Still Snoring With CPAP: What to Do

Snoring is one of the prime symptoms of sleep apnea. As well as impacting on the quality of your own sleep, snoring often affects a partner’s sleep too. It can place a strain on a relationship, with a partner potentially starting to sleep in another room.

Although not everyone with sleep apnea snores, it is a principal indicator of the sleep disorder. Sleep apnea is a common condition affecting millions of people, of whom over 85% or more will snore. Therefore, it comes as a relief to learn that CPAP, the leading treatment for obstructive sleep apnea and the most common form of the disorder, should eliminate your snoring too.

Why Do I Snore?

Snoring results from the vibrations as air passes over obstructions in the airways. Everyone snores from time to time, yet some people are more prone to persistent and heavier snoring. Indeed, it is estimated that one in four adults are habitual snorers.

The main reasons you are more likely to snore include:

  • nasal congestion resulting from colds or allergies
  • large tonsils or adenoids
  • low, thick soft palate
  • obesity
  • thicker neck tissue

Obesity is also one of the risk factors contributing to sleep apnea. When you sleep, the muscles relax and excess tissues in the throat can sag to cause an obstruction to the air flowing to the lungs.

Obstructive sleep apnea results from the complete or partial blocking of the airways, leading to frequent breathing pauses. The brain responds to the reduction in blood oxygen levels by prompting the body to wake for air. This can happen hundreds of times every night. The obstruction of the airways is why those with sleep apnea are more likely to snore.

How CPAP Helps Reduce Snoring

CPAP stands for continuous positive airway pressure. It is the leading treatment method for moderate to severe obstructive sleep apnea. The device delivers pressurized air through tubing connected to a mask worn while sleeping. The air is set to a pressure determined by a sleep study and prevents the airways from collapsing.

Therefore, as CPAP is designed to keep the airways open to promote natural breathing, it reduces your snoring too. This is a win-win situation both for you and your partner.

However, the world is not always perfect, and there are occasions when you may find you still snore when using CPAP.

Why You Might Still Snore When Using CPAP

Any deficiency in CPAP can see your sleep apnea symptoms return, including snoring, frequent nighttime awakenings and daytime fatigue. However, one of the main reasons you may still snore when using CPAP is because of incorrect pressure settings.

You tend to find yourself snoring if the pressure settings are too low. The pressurized air delivered using CPAP must be high enough to keep the upper airways clear throughout the night. A return of your snoring is an indicator that the pressure settings need revisiting.

This is why Auto CPAP was invented.  It regulates your breathing on a breath by breath basis and adjusts the pressure to eliminate or greatly reduce apneas caused by snoring.  These devices also have the added benefit of maximizing your REM sleep. The pressure needs to be higher due to disordered breathing being most severe during REM sleep.  With an Auto device this increase occurs automatically preventing the patient from waking up.  

Always consult with your sleep physician if you continue to snore or start snoring with CPAP. The treatment should eliminate or reduce your snoring. 

Never try to adjust the pressure settings on your CPAP device by yourself. This should only be done by a professional, and you may require a further sleep study to ensure your device is set with the correct pressure setting to prevent the airways from blocking.

Mask leaks can be another reason why you snore even though you are using CPAP. Leaks can cause a reduction in the air pressure delivered. Therefore, the air pressure may not be sufficient to keep the airways completely clear of obstructions. A new mask, a new mask type or accessories such as nasal pillow liners could address this issue. Once again, work with your sleep physician for a suitable solution.

If you breathe through your mouth, a full-face mask covering both the nose and mouth could be the better option instead of a nasal mask or a nasal pillow mask. Without a full-face mask, breathing through the mouth could see you continue to snore, while you may also find you tend to wake up with a dry or sore throat.

If you do find yourself snoring with CPAP, your partner’s observations could be useful. By observing and noting the degree to which you still snore they could provide useful information to your sleep physician.

Further Reasons You May Snore

While in theory CPAP should eliminate snoring, there are other factors which could be behind your snoring. If diagnosed with sleep apnea, lifestyle factors will be a consideration in devising a treatment plan to reduce the disorder’s symptoms and return you to nights of uninterrupted sleep.

We have touched upon how obesity is a contributing risk factor for sleep apnea. A healthier lifestyle which sees you lose weight helps reduce any excess throat tissues and can help you reduce your snoring. You also lose muscle tone when you put on weight, making it more likely that the muscles in the throat will relax and sag to block the airways while you sleep.

Another lifestyle component to consider is alcohol consumption, particularly that late nightcap. Alcohol acts as a relaxant, and therefore drinking alcohol close to bedtime can cause the throat muscles to relax further, making them more prone to collapse and obstruct the flow of air to the lungs. Studies also suggest alcohol may affect sleeping patterns and increase the odds of snoring.

Nasal congestion from colds, flu or allergies can also mean you continue to snore. CPAP can keep your airways clear in some instances, but otherwise you should consult with your doctor for nasal decongestants. Elevating the head on extra pillows can also be beneficial.

Is Snoring So Bad?

Snoring can certainly be a huge issue for a partner. However, for the snorer it can disrupt sleep and lead to a weakened immune system, poor concentration, memory issues, irritability and depression. Persistent sleep deprivation also increases the risk of serious health issues like heart disease, stroke and diabetes. 

Therefore, if you are still snoring when using CPAP, it is important to evaluate why with your sleep physician.