Snoring with CPAP? Why It Happens and What You Can Do

A CPAP machine is often used to improve airflow during sleep and may help reduce noise for some users. So when snoring doesn’t go away - or comes back - it’s easy to wonder if something’s not quite right. While CPAP is a go-to solution for sleep apnea, it’s not a one-size-fits-all fix for every snoring scenario.

The good news? Most of the reasons behind snoring with CPAP have clear explanations and practical solutions. This guide explores the most common issues, offers advice on what can be done, and highlights when to consult a healthcare provider.

Why CPAP Users Might Still Snore

Even though CPAP is designed to keep your airway open and reduce snoring, a few things can get in the way. Here are some of the most common culprits:

1. The Pressure Might Be Off

CPAP machines are designed to deliver air pressure that may help keep the airway open during sleep. If the pressure is too low, your airway might still partially collapse during sleep - and that can bring snoring back. In some cases, higher pressure levels might cause air to escape through the mouth, which could result in noise during the night.

What to do:

• Talk to your provider about reviewing your pressure settings

• If you use a fixed-pressure machine, ask whether switching to an auto-adjusting (APAP) model might help. APAP machines respond to changes in your breathing and adjust pressure levels throughout the night

• Never adjust the pressure without medical supervision. Incorrect settings can reduce effectiveness or cause complications, especially for people with heart conditions

2. The Mask Isn’t Sealing Properly

Even a small mask leak can let air escape, reducing the machine’s effectiveness. That escaping air might hit soft tissues and cause snoring sounds.

Try this:

• Check for air escaping around the nose or cheeks

• Refit your headgear so it feels secure but not tight

• Make sure the mask size matches your face shape and features

• Inspect the mask regularly for wear and tear

• Explore different styles - nasal pillows, full-face masks, or hybrid options

3. You’re Breathing Through Your Mouth

If you’re wearing a nasal mask but still snoring, mouth breathing might be to blame. It can lead to throat dryness and reduce the pressure delivered to the airway, potentially allowing partial airway collapse and leading to snoring.

Possible fixes:

• Try a chin strap to encourage nasal breathing

• Consider switching to a full-face mask that covers both the nose and mouth

• Some consider mouth tape to encourage nasal breathing, but this carries risks, such as potential asphyxiation in cases of severe sleep apnea or nasal obstruction, and should only be used under strict medical supervision.

4. Nasal Congestion Is Getting in the Way

Nasal congestion can sometimes affect how air flows during CPAP use. This may be related to temporary factors like colds or seasonal allergies, or structural issues that require evaluation by a medical professional.

Helpful adjustments:

• Use a saline rinse or nasal spray before bed (consult a doctor before using medicated sprays)

• Run a humidifier with your CPAP if dryness is an issue

• Add nasal strips for extra support

• Make sure your filter is clean and your equipment is well maintained

Lifestyle and Sleep Habits That May Help

Your Sleeping Position Could Be Contributing

Back sleeping can make it easier for the tongue and soft palate to fall backward and block the airway, even with CPAP in use. This tip may not work for everyone, particularly in more severe cases of sleep apnea.

What to try instead:

• Sleep on your side using supportive pillows

• Use a wedge pillow to slightly elevate your upper body

• Experiment with positional therapy tools if staying on your side is tough

Weight Changes Might Be Affecting Your Therapy

Weight changes may influence how well CPAP therapy works, as additional tissue around the neck could affect airflow for some individuals. On the flip side, weight loss may reduce the pressure needed.

Steps to consider:

• Ask your provider to reevaluate your therapy if your weight has changed significantly

• Keep in mind that weight loss can support CPAP use, but may not eliminate the need for therapy entirely

Alcohol or Sedatives Could Be Playing a Role

Alcohol and certain medications are known to affect muscle tone in the throat, which may influence how effective CPAP therapy feels for some people.

Smart habits:

• Avoid alcohol in the evening

• Talk to your doctor if you're using medications like muscle relaxants, antihistamines, or certain antidepressants that might impact throat muscle tone

• Stick to a regular sleep routine to help keep muscles and breathing patterns stable

When It’s Time to Reassess

If none of the earlier adjustments seem to be helping, it might be time to consider a follow-up evaluation. If snoring continues despite adjustments, it might be related to issues beyond the current CPAP setup. In some situations, this could involve other sleep-related conditions that require clinical evaluation.

Some clues that suggest a new assessment is needed include feeling just as tired during the day as before therapy, noticing little or no improvement in sleep quality, or hearing from a partner that snoring is still a nightly occurrence. When those signs persist, a follow-up sleep study - either in a clinical setting or with at-home equipment - may help identify contributing factors and inform possible adjustments to therapy.

Quick Summary of Snoring Fixes for CPAP Users

Here’s a breakdown of simple steps that may reduce or eliminate snoring with CPAP. Always check with your healthcare provider before making any significant changes.

Adjust equipment:

• Recheck pressure settings with your provider

• Replace or refit your mask if it leaks

• Try a chin strap or full-face mask for mouth breathing

Improve airflow:

• Use a humidifier

• Treat nasal congestion

• Add nasal strips

Revisit routines:

• Sleep on your side

• Avoid alcohol and sedatives before bed

• Reevaluate if your weight has changed

Get help if needed:

• Schedule a sleep study if symptoms persist

• Don’t try to fix pressure settings alone

• Keep a sleep journal and ask your partner to help track snoring

Conclusion

Still snoring with CPAP doesn’t always indicate a failure in therapy, but it may be a sign that something in the setup could use attention. Many of the solutions are straightforward, especially with the right support. A step-by-step approach and regular check-ins with a provider can help you stay on track and move toward quieter, more restful nights.

FAQs