Types of Sleep apnea treatment devices: CPAP, BiPAP, and APAP

• You probably feel overwhelmed by the options for treating your sleep apnea, but learning about the different types of CPAP devices can be helpful. 
• You may be wondering what other devices are about and which suits you. 
• These questions can lead you to wonder which option is best regarding cost, size, and treatment effectiveness.
• First, you'll likely come across various terms and abbreviations associated with sleep apnea therapy devices, including continuous positive airway pressure (CPAP), two-stage positive airway pressure (BiPAP), and automatic positive airway pressure (APAP).

How do they all relate to each other?

• All three devices provide positive airway pressure therapy (PAP) to treat obstructive sleep apnea (OSA). 
• OSA is one of three forms of sleep apnea. 
• Each acronym represents a device that provides filtered compressed air to keep the airway open during sleep, preventing obstructions from interfering with breathing during restful sleep.
• No matter which device you choose, better sleep starts with a sleep study in the lab or at home, performed by a qualified physician. 
• In either case, the physician or sleep specialist can determine which device is best while identifying your ideal pressure settings.
• Measure pressure settings in centimeters of water (cmH2O). 
• Most CPAP and APAP devices offer pressure settings from four to twenty cmH2O; BiPAP devices may offer lower or higher values to help people with severe OSA, central sleep apnea (CSA), or other severe breathing disorders.

Sleep apnea machines come in three main types.

(CPAP)

• After the sleep study, your doctor may recommend using a Continuous Positive Airway Pressure (CPAP) device with the optimal air pressure setting to help you breathe during sleep. 
• This air pressure setting remains constant throughout the night, meaning you breathe in at that pressure setting and breathe out at the exact location. 
• These devices are the most widely used method of treating OSA.

(APAP)

• An APAP device is an automatic device that operates within a preset pressure range and automatically adjusts to the individual's pressure needs during the night based on breath measurements. 
• It makes using an APAP device more comfortable.

(BiPAP)

• BiPAP (Bi-Level Positive Airway Pressure) devices provide two levels of airway pressure: one for inspiration and one for expiration. 
• BiPAP machines allow people with severe OSA to breathe air into their lungs during inhalation and exhalation. 

CPAP therapy

• Why use CPAP therapy instead of APAP or BiPAP? Continuous Positive Airway Pressure (CPAP) therapy provides continuous favorable airway pressure treatment and may be a better choice over APAP or BiPAP treatment plans.
• CPAP machines use constant air pressure to keep your airway open during sleep. 

CPAP benefits

Effectiveness

• They're an effective treatment option for sleep apnea because their constant airflow prevents airway collapse.

Widely available 

• CPAP machines are easily accessible and offer different mask options to meet individual sleep needs. 

Improved sleep quality

• It Provides uninterrupted breathing during sleep. 
• CPAP therapy improves restful REM cycles, reducing daytime sleepiness and improving cognitive function.

Health benefits of CPAP use

• Consistent use of a CPAP machine can relieve some sleep apnea symptoms, such as snoring, morning headaches, and daytime sleepiness.

Why should you choose CPAP therapy?

• CPAP machines are an effective and safe way to keep the airway open during sleep apnea episodes, preventing their severity.
• Sleep apnea occurs when excess throat tissue loses tone and relaxes during sleep, obstructing breathing. 
• Either way, you may gasp for air and try to continue breathing - these moments are called "apnea events."
• CPAP machines can also help treat upper airway resistance syndrome (UARS). 
• UARS is an early precursor to OSA. Instead of a complete airway blockage due to the accumulation of loose tissue, there is decreased airflow due to decreased airway elasticity.
• While OARS does not cause you to gasp for air while awake, you will experience more difficulty breathing as your lungs work harder to breathe air during sleep. 
• Even though your brain still senses some amount of oxygen flowing through, sometimes enough to wake you up periodically and allow you to breathe more evenly and openly, uncontrolled UARS usually develops into OSA.
• If you are otherwise healthy, have no lung or respiratory conditions, and have been diagnosed with mild or moderate OSA, using a CPAP machine is probably the first step in treating sleep apnea.

Automatic Positive Airway Pressure (APAP) Devices

•  Automatically adjust pressure during the night based on real-time feedback on a person's breathing patterns, providing optimal comfort. 

Benefits of (APAP) Devices 

Tailored therapy

• APAP devices adapt to the person's changing needs and deliver optimal pressure to keep the airway open during sleep.

Flexibility

• APAP devices offer great flexibility to individuals suffering from varying degrees of sleep apnea, as the pressure automatically adjusts to meet their needs.

Data collection

• APAP devices' advanced data collection capabilities allow patients and healthcare professionals to track the effectiveness of therapy and make necessary changes.

Why would someone prefer or need an APAP device over a CPAP or BiPAP device? 

• An APAP device (sometimes referred to as "automatic" or "auto-set") uses computer algorithms to determine what air pressure you need at any given time during sleep based on variables such as body position or breathing patterns at different stages of sleep.
• APAP therapy may be more comfortable if your breathing patterns fluctuate at night. While most people with OSA benefit from CPAP therapy, others find APAP therapy more natural. 
• An APAP machine might also be appropriate if Your apnea events often increase during rapid eye movement sleep (REM) and decrease during other sleep stages, and some people only need higher air pressure during REM sleep; otherwise, it could disrupt different sleep stages and wake them up from their discomfort, an APAP machine can adjust pressure accordingly.
• Your sleeping position can affect how and when you snore and experience apnea events; for example, if you sleep on your back, gravity pulls loose tissue toward the back of your throat and requires higher inspiratory pressure for more effective breathing.
• Sleep on your side. Sleeping on your side, one of the recommended sleep positions for sleep apnea, can significantly reduce apnea events. Y
• Our APAP machine can adjust the air pressure based on your sleep position, allowing you to use a lower-than-maximum pressure setting.
• Some patients who suffer from sleep apnea find an APAP machine more comfortable and accommodating because of its flexibility and comfort: Unlike a CPAP machine, which can't work like a CPAP machine, an APAP machine can work similarly with only one pressure setting; and its adjustable air pressure settings help make each night more restful for patients.

Bilevel Positive Airway Pressure (BiPAP) devices 

• BiPAP devices offer two air pressure levels during inhalation and exhalation: one higher for inhalation and one lower for exhalation. 
• Prescribed BiPAPs if you have breathing problems that prevent exhalation against higher air pressure.

Advantages of BiPAP devices

Individual pressure

• BiPAP devices allow air pressure to match the patient's breathing pattern better, making them suitable for patients who have difficulty exhaling due to high air pressure.

Respiratory conditions

• BiPAP therapy may be recommended for individuals suffering from respiratory diseases such as chronic obstructive pulmonary disease (COPD) or neuromuscular disorders, as it provides targeted respiratory support.

Comfort 

• Alternating between inspiratory and expiratory pressures may increase comfort, making BiPAP therapy easier for some users.

Why is BiPAP helpful? 

• Before discussing BiPAP therapy, it's essential to know that BiPAP is a brand name of BMC RESmart G2S Auto BIPAP System, however, many physicians and suppliers often refer to this device by the acronym BiPAP (or, in some cases, BPAP). 
• Both acronyms refer to similar therapies.
• Why do you need two airway pressure settings? BiPAP therapy can benefit people with difficulty exhaling against their inspiratory pressure settings. 
• It is the case; for example, if your OSA requires high inspiratory pressures that make it difficult to exhale, exhaling against these high settings can become difficult due to severe obstruction.
• Suppose you're unable to exhale carbon dioxide. In that case, this can be detrimental to your health over time because not enough oxygen is getting into your system, and CO2 accumulates in your body, causing blood gas levels to become disrupted and potentially leading to organ damage or severe health complications. 
• However, in the best-case scenario, exhalation difficulties can disrupt sleep and wake you up.
• Central sleep apnea (CSA), chronic obstructive pulmonary disease (COPD), and overlap syndrome can increase risk.
• Once you understand what differentiates the devices, the main similarities are that they open the airway to facilitate breathing while helping to reduce sleep apnea events.

The main difference is how they address these challenges.

• While CPAP devices are the first choice for most people with sleep apnea, BiPAP and APAP devices can provide more comfort if you have variable breathing patterns or respiratory conditions that make exhaling against higher pressure uncomfortable or need uneven pressure during the night.
• Remember that no device is perfect, but the ideal CPAP device should help you breathe easier at night to get all the benefits of CPAP therapy for restful sleep. 
• We have created an in-depth guide to the best CPAP machines to help you find the one that best suits your needs; be sure to read on!