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CPAP vs APAP vs BiPAP - What the PAP is the difference?!

"CPAP" is often used as a catch-all term for PAP Therapy; however, not all PAP therapy is the same. It's important for you, your Doctor, and your PAP Therapy provider to be knowledgeable about the various PAP therapies and the advantages and disadvantages of each.

PAP stands for Positive Airway Pressure, and is delivered via a Therapy Device (PAP Machine), Tubing, and Mask. Positive Airway Pressure acts like a splint to keep your airway open throughout the night, preventing obstructions, apnea events, and snoring.

Continuous Positive Airway Pressure, or "CPAP", delivers a continuous pressure throughout the night. The pressure level is set by your PAP therapy provider on your device, and typically determined during a sleep study or Auto-PAP titration.   

  • PROS: CPAP is typically less costly than other PAP therapy options. If your comfortable and confident in your pressure setting, it is therefore a good option. 
  • CONS: Many people shift positions throughout the night, and we all move between various stages of sleep. In different positions or sleep stages, you may require more or less pressure. Therefore, delivering a fixed pressure is less optimal and can result in less effective therapy and lower therapy compliance rates.

Automatic Positive Airway Pressure, or "APAP", continually adjusts the pressure throughout the night depending on your needs. Your Therapy Provider sets a minimum pressure (e.g. 4cm H2O) and a maximum pressure (e.g. 20 cm H2O). Throughout the night, your machine is continually monitoring for Apnea events, and increasing or decreasing the pressure level as required to eliminate Apnea events. 

How does the APAP machine know how to make these automatic adjustments? By constantly measuring how much resistance is present in your breathing on a breath-by-breath level, APAP technology knows whether to decrease pressure when your upper airway is stable, and increase pressure when it senses an airway event (such as an apnea, a hypopnea, flow limitation or snoring).

  • PROS: Unlike a CPAP device, APAP machines only deliver the amount of pressure that’s necessary at any given moment. Physicians sometimes find that patients may experience better results with APAP therapy, and patients generally find it a more comfortable form of therapy
  • CONS: at high pressure levels, some patients may find it difficult to exhale against the positive pressure. For this, Bi-Level or "Bi-PAP" may be preferred

Bi-Level Positive Airway Pressure, sometimes referred to as "Variable Positive Airway Pressure", "VPAP", or "BiPAP", include two pressure level settings: a higher pressure when you inhale, and a lower pressure that makes it easier to exhale. Bi-Level devices are excellent for patients requiring very high pressures and find it difficult to exhale against the pressure.  

  • PROS: Bi-Level therapy helps patients who cannot tolerate exhalation against a single pressure, or who have other breathing problems that could affect their ability to exhale against a higher pressure, such as COPD, Central Sleep Apnea, Overlap Syndrome, or Obesity Hypo-ventilation.
  • CONS: Bi-Level therapy is typically more expensive than CPAP or APAP therapy, and not necessary in most cases of Sleep Apnea. Speak with your doctor or therapy provider if you think you may benefit from BiPAP therapy.

Feel free to call one of our Sleep Specialists at 1-877-820-4878 today with any questions about your PAP therapy needs. There are many options of machine and mask available, and we'll help determine which therapy device and system is best for you.

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This blog post contains general information about medical conditions and potential treatments. It is not medical advice. If you have any medical questions, please consult your doctor. 

April 17, 2020 by CPAP Machines Canada Support
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