CPAP or BIPAP therapy – Which One Do You Need?

Breathing disorders affect millions of people worldwide. While a lot of them may just be temporary, some develop to become conditions that may take away our comfort out of things we enjoy most.

One of them is sleeping. And not being able to breathe properly while being asleep, means no sleep at all, right?

While it’s not the best case scenario for any patient that finds out that he’s suffering from sleep apnea, it’s still highly treatable and should not cause desperation.

If you’re affected by this sleep disorder, you might have heard of CPAP and BIPAP therapies and might be wondering which one would be better for you.

But first, let’s discover what these therapies are, how they work and which one is better.

What are the indications for CPAP or BIPAP therapy?

Sleep apnea is a dangerous sleep disorder which makes the individual stop breathing during sleep. Luckily for 22 million Americans that suffer from this disorder, sleep apnea is treatable.

The most common way of treating it is through the use of CPAP or BIPAP therapy.

Most of people affected by this disorder start by using CPAP therapy, but end up abandoning it or not using it as suggested.

Supposedly, what makes them abandon the therapy is the fact that they find it uncomfortable. Even if there are other ways of treating sleep apnea, people are usually not aware of alternative PAP therapy options.

What are the other health conditions that CPAP and BIPAP treat?

Mayo Clinic

These types of noninvasive ventilation therapy, are designed to treat sleep apnea
and other respiratory problems. Disorders that indicate that the PAP therapy may be for you are :

  • Obstructive sleep apnea (OSA) which is distinguished by pauses in breathing during sleep. These pauses are caused by a physical obstruction of the airways, for example: fatty tissue in the throat.
  • Central sleep apnea (CSA) is a sleep disorder characterized by brain stopping sending signals to the lungs to breath. Unlike OSA, this type of sleep apnea is a result of a neurological communication problem.
  • Mixed sleep apnea is a combination of symptoms from OSA and CSA
  • Complex sleep apnea is a condition similar to Mixed sleep apnea, but it’s diagnosed when the apnea episodes persist despite the CPAP therapy
  • Chronic obstructive pulmonary disorder (COPD) occurs when the airflow from lungs is obstructed
  • Congestive heart failure (CHF) is a chronic progressive condition affecting the pumping power of the heart muscles.
  • Other pulmonary or neuromuscular conditions like Cheyne-Stokes respiration, Alzheimer’s or Parkinson’s can also include PAP therapies.
  • What is the purpose of PAP therapies?

    PAP therapies are non-invasive therapies that deliver a positive airway pressure or PAP.

    Both CPAP and BIPAP machines prevent the collapse of the upper airways while sleeping.This collapsing is caused by the relaxation of the air muscles.

    They are used in order to treat the severity of sleep apnea. When a patient’s apnea-hypopnea index (AHI) is defined, these therapies have the goal in reducing AHI below 5.

    This way, the patients that are affected by sleep apnea can enjoy more peaceful nightime, and prospectively develop a higher quality of life thanks to eliminating sleep deprivation.

    What is a CPAP machine? And What does a CPAP machine do?

    CPAP stands for Continuous Positive Airway Pressure and it’s commonly used in treating obstructive sleep apnea (OSA).

    CPAP machines work by delivering a continuous flow of air at a defined pressure.

    These machines all come with settings that you can manipulate in order to adjust to the air pressure and getting used to the machine.

    Although it might be weird when you first start using it, within a few weeks you will be accustomed to it.

    How do you determine the CPAP pressure?

    Once a patient is diagnosed with sleep apnea or with some of the conditions we mentioned above, a doctor will proceed with a CPAP titration study. This will allow calibrating every CPAP machine to each patient’s needs and achieve the right air pressure setting.

    Are there different types of CPAP machines?

    Yes. These machines can have nasal, nasal pillow or full face masks. Each option has its advantages for a certain condition.

    Patients with allergies mostly prefer the full face mask rather than a nasal variant as they tend to breath through their mouth.

    People who feel claustrophobic from masks tend to choose nasal pillows that are the lightest option of all three.

    Finally, a nasal mask is somewhere between the first two options. It’s smaller than the full face mask but still enough sturdy to stay in place even if the patient moves a lot during sleep.

    What is BIPAP ventilator? What does BIPAP do?

    BIPAP stands for Bilevel or two-level positive airway pressure, and its mostly prescribed to people that suffer from other sleeping or breathing conditions such as Central sleep apnea, COPD, CHF as well as other lung or neuromuscular disorders.

    BIPAP is also referred to as VPAP (variable positive airway pressure). They both do same things and have almost identical effects in therapy, but they differ in the trademarks of the manufacturers.

    At first, this therapy was only available within hospitals, but today they can be done at home.

    Like CPAP, BIPAP sends air through a tube into a mask that fits over the nose. And in contrast to a CPAP machine, BIPAP offers two flows of pressure: one higher flow for inhalation (IPAP) and a lower one for exhalation (epap).

    This is the main reason why patients prefer to switch to BIPAP, as it is easier for them to exhale during sleep.

    Eventhough CPAP is always the first option for OSA, BIPAP may be suggested in cases where CPAP therapy shows inadequate.

    Some patients don’t respond well to CPAP because of the constant air pressure that makes exhaling more difficult. Consequently, they seek adequate therapy in BiPAP next.

    What are the differences between BIPAP and CPAP?

    Unlike what people may think, these therapies do not take over your breathing. Both BIPAP and CPAP regulate your breathing throughout the night by adjusting the air pressure you’re breathing in. But what’s the difference between BIPAP and CPAP machines?

    The main difference between the BIPAP and CPAP is the method of how the flow of pressure is delivered.

    What makes CPAP slightly less comfortable is that it might be tougher to exhale due to the same pressure set for both inhaling and exhaling.

    Therefore, manufacturers gave their best to upgrade the CPAP machines and include a variability pressure setting. These settings are known as C-Flex, AFLEX, Bi FLEX, EPR or SensAwake.

    However, not all of the patients will use this setting, but on the other hand, others will need more pressure relief which often make them think about the BiPAP alternative.

    When do people choose CPAP over BIPAP?

    CPAP is always the first option for people with obstructive sleep apnea (OSA). This therapy is way more common than the other one. One of the reasons for it might be that it is a much cheaper option.

    CPAP is suggested to people that have mild to moderate OSA. It’s usually preferred because it’s easier to use.

    Its mask also comes in different forms, so you can choose which one you find the most comfortable.

    So, if you’re not suffering from a more complex lung condition, CPAP might just work for you.

    When do people choose BIPAP over CPAP?

    People that suffer from more complex lung conditions tend to choose BIPAP rather than CPAP therapy.

    The reason is simple. BIPAP therapy targets successfully dysfunctional breathing patterns such as Central sleep apnea, COPD or CHF and proves to be much more effective at treating wider range of conditions.

    Some patients have found that CPAP therapy proved to be ineffective in treating their OSA, and in consequence, opted for BIPAP after.

    On the other hand, others prefer the dual air pressure flow that BIPAP offers, which makes it more comfortable for some patients.

    Some conditions foresee an additional usage of breathing aid during the daytime. This makes another reason to choose BIPAP over CPAP. BIPAP can be used when you’re awake too.

    What’s better? BIPAP or CPAP?

    They are both equally good in treating sleep apnea.

    Although one type may better suit your health condition and comfort expectations, the other one will prove to be as effective for other health conditions.

    So none is better. You should choose your breathing aids according to your health condition first and your convenience preferences.

    You have to keep in mind that in order to keep these machines working properly, you will need to replace some parts every few months and clean everything on a regular basis.