When you receive a sleep apnea diagnosis, generally, the first treatment option is through some type of positive airway pressure (PAP) machine.
The machine the doctor prescribes you depends on the type of sleep apnea you have — central sleep apnea (CSA), obstructive sleep apnea (OSA) or a combination of both. It also depends on how severe your sleep apnea is, and if you have other types of medical conditions influencing your sleep-breathing issues at night. It might also be based on your response to any given therapy.
Below, we discuss the difference between BiPAP and APAP machines and how they’re both used.
BiPAP vs APAP
There are some differences between these two machines that you should be aware of.
Like continuous positive airway pressure (CPAP) machines, auto adjusting (APAP) machines calculate an individual’s required pressure automatically and adjust to a level of comfort without any pre-set programming. APAP machines are good for individuals requiring various pressures at night.
Instead of the CPAP machine or BiPAP machine where they deliver one or two set pressures, the APAP machine adjusts to your ideal pressure with each breath.
Patients experiencing apneas while in REM sleep, or those who have allergies or congestion or like to sleep on their backs can benefit from this PAP device’s “smart” features.
APAP Machine Uses
If your patterns of sleep breathing vary throughout the night, APAP therapy could be more comfortable for you.
Although most individuals with OSA do fine with CPAP, others might fare better with an APAP machine since the APAP might feel more like breathing naturally. For instance, you might prefer APAP if:
Your apnea episodes increase when you’re in the REM sleep stage and decrease while in the other stages of sleep. Some individuals require a higher air pressure when they’re in their REM stage of sleep. If the higher pressure is used during other stages of sleep when they don’t require it, they could wake up because they’re uncomfortable. The APAP adjusts the pressure accordingly.
You move around in your sleep. If you sleep on your side during one part of the night and your back during the other, your apnea events and snoring could change depending on the sleep position you’re in. You might require a higher inspiratory pressure when sleeping on your back because gravity pulls the loose tissue toward the back of your throat downward.
Your apnea episodes might decrease while you’re sleeping on your side. The APAP adjusts the air pressure based on the position of sleep you’re in, therefore you don’t require higher pressure all the time.
APAP therapy is also an ideal option for individuals wanting to start their therapy immediately, without having to wait for a titration study to figure out the right single air pressure they require. Some patients appreciate the use of an APAP machine due to its flexibility — a CPAP can’t function like an APAP, but you can set the APAP machine to function like a CPAP, using a single set of continuous air pressure.
Examples of APAP Machines
There are a number of APAP devices you can choose from. Some models include:
This model combines the proven AutoSet algorithm technology with the integrated Optional ClimateLineAir Heated Tube. It’s an auto-titrating CPAP device that adjusts pressure according to how you breathe, delivering minimal pressure you required to maintain your airway.
The Z1 Auto Travel CPAP machine is an auto-adjusting CPAP device made for delivering the ideal air pressure level on a breath by breath basis during the night. You can set it as a single pressure CPAP if you want. It’s lightweight and small enough where you can put it in a tote or your carry on luggage when traveling.
The AirMini machine is one of the smallest device available today. It weighs only 0.66 pounds. Pair it with the AirMini smartphone app to adjust machine settings and track therapy.
Bilevel Positive Airway Pressure (BiPAP) machines deliver a pressure for inhaling and a pressure for exhaling that delivers a single level of positive airway pressure during an entire respiratory cycle, unlike the CPAP that only delivers a single pressure.
Some uses of BiPAP therapy include:
You have a CPAP Intolerance. Some patients don’t tolerate CPAP’s single continuous pressure. Either they can’t adjust to the high pressure or they struggle exhaling against the single pressure being delivered. BiPAP provides them with lighter EPAP pressure making it simpler to exhale.
You require increased ventilation. If you have trouble exhaling against the inhalation pressure setting, a lower expiratory setting could help. A good example would be if you have severe apnea and you require a high inspiratory setting to keep your airway open. When you’re wearing a full face mouth and nose mask, exhaling against this high setting could be difficult.
Over time, when you can’t exhale carbon dioxide, it can be threatening to your health because you’re not able to inhale enough oxygen. There’s a buildup of CO2 in your system which can throw your blood gas levels off and lead to severe medical issues like organ damage.
Other reasons your doctor might prescribe BiPAP instead of CPAP is if you’re having breathing problems that could affect you being able to exhale against a high air pressure. Some of these conditions include:
- COPD (Chronic obstructive pulmonary disease)
- Central Sleep Apnea
- Obesity Hypoventilation
- Overlap Syndrome
- A medical condition with a restrictive or obstructive component affecting your breathing while you sleep
Examples of BiPAP Machines
Some BiPAP machines include:
The DreamStation BiPAP is a user-friendly, sleek bilevel machine that has auto-adjusting pressure. It records advanced data and may be viewed in various ways for tracking the effectiveness of your therapy. You may add the optional heated humidifier that increases your comfort with its easy maintenance chamber.
The S9 VPAP device delivers an automatically adjusting pressure steam for inhaling and another for exhaling. This bilevel machine, at its core, adjusts inhalation and exhalation pressure automatically on a breath by breath basis, keeping your airway open.
The DreamStation BiPAP Pro device combines technology for pressure relief with optional humidification for increased comfort on a dual pressure device. It has bi-flex built right in to soften the transition between the lower Expiratory Positive Airway Pressure (EPAP) and higher inspiratory positive airway pressure (IPAP). Warm air from the water chamber and humidifier is provided to therapy air if you integrate the optional DreamStation Heated Humidifier with the device.
Related Reading: Best BiPAP Machines Reviewed
Purchasing a BiPAP or APAP Machine
Both the BiPAP and APAP devices help open your airway allowing you to breathe better. They both provide positive airway pressure, helping reduce apnea episodes while you’re sleeping. And, while CPAP is often the standard therapy for many patients with apnea, APAP and BiPAP could provide greater comfort if you have respiratory conditions or variable breathing patterns that make it uncomfortable for you to exhale against a higher pressure.
Here at CPAP.com, we have an extensive selection of APAP, BiPAP, and CPAP machines and accessories for you to choose from. You can order online or by phone by calling 800-356-5221. When you call us toll-free, you can speak with an experienced CPAP expert who will answer your questions.
David Repasky has been using CPAP treatment since 2017 and has first-hand experience with what it’s like to live with Sleep Apnea. He brings the patient’s perspective to the CPAP.com blog and has received formal training in CPAP machines, masks, and equipment.