Signs Your CPAP Machine Is Not Working or Needs Adjusting

Continuous positive airway pressure (CPAP) is widely regarded as the best treatment available for obstructive sleep apnea, a breathing disorder that affects millions of people. If your CPAP is not working, there are ways to know it has become less effective.

When correctly used and kept in good condition, CPAP effectively treats sleep apnea. However, persistent symptoms, snoring, and cold air from the humidifier are indications that your CPAP is not working effectively and may need to be adjusted or replaced entirely.

1. You're Breathing in Cold Air

Cold air coming in through the CPAP machine can be a sign that the humidifier isn't working properly. Humidity in the CPAP air is extremely important because it helps prevent dry mouth, difficulty sleeping, and other uncomfortable side effects.

The two main problems that could be happening with the humidifier have to do with the water chamber and the hot plate:

• Your heated humidifier tank should be refilled on a daily basis. Clean the water chamber carefully and allow it to dry completely between each use. Fill it with fresh distilled water. If the water never goes down, the humidifier may not be working at all.
• The hot plate under the water chamber may not be warming up. There is still some evaporation as the air passes over the water, but it's at a much slower rate. Check your machine's manual for hot plate cleaning instructions.

The humidifier should be fairly quiet when it's operating. If it is pretty noisy when it's running, see if you need to get the humidifier replaced. Start by checking the humidity settings on your machine and contact a CPAP specialist for additional help.

2. You're Still Snoring or Having Apnea

Snoring should never occur when the CPAP pressure is set properly. That's because the constant flow of air will keep the airway open and prevent its collapse. It also stops the airway tissue vibrations that cause snoring.

You may have pauses in your breathing or episodes where you wake up gasping and choking even while using your CPAP machine. If these events are confirmed, it's likely the pressure setting needs to change.

The apnea-hypopnea index (AHI) gives you an average number of breathing disruptions that occur per hour of sleep. You can sometimes find an AHI display on your machine or monitoring apps.

Using a CPAP machine can improve your AHI. If your AHI does not get better with the use of a CPAP machine, talk to your healthcare provider about adjusting the pressure settings.

If you have any of these problems, you should discuss them with your sleep specialist.

3. You Feel Worse

Some people who start using a CPAP machine will see benefits in a matter of days or weeks. Signs that CPAP treatment is working may include:

• Better quality sleep
• Decreased daytime sleepiness
• Less or no snoring

Over the long term, other conditions associated with untreated sleep apnea may also improve. The long-term benefits of CPAP include:

• Helping to prevent or control high blood pressure
• Lowering the risk of stroke
• Improving memory and other cognitive function

When there is a problem, people using CPAP will most often complain that their excessive daytime sleepiness has returned and they need to have long or frequent naps. Possible causes include a mask leak or not enough treatment pressure.

Other changes in your health or lifestyle may cause your symptoms to return. That may mean your CPAP settings need to be adjusted. The following factors can affect how well your CPAP treatment is working:

• Weight gain: Putting on weight can make sleep apnea worse. Losing weight can improve sleep apnea and even works as a single treatment for some people.
• Alcohol use near bedtime: Using alcohol before bedtime can make sleep apnea worse. Opioids and sedatives should also be avoided at bedtime for the same reason, if possible.

4. Your CPAP Machine Is Aging

Unfortunately, CPAP machines do not last forever. Your machine may start to make a funny noise, become harder to operate, or won't generate the same pressure as before. That may mean it's time to replace the machine.

These devices do have some degree of built-in obsolescence, meaning that they are not meant to work forever. They will gradually begin to fail, and you'll need to replace it with a new device. Cleaning your CPAP regularly can help it last longer.

If your CPAP machine is old enough and it's no longer working well, a replacement is due. Fortunately, next-generation models often have improved features. The new machines often are quieter and easier to use when compared to old equipment.

5. The CPAP Machine Just Isn't Working

If the machine does not turn on, it is not working correctly. When plugged in, most CPAP machines can be turned on with the push of a button. If you place it on a specific setting, some machines will start working automatically when you breathe into your connected mask a few times.

If the CPAP stays off or there is no airflow at all, you should take it to your equipment provider. They can determine if the device needs to be repaired or replaced. If it is old, it may need to be replaced. Additionally, if the device was dropped or knocked over, it may need to be repaired or replaced.

There can be other signs that something is amiss with your CPAP machine. That's because there are water and heating systems that can malfunction, too, apart from the power supply. Here are a few to consider.

• If the air feels uncomfortably cool, this is further evidence that the machine is not working.
• Water may condense inside heated tubing in some machines that have them. When this happens, it's called a rainout. A rainout can be solved by adjusting the temperature settings on your heated humidifier, wrapping the hose to keep it warm, or replacing the tubing with heated tubing.
• The machine may also be more noisy, and it seems to provide less airflow than before. A noisy machine could have a clog or may need to be replaced.
  

6. You Can't Get Comfortable

If you are using a CPAP for the first time, getting comfortable and used to the machine so that it can work properly can take time. Common problems individuals face when beginning CPAP include:

• Feeling claustrophobic
• Chest muscle discomfort
• Eye irritation or dryness
• Sore or dry mouth
• Nose issues such as nosebleeds or a runny nose
• Soreness on the bridge of the nose
• Upper respiratory infections

If you experience these challenges and they impact your ability to use your CPAP, contact your healthcare provider for advice. There are several options to help make the CPAP more comfortable. Possible solutions your healthcare provider might recommend include:

• Using a lighter mask
• Using a mask with increased cushion
• Ensuring you use a humidifier with your CPAP
• Using salt water nasal sprays
• Cleaning your equipment regularly
• If your machine is noisy, seeing if you can fit it under your bed to reduce its sound
  

7. Your Power Goes Out

Some CPAP machines come with a battery. If yours doesn't, you can purchase one separately for your unit. However, you need to manually switch over the CPAP from the electrical outlet to the battery.

It's important to note that if your power goes out and your CPAP suddenly stops working, measures are in place to allow you to breathe room air. For example, if your CPAP mask only covers your nose (e.g., nasal pillow masks), you will naturally begin to breathe through your mouth.

If you use a full face mask, it has an anti-asphyxia valve on the front that will automatically open. This allows you to breathe room air.

How to Replace a Broken CPAP

When you've done all the troubleshooting you can, and your machine still isn't working, it may be time for a replacement. Here's what you can do to get a new CPAP machine:

• Check the warranty period: Most CPAP machine manufacturers offer a warranty period. If you have any problems with your machine during this period, you can contact the manufacturer about a replacement. Contact information for the manufacturer can be found in the user's manual or on the manufacturer's website. If your product is out of warranty, it may be time to replace it.
• Get a new prescription if needed: Check your prescription when you're replacing your machine. You want to ensure the new machine meets the correct air pressure requirements for your needs. When you're ready to replace the machine, check in with your healthcare provider to see if you need any changes to your prescription.
• Check with your health insurance company: Talk to your insurance company or check your policy to see if durable medical equipment (DME), like a CPAP machine, is covered. This may save you some money on a new CPAP machine, even if the machine is only partially covered by your health insurance.

Summary

Your CPAP machine is only as good as the health benefits it provides. When your CPAP works well, you'll feel far more rested, and your symptoms of sleep apnea and snoring will be resolved.

But when the device isn't working properly, your symptoms may return. There are several reasons why the CPAP machine may be failing. The problem can be with the power, tubing, or humidifier. Or it may just be that an old machine needs to be replaced.

In other cases, changes in your health or lifestyle may mean that your settings must be changed to ensure you get the right amount of pressure. If you believe your CPAP machine is not working correctly, call your equipment provider or sleep specialist and get your treatment back on track. Your sleep specialist can also help you determine the cause and offer solutions if apnea symptoms return.