CPAP, APAP, and BiPAP Comparison

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This CPAP machine type comparison explains some of the most important information and differences you need to know about CPAP (continuous positive airway pressure), APAP (auto-adjusting/autoset positive airway pressure), and BiPAP (bi-level positive airway pressure) machines.

Which positive airway pressure machine your doctor prescribes depends on what kind of sleep apnea you have (obstructive sleep apnea or central sleep apnea) and what health conditions or habits that may influence your sleep or breathing you have. Some users change the type of device they use after using one type of machine for a while and then realizing that it’s uncomfortable or not suitable for them

Read on, to learn more!

Mechanism

CPAP:

A CPAP machine uses a motor that pressurizes the air that enters the device. It delivers that air through a tubing connected to a CPAP mask at a continuous stream of constant pressure, which keeps your upper air passages open during sleep.

APAP:

APAPs work the same way that CPAPs do, except that the air is dispersed at a range of pressures instead of a single, continuous pressure. The device keeps fluctuating the pressure level and adjusting to the minimum pressure necessary to prevent airways from collapsing.

BiPAP:

BiPAPs have two ‘levels’ of pressure – one pressure at inhalation, and a lower pressure at exhalation.

How common is it?

CPAP:

Most commonly used PAP device

APAP:

Very commonly used PAP device

BiPAP:

Least commonly used PAP device

Who should use it?

CPAP:

Patients with OSA (obstructive sleep apnea) use CPAP machines. People with less severe cases of OSA tend to use CPAPs.

APAP:

Patients with OSA (obstructive sleep apnea) use CPAP machines. People who have allergies/congestion, experience apneas only during REM sleep, change sleep positions often during the night, enjoy drinking alcohol before sleep, or use sedative medication may benefit from the auto-adjusting feature.

BiPAP:

People who struggle to exhale at a continuous pressure level (usually people with severe OSA/high pressure settings), suffer from CSA (central sleep apnea)/COPD (chronic obstructive pulmonary disorder)/CHF (congestive heart failure)/neuromuscular disease/hypoxemia/aerophagia may benefit from using the Bi-level feature.

Disadvantages

CPAP:

Some users find the continuous flow of air pressure upon each exhalation uncomfortable.

APAP:

Some users find the continuous flow of air pressure upon each exhalation uncomfortable. The APAP is also more expensive than CPAP, and many APAP users complain about the practice of bricking.

BiPAP:

The BiPAP machine is very expensive. For that reason, most insurance providers will ask the patient to “prove” that they tried using a CPAP machine and weren’t able to tolerate it, to make sure the patient really needs it.

Benefits

CPAP:

CPAP machines are the cheapest out of the three types mentioned. Also, many of the newer CPAP machines are able to sense the user’s breathing at a breath-by-breath case, decreasing the machine pressure up to 3 cm H2O at every out-breath. ResMed calls it “EPR (expiratory pressure relief), Respironics calls this feature ‘CFLEX/AFLEX/BiFLEX’, and Fisher & Paykel calls it “SensAwake”.

APAP:

Because an APAP can adjust its own pressure, patients can skip the sleep lab and, instead, take a home sleep test. Then, an APAP can be used for a month or two, after which your healthcare provider can evaluate the usage data to help you determine your optimal pressure level.

BiPAP:

It’s an effective solution for people with high therapy pressure levels who find the continuous pressure uncomfortable, or people with certain health disorders.

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