Snoring with CPAP: Why It Happens and How to Fix It

Getting a CPAP machine is a major step toward treating obstructive sleep apnea, and for many, it also means finally saying goodbye to disruptive, exhausting nighttime snoring. CPAP (continuous positive airway pressure) therapy works by gently blowing air into your airway to keep it open and prevent pauses in breathing that characterize sleep apnea. Many patients and their partners experience dramatic improvements in sleep quality, daytime alertness, and even heart health after starting CPAP therapy.

However, some people are surprised to find that snoring can still occur—even when their CPAP machine is on and in use throughout the night. If you or your bed partner notices that snoring persists while using CPAP, don’t worry—you’re not alone, and there are practical solutions available. Understanding why snoring occurs with CPAP and the steps you can take to address it is key to improving your therapy success and achieving truly restful sleep.

Understanding Snoring with CPAP Therapy

CPAP therapy is specifically designed to hold the airway open by delivering steady pressurized airflow, reducing or eliminating the snoring caused by airway collapse in obstructive sleep apnea. Ideally, snoring should dramatically decrease or disappear once you begin therapy.

But sometimes, snoring with CPAP persists. Why does this happen? Ongoing snoring might indicate your therapy isn’t as effective as it could be or that an underlying issue needs attention.

For example, your CPAP pressure might be set too low, not adequately splinting open your airway during sleep. Mask leaks can allow pressurized air to escape, disrupting therapy effectiveness and causing vibrations that sound like snoring. Nasal congestion or mouth breathing can also interfere with optimal airflow, triggering snoring noises despite CPAP. Additionally, changes in your airway anatomy or weight fluctuations can alter your therapy needs over time.

Managing snoring during CPAP therapy is essential not only for quiet nights but also for overall health and well-being.

Is This Guide for You?

If you’re using CPAP therapy but still notice snoring—either you hear it yourself or your partner reports it—this guide is for you. It also targets those experiencing related issues like mask leaks, equipment discomfort, dry or congested nasal passages, or insufficient rest despite regular therapy use.

Whether you want to adjust your equipment, better manage nasal symptoms, or understand why persistent snoring occurs, you’ll find useful insights and practical advice here. Remember, snoring with CPAP is common, and often a few adjustments can make a significant difference.

Step-by-Step: How to Reduce Snoring with CPAP

Experiencing snoring while using CPAP does not mean you should give up on this therapy—far from it. Here is a structured approach to troubleshooting and improving your treatment to achieve quieter, more restful nights.

1. Check and Adjust Pressure Settings

One common cause of ongoing snoring during CPAP therapy is improper pressure settings. If the pressure is too low, your airway may still partially collapse, triggering snoring vibrations—similar to water flowing through a partially blocked pipe making noise. Conversely, pressure that is too high can cause discomfort, promote mask leaks, or lead to sleep disturbances such as aerophagia or pressure intolerance.

For example, some patients have reported persistent snoring despite CPAP use; after pressure reassessment with their sleep specialist, adjusting to a slightly higher pressure setting eliminated snoring and improved sleep quality.

Auto-adjusting CPAP machines, also called APAP devices, sense airway resistance and automatically fine-tune pressure throughout the night. These can provide personalized therapy and may reduce snoring more effectively.

Always consult your healthcare provider before making any pressure adjustments.

2. Ensure Proper CPAP Mask Fit

A proper mask fit is crucial for successful CPAP therapy. Mask leaks are a frequent cause of persistent snoring because leaking air reduces therapeutic pressure and creates noise. Think of it like trying to inflate a balloon with a hole—it won’t hold properly.

Choosing a mask style that fits your facial structure and sleep position is important. Mask types include nasal masks, full-face masks covering both nose and mouth, and nasal pillow masks resting at the nostrils. Side sleepers may find some mask designs more comfortable and better fitting.

If you notice air leaks—characterized by whistling sounds or dry eyes—it might be time to try a different mask type or adjust the straps for a snug yet comfortable fit. Also, worn-out masks lose their sealing ability and should be replaced every 3 to 6 months as recommended. Regular cleaning of your mask, tubing, and cushions also helps maintain a proper seal and prevents skin irritation.

3. Manage Nasal Congestion

Nasal congestion caused by allergies, sinus infections, colds, or anatomical issues like a deviated septum can be a major barrier to CPAP effectiveness. Congestion increases airway resistance, making it harder for the machine to maintain adequate pressure, which may cause snoring.

If you struggle with nasal stuffiness, practical steps like saline nasal rinses or sprays, and nasal strips before bedtime can open your nasal passages. Decongestant sprays may provide relief but should only be used as directed by a healthcare professional to avoid rebound congestion.

Many CPAP machines include heated humidifiers, which add moisture to the airflow, reducing dryness and irritation that can worsen congestion. Keeping nasal passages clear ensures smoother airflow and reduces the chance of noisy breathing.

4. Address Mouth Breathing

Mouth breathing during sleep is common among CPAP users, especially those with nasal congestion or certain anatomical traits. When air escapes through the mouth, CPAP therapy becomes less effective, and snoring can worsen.

If you naturally breathe through your mouth, discuss mask options with your provider. A full-face mask that covers both nose and mouth can help maintain pressure. Additionally, a chin strap may help keep your jaw closed during sleep to prevent air leaks.

Mouth breathing may also exacerbate dry mouth or throat irritation. Dryness may be a side effect of CPAP machines used without humidification. Proper mask selection and strategies to encourage nasal breathing are important to reduce symptoms and improve therapy success.

5. Monitor and Manage Weight Changes

Weight directly impacts airway anatomy and CPAP pressure needs. Increased weight can lead to fatty tissue accumulation around the neck and throat, narrowing your airway and increasing snoring risk. Conversely, significant weight loss may reduce your pressure requirements.

Regularly monitoring your weight and reporting substantial changes to your sleep specialist allows for timely adjustments in therapy settings. Significant weight changes can alter your therapy needs and should be discussed with your provider.

Expert Tips to Minimize Snoring with CPAP

Besides troubleshooting common issues, incorporating these best practices can improve your therapy outcomes:

• Maintain your equipment: Clean and replace your mask, tubing, and filters as per manufacturer recommendations to avoid leaks, buildup, and infections.
• Use a humidifier: Heated humidification adds moisture to the pressurized air, preventing dryness that can cause nasal irritation and congestion.
• Clear nasal passages before bed: Use saline sprays or gentle nasal irrigation when prone to stuffiness or allergies.
• Be consistent: Keeping a regular sleep schedule supports your body’s internal clock and helps improve sleep quality and therapy adherence.
• Monitor progress: Many CPAP devices track usage hours and snoring intensity. Reviewing this data with your provider during follow-ups helps tailor treatment.

Small adjustments and consistent care can make a significant difference in therapy success.

What to Do If You Still Snore Despite CPAP Therapy

If you’ve tried these steps and snoring persists, it’s important to reconnect with your care team. Persistent snoring might indicate:

• The pressure setting still isn’t optimal.
• Your mask fit requires further adjustment or replacement.
• Nasal congestion remains inadequately treated.
• Another sleep-related disorder or medical condition contributes.

Your doctor may suggest a repeat sleep study—known as a CPAP titration study—to assess therapy effectiveness overnight or additional examinations to explore other causes.

Fine-tuning CPAP therapy is a normal and important part of treatment, so professional guidance is essential.

Alternatives if CPAP Therapy Isn’t Enough

For some patients, snoring and apnea symptoms may continue despite optimal CPAP use or CPAP may not be well tolerated. Alternative options include:

• Lifestyle adjustments: Weight loss, avoiding alcohol within 3 to 4 hours of bedtime, quitting smoking, and sleeping on your side can reduce airway collapse and snoring.
• Oral appliances: Custom dental devices designed by sleep dentists reposition the jaw or tongue to keep your airway open.
• Surgical options: Procedures targeting anatomical blockages (such as septoplasty or uvulopalatopharyngoplasty [UPPP]) may be appropriate in select cases after other treatments have been considered.
• Other therapies: Positional trainers (devices that encourage side sleeping), nasal dilators, or newer technologies might help depending on your specific snoring patterns.

Each approach is individualized, so working closely with a sleep and sinus specialist ensures you find the best plan forward.

FAQs About Snoring While Using CPAP

Why am I still snoring with my CPAP machine on?
Snoring during CPAP therapy is usually due to mask leaks, incorrect pressure settings, untreated nasal congestion, or mouth breathing. Evaluating these factors often reveals manageable causes.

Can a leaky mask cause snoring?
Yes. Leaks allow pressurized air to escape, reducing therapy effectiveness and often creating noise that sounds like snoring.

How often should I replace my CPAP mask?
Most masks should be replaced every 3 to 6 months, depending on use and wear. Worn masks lose their seal, increasing leaks and noise.

Is it safe to adjust CPAP pressure on my own?
No. Adjusting pressure should always be done under professional supervision to ensure safety and treatment effectiveness.

Can nasal congestion be treated while using CPAP?
Absolutely. Using humidifiers, saline rinses, or recommended medications helps keep nasal passages clear and improves CPAP effectiveness.

What are signs I should see a sleep specialist?
If you continue snoring, experience daytime sleepiness, or feel your CPAP therapy isn’t improving your sleep, it’s time to consult your healthcare provider.

Get Professional Help for Your Snoring and CPAP Issues

Noticing snoring despite CPAP use doesn’t mean your therapy has failed or that restful sleep is out of reach. Experienced sleep specialists can diagnose reasons behind persistent snoring and sleep disruption. They tailor therapies, adjust CPAP settings, recommend suitable masks, and create personalized plans to help you achieve quieter, healthier sleep.

Contact your sleep specialist today to schedule a consultation and take the next step toward restful nights and refreshed days.

Disclaimer:
This article is for educational purposes only and is not medical advice. Please consult a qualified healthcare provider for diagnosis and treatment.

Taking action on persistent snoring can significantly improve your sleep quality and overall health.