor Mask Fit
Most CPAP masks are made from silicone that can break down after time, lose its sealing abilities and cause air to leak. Replacing masks on a regular schedule can help ensure that you always get the right amount of pressure during CPAP therapy. How well a mask fits also makes a difference. If it doesn’t seal completely against your face, you won’t receive enough air from the CPAP machine to keep your breathing passages open.
Wrong Type of CPAP Mask
There are multiple styles of CPAP mask, including full-face, nasal, and nasal cushion masks. All types come in different size options. One type of mask may work better than others with your sleeping position and facial shape. If you sleep on your side or stomach with a mask that hits the pillow, your mask may shift and the seal can be compromised. Facial hair can also affect how masks fit. Using a mask that doesn’t fully seal against facial hair can lead to leaks .
Mouth Breathing While Using CPAP
Mouth breathing is linked to snoring . Nasal and nasal pillow masks require you to breathe through your nose and sleep with your mouth closed. Sleeping with an open mouth can impact CPAP therapy because of the extra, non-pressurized air that enters your mouth in addition to air you receive from the CPAP machine. If you breathe through your mouth, you can use a full-face mask, or wear a chinstrap or mouth tape to keep your mouth closed during sleep.
Nasal Congestion or Blocked Airways
Congestion clogs your nose and nasal passages, which can make it tough to get the amount of air you need at night. Often, people with colds or congestion can’t breathe fully through their noses, so they breathe through their mouths instead, which can cause snoring. To address long-term blockages or anatomy-related issues, you may need to speak with your physician.
Alcohol or Sedative Use
Alcohol and certain sedatives are linked to OSA and sleep apnea symptoms, such as airway collapse and snoring. They relax your throat and airway, potentially leading to breathing pauses or snoring. Avoid alcohol before bed and make sure that your physician or pharmacist is aware of any benzodiazepine use.
CPAP Machine or Equipment Issues
If your CPAP machine components aren’t connected correctly, air can leak and prevent you from getting enough pressure to keep your airway open. Many newer CPAP machines have settings that detect leaks, which can be a helpful feature.
How to Stop Snoring While Using CPAP
Usually, CPAP machines decrease snoring in people with sleep apnea, but that’s not always the case. Determining what’s behind your snoring may take some detective work, time, and help from a partner. Luckily, most snoring-related issues are simple to identify and fix.
Check CPAP Pressure Settings
CPAP pressure settings are prescribed by a physician and shouldn’t be changed unless directed. Make sure that your settings match the original prescription. Pressure that’s too low can fail to keep your airway open. If your settings are correct, but you’re still snoring and suspect the issue is pressure-related, you may need to schedule an appointment or titration test with your physician.
Improve Mask Fit and Reduce Leaks
Your CPAP mask should fit flush against your skin without you needing to tighten it too much. The sides of the mask and cushion should prevent air from leaking as long as the seal is secure. Replace your mask regularly and use headgear that allows you to customize the fit to work with your anatomy.
Consider Switching Mask Types
Everyone’s face is shaped differently and there isn’t a CPAP mask that fits everyone perfectly. You may need a little trial and error to determine whether a full-face, nasal, or nasal pillow mask will work best for you. You can purchase the mask in one size, or opt for a fit pack with different size options included to figure out what works best. Think about how you usually sleep because side, back, and stomach sleepers typically have different needs.
Address Mouth Breathing
Mouth breathing isn’t ideal for CPAP and is a known factor that contributes to snoring. If you use a nasal or nasal pillow mask and breathe through your mouth, you aren’t getting air to prevent your breathing passages from collapsing. A full-face mask can help because it covers your mouth and nose, ensuring that you only get air from the CPAP machine. If you can’t tolerate a full-face mask, consider using a chinstrap or tape to keep your mouth closed.
Treat Nasal Congestion
When you’re congested, it’s hard to get air to pass through your nasal passages. This often leads to mouth breathing and snoring . Decongestants and cold medicine work to break up mucus and clear your nose. CPAP machines can sometimes cause sinus infections . If you have persistent congestion issues while using CPAP, you may want to speak with your physician.
Use the Humidifier and Adjust Humidity Levels
Humidifiers can make CPAP therapy more comfortable and easier to comply with . Using a CPAP without added humidity can dry out your nose and mouth. Humidity keeps your breathing passages moist and better equipped to prevent irritation, sinus trouble, and snoring. Keep in mind that some CPAP machines are not compatible with humidifiers.
Avoid Alcohol Before Bed
Alcohol is a depressant. While it may help you fall asleep, it’s unlikely to help you stay asleep. It also relaxes the muscles in your throat, which can be problematic for people with sleep apnea . Your usual CPAP pressure settings may not be high enough to keep your airway open if you drink before bed.
When to Talk to Your Doctor
If you’re still snoring after trying the solutions listed above, it may be time to speak with your doctor. They can help pinpoint mechanical or equipment issues or determine whether you may need to switch machines.
Sometimes people’s bodies change too – weight gain, facial surgery, or broken bones can alter your airway enough to change what CPAP settings you may need. Chronic nasal problems and infections are also reasons to speak with your physician.
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Cassandra is a health writer who has been a contributor to Sleep Foundation since 2021. She writes about sleep products and reads emerging research to develop science-based articles that help demystify the connection between health and sleep. She's happy to report that she sleeps well most nights, which is probably thanks to her energetic dog and her other work managing a family-owned whitewater rafting business in Upstate New York.
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