CPAP v. BPAP

Understanding the Treatment Devices for Sleep Apnea

Sleep apnea is a condition in which the upper airways are either blocked or drastically narrowed during sleep. This prevents individuals from breathing and causes them to gasp awake throughout the night. One of the primary treatments for sleep apnea is positive airway pressure therapy, with the most common forms being Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BPAP). 

“The right sleep apnea treatment, whether CPAP or BPAP, is crucial for achieving restful sleep and improving overall health. Understanding the differences and working with your healthcare provider can make all the difference in effective management of your condition,” says Robert Miller, Apria's Vice President of Sleep Business.

How CPAP and BPAP Work

CPAP and BPAP machines are designed to keep your upper airways open by pushing compressed air through a tube and into a face mask or nasal mask. This ensures you can breathe easily throughout the night, effectively treating sleep apnea. Both systems are portable and can utilize humidification and other accessories to enhance comfort.

CPAP Machines

CPAP is most commonly prescribed for Obstructive Sleep Apnea (OSA) as the first line of treatment. Here are some key points about CPAP:

• Pressure Setting: CPAP delivers a continuous air flow at one set pressure, measured in centimeters of water pressure (cm H2O). This pressure remains constant whether you are breathing in or out, typically ranging from 4 to 20 cm H2O, with the average setting between 8-10 cm H2O.
• Pressure Relief Technology: Pressure relief technology in CPAP machines is designed to make therapy more comfortable by reducing the pressure during exhalation. These features aim to improve the overall comfort so that you can remain on your therapy as prescribed with ease.
• Accessories: CPAP machines usually come with integrated accessories like humidifiers, heated tubing, and ramp features, although aftermarket accessories are also available.
• Sizing: CPAP devices come in various sizes, from larger home-use models to smaller, travel-friendly options.
• Cost: Prices typically range from $500 to $1200.
• Insurance: Often covered by private insurance and Medicare, which usually covers three months initially and continues coverage with proven adherence to treatment.
• Ease of Use: There is an adjustment period as users get used to breathing out against the air pressure. However, most people adapt quickly, especially with the ramp feature gradually increasing pressure.

BPAP Machines

BPAP therapy is versatile and can be tailored to meet the specific needs of patients with various respiratory conditions:

• Pressure Setting: BPAP machines have two pressure settings: inhalation (IPAP) and exhalation (EPAP). The EPAP setting is usually lower, making it easier to breathe out against the pressure. BPAP machines generally have a pressure range of 4 to 30 cm H2O.
• Switching Mechanisms: The machine can switch between IPAP and EPAP in three ways:

1. Spontaneous: The machine senses your breathing pattern and adjusts accordingly.
2. Timed: Switches based on a set timer to ensure the correct number of breaths per minute.
3. Spontaneous/Timed: Starts as spontaneous and switches to timed if your breaths drop below a specific rate.

• Accessories: Similar to CPAP, BPAP machines have integrated accessories and additional aftermarket options.
• Sizing: BPAP machines are primarily for home use and generally do not have travel-sized options.
• Cost: Prices are higher than CPAP, ranging from $1700 to $3000.
• Insurance: BPAP coverage is usually conditional on criteria like documented CPAP intolerance or ineffectiveness. Always check with your insurance provider for specific coverage details.
• Ease of Use: People who struggle with CPAP often find BPAP easier to use, but reach out to your healthcare provider to discuss your options.

How CPAP and BPAP Treat Sleep Apnea

CPAP is generally more effective for treating OSA, while BPAP is better for patients who find CPAP intolerable and for those with Central Sleep Apnea or other complex breathing conditions.

In summary, both CPAP and BPAP offer practical solutions for managing sleep apnea, each with specific-use cases and benefits. If you’re having trouble with your current treatment, don’t hesitate to contact a Respiratory Therapist at your local Apria branch to seek advice on possible adjustments or alternatives. For information on Apria's sleep care program, visit our website. 

References
Baluch, Anna. “CPAP vs. BiPAP: What’s the Difference?” Edited by Rafael Sepulveda Acosta. Forbes, December 1, 2023. https://www.forbes.com/health/conditions/sleep-apnea/cpap-vs-bipap/.
Cleveland Clinic medical. “BIPAP.” Cleveland Clinic, May 10, 2023. https://my.clevelandclinic.org/health/treatments/24970-bipap.
Girouard, Ayla. “CPAP vs. BiPAP vs. APAP: What’s the Difference?” Edited by Donya Currie. NCOA Adviser, February 22, 2024. https://www.ncoa.org/adviser/sleep/cpap-apap-bipap/.
Peters, Brandon. “Learn the Difference between CPAP versus BIPAP to Treat Sleep Apnea.” Verywell Health, October 10, 2022. https://www.verywellhealth.com/what-is-the-difference-between-cpap-and-bipap-3015316. 
 

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