CPAP vs. BiPAP: What’s the Difference?

Both CPAP, BiPAP, and other non-invasive breathing machines, deliver forced air that keeps a user’s throat airway open to prevent sleep apnea episodes before they start.

The main difference between a CPAP machine and a BiPAP machine is that a CPAP machine delivers a steady, consistent airflow, and the airflow can be adjusted for comfort. An average cost without insurance is around $500. A BiPAP machine delivers more pressure when you breathe in and less pressure when you breathe out (the “Bi” stands for “bi-level”). An average cost without insurance is around $1,250.

An APAP machine is another type you may hear about (the “A” stands for automatic). These machines use algorithms to sense and deliver the correct amount of air pressure. An average cost without insurance is around $600.

A VPAP™ is the name of a specific type of machine made by the company ResMed. The cost varies depending on the model you choose.

The difference between CPAP and BiPAP machines? CPAP machines are less expensive, simpler to operate, and are usually the first non-invasive breathing machine prescribed to sleep apnea patients. BiPAP machines are more expensive, have multiple customization options, and are usually only prescribed if a CPAP machine isn’t providing relief.

What Is Sleep Apnea?

Sleep apnea isn’t a disease caused by germs or viruses. It’s a condition resulting from a variety of internal bodily factors. Science isn’t sure exactly what causes it.

They do know that when we sleep, the muscles in the back of the throat relax. As a result, the path that air takes from our lungs to our nose and mouth gets narrower.

That narrowing can cause snoring. The sound your partner (or cat) hears is air vibrating when it passes through the narrow gap. In some people, the pathways narrow too much, and air doesn’t get through. The body thinks it is about to suffocate, so the brain shifts out of deep sleep and corrects the problem. The person may not wake up, but their sleep cycle has been interrupted.

These episodes can happen many times during the night — interfering with the natural rhythms of sleep we all need to stay healthy.

This describes the most common form of sleep apnea, obstructive sleep apnea (OSA). Another type, central sleep apnea (CSA), is the result of irregularities in the brain’s breath-regulating signals. Most people with sleep apnea suffer from a combination of both types.

How Do You Know if You Have Sleep Apnea?

Snoring can sometimes be a clue that you suffer from sleep apnea, but it’s not that easy. Not everyone who snores has sleep apnea, and not everyone who has sleep apnea snores.

Daytime sleepiness is the big tip-off for sleep apnea, because sleep apnea sufferers may not notice their episodes at night. It’s only during the day when the effects of missing out on deep sleep become apparent.

Excessive napping, morning headaches, difficulty concentrating, forgetting things, mood changes. All can be caused by missing out on sleep because of sleep apnea. All are serious health issues that require a doctor appointment.

Sleep Studies to Diagnose Sleep Apnea

Sleep apnea is usually diagnosed during a visit to a sleep clinic. The experts at sleep clinics use instruments that monitor your body while you sleep. Two specific things a sleep apnea sleep study measures are:

• The number of episodes of stopped or slowed breathing (obstructive sleep apnea).
• Dips in the level of oxygen in the blood, another symptom of sleep apnea.

Five or fewer apnea episodes per hour is considered normal. Anything more than that is considered a mild case of sleep apnea, and over than 30 is considered to be severe.

Dangers of Sleep Apnea

If you’re suffering from sleep apnea — and 26 percent of adults between the ages of 30 and 70 do according to the latest estimates — getting relief from sleep apnea could save your life.

The condition increases the risk of:

• High blood pressure
• Heart disease
• Type 2 diabetes
• Stroke

Quality sleep is critical for proper brain function. The interrupted sleep caused by sleep apnea literally breaks the brain. Obstructive sleep apnea patients suffer from deterioration of the white matter in their brains leading to decreased awareness and cognition levels.

But studies have shown a happy result. All that white matter regenerates to healthy levels after a year of CPAP treatment.

Do All Sleep Apnea Sufferers Need a CPAP or BiPAP Machine?

If you are diagnosed with sleep apnea, your doctor will likely recommend inexpensive lifestyle changes and technology to try to improve your sleep rather than asking you to spend hundreds of dollars on a machine.

Lifestyle Changes That Can Improve Sleep Apnea

Since obesity is correlated with sleep apnea, your doctor may first suggest that you lose excess weight to try to correct the problem.

Cutting back on substance use may get you breathing normally again. Alcohol, tobacco, and sedatives like sleeping pills relax your muscles — including those throat muscles that are keeping your airways open.

Aerobic exercise and resistance training have been shown to be an effective treatment for sleep apnea. Not only can it help reduce weight, but resistance training can help build up neck muscles. Overall, exercise training reduces both sleep apnea episodes and daytime sleepiness.

Specific mouth exercises such as those recommended by the National Sleep Foundation, can strengthen the throat muscles that keep your airways open. Also called myofunctional therapy, this form of treatment has been shown to reduce sleep apnea by 50 percent in adults.

Changes to Your Sleep Hygiene and Sleep Tech

Any sleep improvement plan starts with changes to your daily sleep plan or sleep hygiene. Simple steps like going to bed at the same time every night can make a big difference. Science believes that the more consistent your sleep routine is, the better your sleep will be.

Changes to your sleep tech may help too.

Specialized pillows can position the head and neck for maximum airflow.

Recent studies have shown that anti-snoring oral appliances help reduce the number of apnea episodes. These appliances hold the jaw forward which widens the breathing airway.

Patients who don’t find relief from lifestyle changes or from sleep aid devices, or those with extremely severe sleep apnea, may be prescribed a CPAP or BiPAP machine.

Just to emphasize, these machines aren’t for sale to the general public. It’s illegal to buy one without a prescription. There are multiple models of all machines, and you can decide with a doctor which model is best for you.

How Do CPAP and BiPAP Machines Work?

CPAP and BiPAP machines blow pressurized air through a patient’s airways. This prevents the constriction of the airways which is what causes sleep apnea episodes.

The air is blown through a mask that the patient wears while sleeping. Some masks cover both the nose and the mouth. Some cover the nose only.

The machines themselves aren’t very big — about the size of a large clock/radio. They will come with a tube that attaches to the machine on one end and the mask on the other.

Comfort Issues With CPAP and BiPAP Machines

Nearly everyone who uses a CPAP or BiPAP machine feels uncomfortable at first. It’s strange to sleep with a mask on. Home medical equipment suppliers urge you to be patient during this adjustment period.

Some of the most common problems CPAP or BiPAP users encounter are:

• The forced air feels too strong.
• Their nose gets dry or stuffy.
• The mask makes them feel claustrophobic.
• Ill-fitting masks cause skin irritation.
• Device worsens dry mouth.
• The mask comes off during restless sleep.

Some patients sleep with their mouths open which can cause the CPAP therapy to work less well. So they supplement their treatment with a CPAP chin strap which keeps the mouth closed during sleep.

If comfort issues persist, patients are urged to speak to their equipment provider or doctor. The machine and its components can be adjusted to alleviate issues. Or, you can order a different machine.

CPAP or BiPAP? Work With Your Doctor to Decide

Sleep apnea appears to be on the rise. As a result, medical researchers and medical equipment manufacturers are developing innovative technology to get people sleeping soundly again. Your doctor or sleep therapist will have the best information about new technologies and techniques for alleviating sleep apnea.

Your treatment plan may be a bit of a journey, including lifestyle changes, exercise, and multiple machines and settings. Don’t give up. Getting regular, restorative sleep is one of the most important things you can do for your health.