CPAP, APAP and BiPAP: Examining Sleep Apnea Therapies

You may already know that there are three core forms of PAP therapy - CPAP, BiPAP and APAP. All of these are known for effectively treating various breathing-related disorders. However, one of the most asked questions by users of PAP therapy is: What’s the difference between BiPAP vs CPAP vs APAP therapy?

BiPAP and CPAP therapy are two of the most well-known Sleep Apnea solutions. Yet, many individuals who are new to the world of PAP treatment aren’t aware of the subtle differences and similarities between these two therapy options. While your sleep specialist will ultimately decide which PAP therapy is best suited to your diagnosis, it is beneficial to educate yourself on the ways that breathing-related sleep disorders can be treated.

In this article, we are going to explain the differences between BiPAP therapy and CPAP therapy. We’ll explain how each of these PAP therapies works, their uses and the best-selling machines that are highly recommended for each therapy. So, without further ado, let’s get started.

What Is BiPAP Therapy?

BiPAP therapy, which can also be referred to as Bilevel positive airway pressure or VPAP therapy, shares the same basic goal as CPAP - to relieve symptoms of Sleep Apnea - but its form of treatment is provided in a slightly different way.

How Does A BiPAP Machine Work?

On first look, a BiPAP machine doesn’t look too dissimilar to that of a CPAP machine. Its components are the same as it includes a face mask, motorized machine and tubing. So, while on the surface it may be hard to distinguish the difference between BiPAP vs CPAP, it is the way in which this machine works that sets it apart.

A BiPAP machine works by delivering positive airway pressure to an individual as they are sleeping to keep their airways open at night preventing apneic events. A BiPAP machine is unique in that it provides two pressure levels: one for inhaling and one for exhaling.

In some situations, a Sleep Apnea patient may need extra respiratory support or find themselves intolerable to other forms of treatment. In this case, a BiPAP machine may be prescribed to you. These machines have also been noted as being a great travel PAP machine and good for those with breathing restrictions.

How Is Pressure Level Set?

As we mentioned above, BiPAP therapy delivers two pressure levels. These are Inspiratory Positive Airway Pressure (IPAP) and Expiratory Positive Airway Pressure (EPAP). IPAP is the pressure level that is set when inhaling and EPAP is the pressure level that is set when exhaling.

These pressure levels are determined by a sleep specialist based on the results of your initial sleep study. They were created to replicate a more natural breathing rhythm for patients which makes getting used to therapy easier.

IPAP settings are generally set at a higher pressure level (between 8 -10 cm H2O) to support the patient’s breath while inhaling. EPAP is set at a lower pressure level (between 2 - 4 cm H2O) so that there’s less pressure resistance for patients when exhaling. Again, these settings will be determined by your sleep specialist but can be adjusted if need be. That’s why the use of BiPAP machines is often closely monitored to ensure that a patient is being treated adequately.

What Are Its Uses?

BiPAP therapy is less commonly prescribed for those with Obstructive Sleep Apnea (OSA) as an initial form of treatment. Generally, this form of treatment is prescribed to OSA patients when CPAP therapy isn’t working. However, that’s not to say it is in any way less beneficial.

But its uses don’t just stop there. Bilevel PAP therapy is often recommended for those who are suffering from other serious breathing disorders such as:

• Central Sleep Apnea
• Chronic Obstructive Pulmonary Disease (COPD)
• Overlap Syndrome Complex Sleep Apnea

What Is CPAP Therapy?

The difference between BiPAP and CPAP therapy is in the name. Continuous Positive Airway Pressure (CPAP) therapy provides an OSA patient with a consistent stream of airway pressure as part of their Sleep Apnea therapy.

Many people that are prescribed CPAP therapy to treat their OSA note how much of an improvement they see in their sleep quality. It’s no wonder why CPAP has been dubbed with the label of the gold standard for Sleep Apnea treatment.

How Does A CPAP Machine Work?

As mentioned above, a CPAP machine consists of a motorized machine, a built-in humidifier, a CPAP mask and tubing.

These features ensure that the machine can blow a specified level of pressurized air into the patient’s airway passage via a face mask. This pressurized air increases oxygen levels being received in the throat preventing muscles from collapsing either partially or fully. The constant flow of pressurized air will also help to regulate breathing and reduce the vibrations that cause snoring.

How Is Pressure Level Set?

Based on the results of your sleep study, a sleep specialist will determine what pressure level you will need in order to counteract the number of apneic events you experience during sleep. How exactly is this determined?

During a polysomnography test, a sleep technician will be monitoring how many apnea and hypopnea events you have during the test. They will start off by administering a low-pressure setting level and then gradually increase this setting as needed depending on your breathing patterns. As CPAP’s intention is to eliminate apneic events, the sleep technician will adjust CPAP settings until the events are no longer being observed.

Once this pressure level has been determined, your sleep specialist will provide you with a prescribed CPAP pressure level which your CPAP vendor will use when setting up your machine.

What Are Its Uses?

While CPAP therapy is most famously used in the treatment of OSA, it can be used to treat other respiratory illnesses.

In fact, it has been noted that continuous airway pressure is beneficial for those that are suffering from Upper Airway Resistance Syndrome (UARS). UARS is known as the stepping stone between mild snoring and OSA. It has been noted that receiving CPAP therapy during this stage can help to prevent an individual from developing full Sleep Apnea. Additionally, it is also beneficial for those that are experiencing sleep disturbances and poor quality sleep due to snoring.

What Is APAP Therapy?

APAP stands for Automatic Positive Airway Pressure and its configured to deliver air pressure to an OSA patient that adjusts based on the individual's needs. 

How Does An APAP Machine Work?

APAP machines are able to calculate an individual's required pressure levels automatically and can adjust instantaneously to provide comfort with each breath that a person takes while they are sleeping.

How Is Pressure Level Set?

The automatic pressure adjustments feature makes these Sleep Apnea machine unique. Why is this? Because other PAP machines such as a CPAP deliver airway pressure at a consistent pressure level and don't have the ability to adapt to changes in a person's breathing pattern. Your physician will set a pressure range that allows for more fluid movement to adapt to your breathing needs at night. 

What Are Its Uses?

Many Sleep Apnea patients that either find it too difficult to exhale against the constant pressure of a CPAP machine or suffer from allergies and congestion on a regular basis are often prescribed an APAP machine as part of their Sleep Apnea therapy. Most patients appreciate the use of an APAP machine due to their flexibility and ease of adaptability to treatment.

Top List of Best-Selling BiPAP, APAP and CPAP Machines

While you may not have full choice over which Sleep Apnea therapy is right for you, you do have a choice when it comes to the machine that you choose. Below, we list the best-selling BiPAP machines and CPAP machines that are currently available on the market.

Best-Selling BiPAP Machines

1) AirCurve 11

The AirCurve 11 VAuto bilevel machine with heated humidifier and tubing is ideal for people with OSA and those struggling with PAP therapy. 

Pros: Adjusts to your individual breathing patterns as they change through the night and provides you with pressure levels for inhalation and exhalation.

Cons: Similar to other Resmed devices is parts and accessories compatibility. The AirCurve 11 is not backwards compatible with older versions equipment (e.g. heated tubing for the AirCurve 10). 

2) AirCurve 10 VAuto BiLevel With HumidAir

The AirCurve 10 VAuto by Resmed is another BiLevel PAP machine that offers users self-adjusting capabilities. This machine provides Easy-Breathe technology to make sure that therapy is comfortable, easy to use and effective. The addition of the HumidAir heated humidifier has been praised by many PAP users since it was released on the market. Its TiControl feature is also another aspect that makes this machine stand out as it is an advanced tool aimed at helping people with respiratory illnesses such as COPD.

Pros: One of the biggest selling points of the AirCurve 10 VAuto that users enjoy is the fact that this machine feels like an integrated package. With a user-friendly colour LCD display, optimized humidification, Mask Fit seal check and SmartStart functionality, users get all of the bells and whistles when it comes to this machine.

Cons: A potential downside of this PAP machine, however, is the cost. The AirCurve 10 VAuto is one of the most expensive BiPAP machines on the market. Those looking for something more affordable may want to consider the DreamStation BiPAP Auto instead.

Best-Selling CPAP Machines