APAP vs CPAP: Is an Auto CPAP Machine Right for You?

Continuous positive airway pressure (CPAP) is commonly used to treat sleep apnea. In fact, many sleep medicine professionals consider it one of the best treatment options. However, there are a variety of PAP devices out there, and it can sometimes get confusing to determine the difference between each type. Today, we’re exploring what an APAP, or auto CPAP machine, is and how it uniquely treats sleep apnea.

APAP stands for “Automatic Positive Airway Pressure” and it is a type of machine that can be used to treat obstructive sleep apnea (OSA). It is sometimes called AutoPAP, Auto CPAP, Auto CPAP Machine, or self-adjusting CPAP.

APAP works by delivering pressurized air to keep your upper airway open while sleeping. The “automatic” part of APAP refers to “auto-adjusting” or “auto-titrating,” which means that the machine will adjust your air pressure throughout the night. More specifically, the machine’s sensor and algorithm automatically modifies airflow to match your specific breathing patterns.

While an APAP is “self-titrating,” meaning it can automatically adjust your pressure settings as needed, it is still essential that you consult with a sleep specialist first. Through a sleep study, your healthcare provider will set your machine’s pressure range, including low and high pressure settings.

Continuous positive airway pressure, or CPAP machines, deliver one constant pressure to help keep your upper airways open while sleeping. While an APAP device can change your air pressure to uniquely match your breathing pattern, CPAP devices provide one fixed pressure all night long.

CPAPs are often considered the most effective treatment option; however, some users have a difficult time exhaling against CPAP pressure. Others may have differing pressure needs throughout the night, which is where APAP offers a solution.

An auto CPAP machine provides a continuous stream of air, but it simultaneously measures your resistance against that airflow and watches for fluctuations in your breathing pattern. Advanced algorithms can use this information to detect snoring, apnea/hypopnea events, and even mask air leaks. An APAP will then adjust the pressure level to help maintain natural breathing.

BiPAP, or bilevel positive airway pressure, provides only two different air pressure settings. Typically, BiPAP machines will deliver a higher pressure on inhalation and a lower pressure on exhalation.

While both APAPs and BiPAPs provide different levels of air pressure, a BiPAP relies on two fixed pressure settings and these set levels remain constant throughout the night. Additionally, it’s worth noting that there are Auto BiPAPs too, which function similarly to APAPs in that they auto-adjust pressure, but Auto BiPAPs do so with only 2 set pressures.

BiPAP machines are used to treat obstructive sleep apnea. Your doctor may also recommend a BiPAP if you have central sleep apnea, COPD, or a history of congestive heart failure.

With all of the benefits APAP offers, it's important to include why it is not the most common sleep apnea treatment…

• APAPs tend to be more expensive. Since APAPs offer advanced technology, if you are purchasing one out of pocket, it can cost several hundred dollars more than a CPAP machine. However, you may be eligible for an APAP machine through your insurance, meaning that the cost is covered up to 100% by your insurance provider.
• You may be sensitive to pressure changes. Some APAP users share that the pressure changes wake them up during the night. Newer APAP machines offer a more gradual change; however, if you are sensitive to pressure changes, a CPAP is likely a better option for you.
• APAP therapy may not work well with certain health conditions. For example, you may not be a good candidate for APAP if you have congestive heart failure, chronic obstructive pulmonary disease (COPD), or if your breathing problems stem from obesity or opioid use.

An APAP may be a good option for you, if:

• You have a difficult time adjusting to CPAP therapy. While it takes time to get used to CPAP, some people are unable to tolerate the same continuous pressure throughout the night. With an APAP, it can increase or decrease pressure as needed offering more comfort.

• You frequently change sleeping positions throughout the night. If you’re an active sleeper and change sleeping positions often, your airflow needs may also change often. An APAP machine can account for your tossing-and-turning, giving you the necessary pressure.

If you have been diagnosed with sleep apnea, Aeroflow Sleep can help you get the supplies you need for successful PAP therapy covered up to 100% through your insurance. We offer a variety of PAP machines (including CPAP, BiPAP, and APAP) to help you effectively treat sleep apnea. If you’re not a part of the Aeroflow Sleep family yet, we invite you to take 5-7 minutes to fill out our online qualify form and check your eligibility today!

References

Huff, Charlotte. “What Is Automatic Positive Airway Pressure (APAP)?” Edited by Nayana Ambardekar, WebMD, WebMD LLC, 23 Mar. 2024, www.webmd.com/sleep-disorders/sleep-apnea/sleep-apap-overview. 

Summer, Jay. “Sleep Apnea Treatment.” Edited by Abhinav Singh, Sleep Foundation, 3 Nov. 2023, www.sleepfoundation.org/sleep-apnea/treatment. 

“BiPAP.” Cleveland Clinic, Cleveland Clinic, 10 May 2023, my.clevelandclinic.org/health/treatments/24970-bipap.