CPAP vs. BiPAP Therapy: Which is Best for You?

CPAP or BiPAP? Learn how to choose the best positive airway pressure device to treat your sleep disorder and experience the luxury of deep, restful sleep.

By Nicole Gleichmann

If you struggle with obstructive sleep apnea or other nighttime breathing problems, achieving a full night’s rest can be challenging. Fortunately, there are a variety of PAP (positive airway pressure) machines that are designed to help you regain your sleep, and with it, your energy and quality of life.

So, which of these devices is right for you?

The most common non-invasive ventilation therapy machine is the continuous positive airway pressure, or CPAP, machine. Yet, for some, the continuous pressure of CPAP therapy can leave restful sleep tantalizingly out-of-reach. Fortunately, many patients who do not respond well to CPAP therapy do find results with another PAP device: the BiPAP.

Read on to learn more about the differences between these two devices and who may benefit the most from each.

What is BiPAP?

The bilevel positive airway pressure device, or BiPAP, is a ventilator that helps your breath by alternating between two pressures while you sleep.

The pressure setting for your inhale, called the inspiratory positive airway pressure, is the higher of the two pressure settings that facilitates a full inhale. The pressure setting for your exhale, called the expiratory positive airway pressure, is lower, allowing for a more comfortable exhale.

You may also hear the BiPAP referred to as a VPAP. These two machines do the same thing but are made by different manufacturers; the BiPAP is produced by Respironics, while the VPAP is produced by ResMed.

CPAP vs. BiPAP: What’s the Difference?

Both BiPAP therapy and CPAP therapy are designed to keep you breathing while you sleep. Depending on your condition, this will either be through keeping your airway open from obstruction, or by eliminating pauses during breathing. For those with obstructive sleep apnea, it is this airway collapse that’s the cause of interrupted sleep throughout the night, and the resultant snoring.

The difference between these two sleep apnea therapies comes down to one factor: air pressure.

Unlike the BiPAP, which alternates between high pressure for exhales and low pressure for inhales, the CPAP machine provides a single pressure for inhaling and exhaling throughout the night. While most people with obstructive sleep apnea will find relief following CPAP use, others will find this continuous pressure during the exhales uncomfortable.

Which PAP Device is Right for You?

While it might sound like two pressures would be the ideal option as this closely mimics normal breathing, it is your personal situation that determines which of these machines is best for you.

CPAP: For Mild-to-Moderate Obstructive Sleep Apnea

CPAP is the most commonly used form for PAP thanks to its efficacy for those with mild-to-moderate obstructive sleep apnea. For those who fall into this group, the continuous pressure of the CPAP can help to keep your airway open throughout the night, allowing you to sleep soundly.

BiPAP: For Sever Sleep Apnea and Other Conditions

Unlike the CPAP machine, the BiPAP machine is used not only for those with obstructive sleep apnea, but those with other disordered breathing at night. BiPAP is typically used for those with:

  • Severe sleep apnea
  • Central sleep apnea
  • Neuromuscular disorders
  • Congestive heart failure
  • Chronic obstructive pulmonary disorder (COPD)
  • Diseases affecting the lungs and heart (pneumonia, asthma)

The variable pressure of the BiPAP machine is particularly helpful for those with disordered sleep caused by something other than airway constriction. Patients with conditions like congestive heart failure or central sleep apnea will simply stop breathing at night or not breath sufficiently.

Thanks to the changes in pressure between the inhale and the exhale, the BiPAP machine can be set for a certain number of breaths per minute, allowing a unique type of breathing assistance for those whose breathing ceases at nighttime.

This isn’t to say that those with mild-to-moderate sleep apnea cannot benefit from the BiPAP machine. There are those who switch over from the CPAP machine due to an inability to adjust to the singular pressure of the CPAP.

Deciding Which Therapy is Right for You

How do you decide which of these machines is best for you? Fortunately, you don’t have to do it alone! You will want to go to your sleep specialist for an examination, which can include a questionnaire, sleep study, and other testing. Through the insights gleaned from these visits, your doctor will advise which of the PAP devices is best for you.

Keep in mind that it can take some time to become accustomed to PAP therapy. Wearing a mask and having a noisy machine next to your bed will be a new experience for most, but after a few months, you will likely have become accustomed to your PAP machine, even looking forward to the deeper sleep that it enables.

Be sure to stay in close contact with your sleep clinic as you begin any new type of therapy. It is not unusual to adjust pressures or treatment depending on how you respond. For some, a titration study may be warranted, where you will test out different PAP devices in a controlled setting.

Closing Thoughts

Finding the best therapy to treat sleep disorders like obstructive sleep apnea is important for the long-term management of these conditions. While CPAP therapy is the most common treatment for mild to moderate sleep apnea, more severe sleep apnea and other sleep disorders are typically better treated by using BiPAP therapy. Schedule a visit with your sleep specialist to determine the best treatment for you and start on a path towards a restorative night’s sleep.

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