Comfort and side effects
CPAP Pressure Too High? Signs and What to Do
If CPAP feels like too much air, fighting to breathe out, leaking, bloating or dryness may follow. Comfort features like ramp and exhale relief can help, but the pressure itself is a prescription, so only your sleep clinician should change it.
Signs
- Feeling like air is being forced into you
- Hard to breathe out against the air
- Mask leaks or mouth leaks
- Morning bloating or burping
- Dry nose, mouth or throat
- Waking up often and taking the mask off
Common causes
- Prescribed pressure is not yet comfortable
- Many people need time to get used to their pressure, especially in the first weeks.
- Pressure may need review
- The Sleep Foundation lists exhale discomfort, leaks, dryness, bloating and nosebleeds as signs pressure may be too high. Weight change, alcohol and sedatives can also change the pressure you need.
- No exhale relief or ramp in use
- Exhale relief (EPR on ResMed, Flex on Philips) lowers pressure as you breathe out. If it is off, breathing out can feel harder.
- Mask leak
- A leaking mask can make the machine feel loud and blasting, especially on an auto machine that raises pressure.
Fixes to try, easiest first
Do not change your pressure yourself with your clinician
The Sleep Foundation is clear: do not change settings on your own. Your pressure was set to keep your airway open. Turning it down can let apneas return. Write down what you feel and call your sleep clinician.
Use the ramp
Ramp starts at a lower pressure and builds up while you fall asleep. It is a comfort setting on most machines. On the AirSense 11 it can be set Off, 5 to 45 minutes, or Auto.
Turn on exhale relief if your machine offers it
On ResMed machines, EPR lowers pressure by 1, 2 or 3 cm H2O when you breathe out, and pressure never drops below 4 cm H2O. Depending on how your provider set up the machine, you may be able to change it from the patient menu. If you cannot find it, ask your provider.
Fix mask leaks
Refit your mask lying down with the air on. Use the Mask Fit feature if you have one. A good seal often makes the same pressure feel gentler.
Add humidity for dryness
Humidification is widely recommended for the dry mouth and nose that can come with higher pressures.
Ask about auto CPAP or bilevel with your clinician
If pressure still feels too high, ask your clinician about APAP, which adjusts pressure through the night, or a bilevel machine. A new titration study may be considered.
Call your sleep clinician if pressure discomfort keeps you from using CPAP, if you are waking with bloating or stomach pain (NHLBI says to stop and contact your provider), or if you notice nosebleeds or eye irritation. Call 911 for chest pain or severe shortness of breath.
Supplies that can help
Tubing with a built-in heating wire that keeps humidified air warm all the way to the mask, which is the main fix for rainout (water droplets …
A soft strap that supports the jaw to help keep the mouth closed, used mainly with nasal and nasal pillow masks to reduce mouth leaks.
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Mask types this applies to
Frequently asked questions
How do I know if my CPAP pressure is too high?
Common signs include struggling to breathe out, leaks, dryness, bloating and nosebleeds. These can also have other causes, so share them with your clinician who can check your data.
Can I lower my CPAP pressure myself?
No. Pressure is part of your prescription. Your clinician can review your data and decide on changes, a different mode or a new study.
What is EPR on a ResMed CPAP?
EPR stands for expiratory pressure relief. It lowers pressure by up to 3 cm H2O when you breathe out to make exhaling easier, without dropping below 4 cm H2O.
Sources
Last reviewed October 11, 2026. How we research · Report an error