Difference of BIPAP and CPAP
CPAP Delivers One Fixed Pressure
Continuous Positive Airway Pressure (CPAP) machines are designed to deliver a single, constant level of air pressure throughout the night. This steady pressure keeps the airway open, preventing collapses that can interrupt breathing during sleep. CPAP therapy is particularly effective for treating obstructive sleep apnea (OSA), where the airway becomes blocked or collapses during sleep.
In contrast, Bilevel Positive Airway Pressure (BiPAP) machines provide two distinct pressure settings: a higher pressure when you inhale (IPAP) and a lower pressure when you exhale (EPAP). This dual-pressure system makes breathing more natural and comfortable, especially for individuals who find it challenging to exhale against the continuous pressure of a CPAP machine. BiPAP’s design can be particularly beneficial for patients with conditions like central sleep apnea, where breathing patterns are more complex.
The choice between a CPAP and a BiPAP machine often depends on individual tolerance and specific medical needs. While CPAP is typically the first-line treatment for OSA due to its simplicity and effectiveness, BiPAP may be recommended for patients who require higher pressure settings or have difficulty exhaling against continuous pressure. Consultation with a sleep specialist is essential to determine the most appropriate therapy.
BiPAP Suits Complex or Intolerant Cases
CPAP therapy is generally the first-line treatment for individuals diagnosed with mild to moderate OSA. Its simplicity and effectiveness make it a common choice. However, some patients may experience discomfort or find it difficult to exhale against the continuous pressure, leading to poor adherence.
BiPAP is often recommended in the following scenarios:
- High Pressure Needs: Patients requiring higher pressure settings may benefit from BiPAP’s dual-pressure system.
- Central Sleep Apnea (CSA): BiPAP is effective in treating CSA, where the brain fails to send proper signals to the muscles that control breathing.
- Chronic Obstructive Pulmonary Disease (COPD): BiPAP can assist patients with COPD by improving ventilation and reducing the work of breathing.
- Neuromuscular Disorders: Conditions like ALS or muscular dystrophy that affect respiratory muscles may require the additional support BiPAP provides.
Clinical considerations, such as titration studies and patient tolerance, play a crucial role in determining the appropriate therapy. Sleep studies help determine the appropriate pressure settings and whether a patient would benefit more from CPAP or BiPAP. Comfort and the ability to adapt to the therapy are crucial for long-term adherence.
ResMed Lumis 150 VPAP ST-A 4G with Built-in Wireless Connectivity, ...
ResMed Lumis 150 VPAP ST with Built-in Wireless Connectivity, Humid...
Philips Respironics DreamStation Auto CPAP Machine with Humidifier
The Difference Between a BiPAP and a CPAP
While both CPAP (Continuous Positive Airway Pressure) and BiPAP (Bilevel Positive Airway Pressure) machines deliver pressurised air through a mask to keep the airway open, they do so in different ways.
CPAP Machines
CPAP machines deliver a single, continuous level of air pressure throughout the night. This pressure prevents airway collapse and is highly effective for treating obstructive sleep apnoea (OSA). CPAP is typically the first-line treatment and is suitable for most patients with mild to moderate OSA.
Many patients find CPAP relatively easy to use once they become accustomed to the airflow and mask fit. Modern CPAP devices are designed with user comfort in mind, featuring humidifiers, ramp-up settings, and quiet motors to help you ease to sleep without discomfort. CPAP machines are also generally smaller, quieter, and more affordable than BiPAP alternatives, which makes them an accessible starting point for many patients.
BiPAP Machines
BiPAP (Bi-level Positive Airway Pressure) delivers two pressure levels: a higher pressure when you inhale (IPAP) and a lower pressure when you exhale (EPAP). In other words, BiPAP machines switch between two settings – one for breathing in and one for breathing outsleepfoundation.org. This makes breathing out more comfortable, since you’re not pushing out against a single high pressure. A BiPAP unit looks much like a CPAP, but under the hood it can be set to automatically alternate pressures as you breathe.
BiPAP provides two pressure levels (IPAP on inhale and a lower EPAP on exhale), easing breathing. BiPAP is often prescribed when CPAP isn’t tolerated or sufficient.
Choose Between CPAP and BiPAP With Expert Support
Choosing between CPAP and BiPAP isn’t just about the machine specs — it’s about matching your clinical diagnosis, comfort needs, and lifestyle to the right therapy.
For many patients, CPAP is more than sufficient, especially when paired with the right mask and accessories. But if you’re experiencing significant discomfort, struggling with therapy adherence, or have a more complex sleep-disordered breathing condition, BiPAP may offer a more customised approach.
At Sove, our CPAP Consultants and Respiratory and Sleep Physicians can also help identify whether features like auto-adjusting pressure, humidification, or event detection will benefit your therapy and how they differ between machine types.
If you’re deciding between CPAP and BiPAP, a rental period can help you experience the comfort differences firsthand, especially if you’re trying to determine whether the dual-pressure support of a BiPAP machine makes therapy more manageable for you.
ALWAYS FOLLOW THE DIRECTIONS FOR USE. CPAP is used for Obstructive Sleep Apnoea treatment. When considering whether CPAP is right for you, speak to your doctor.
FAQS
Why would you use BiPAP instead of CPAP?
BiPAP (Bilevel Positive Airway Pressure) is typically recommended in situations where CPAP (Continuous Positive Airway Pressure) is either not well tolerated or is clinically inadequate. While CPAP is a reliable first-line therapy for obstructive sleep apnea (OSA), its single fixed pressure setting can be challenging for some individuals to manage—especially those who struggle during the exhalation phase.
BiPAP offers a more adaptable solution by using two separate pressures: a higher one for inhalation (IPAP) and a lower one for exhalation (EPAP). This makes the act of breathing—particularly exhaling—less laborious, and allows patients to rest more comfortably throughout the night.
How does a CPAP machine get rid of carbon dioxide?
CPAP’s primary function is to maintain an open airway by providing a continuous flow of air at a fixed pressure. This prevents airway collapse and supports normal breathing, particularly during sleep. However, CPAP is not directly designed to expel carbon dioxide (CO₂). Instead, it facilitates better breathing conditions so the body can manage CO₂ exchange more effectively through natural respiration.
BiPAP, on the other hand, is better suited for aiding in CO₂ clearance. The higher inspiratory pressure (IPAP) helps deliver a deeper, more efficient breath, which can expand the lungs more fully and improve ventilation at the alveolar level (where oxygen and CO₂ are exchanged). The lower expiratory pressure (EPAP) makes it easier to exhale, allowing for more complete removal of CO₂ with each breath.
How long can a patient stay on BiPAP?
BiPAP therapy can be used both short-term and long-term, depending on the underlying condition and therapeutic goals.
Short-Term Use: In acute hospital settings, BiPAP is often used to stabilize patients with respiratory distress, particularly those experiencing acute exacerbations of COPD, congestive heart failure, or pneumonia. In these cases, BiPAP can prevent the need for intubation by supporting breathing until the underlying issue is resolved. Once stabilised, patients may be weaned off BiPAP entirely.
Which is more expensive: CPAP or BiPAP?
BiPAP machines are generally more expensive than CPAP units due to their advanced pressure control, additional settings, and more complex internal components.
CPAP Machines: These are usually priced between $500 and $1,000. They’re widely available, relatively simple to use, and covered under most insurance policies when prescribed for obstructive sleep apnea.
BiPAP Machines: These typically range from $1,700 to $3,000 or more, depending on features such as auto-adjusting settings, data tracking, and backup respiratory rate. BiPAP is classified as a more advanced medical device, often requiring detailed physician evaluation and titration.
While initial costs may be higher for BiPAP, many insurance plans—including Medicare—will cover some or all of the expense if medical necessity is documented. Ongoing costs should also be considered, including replacement filters, tubing, masks, and periodic maintenance.
For those unsure about investing upfront, rental programs are often available, allowing patients to try the device before making a purchase decision. In Australia, as in many countries, these devices must be purchased under prescription due to the need for proper clinical evaluation and follow-up.
Do you breathe through your nose or mouth with a BiPAP?
BiPAP therapy accommodates both nasal and mouth breathing, and the choice often depends on your personal habits and any anatomical considerations (like a blocked nasal passage or tendency to breathe through the mouth while sleeping).
Nasal Masks: These cover only the nose and are generally preferred by those who naturally breathe nasally during sleep. They are smaller, less intrusive, and can be more comfortable for many users. However, nasal masks may not be suitable for people with allergies, congestion, or chronic sinus issues.
Full-Face Masks: These cover both the nose and mouth and are typically used by mouth breathers or those with nasal obstructions. They also offer a good solution for patients who tend to open their mouth during sleep, as mouth breathing with a nasal mask can reduce the effectiveness of therapy and lead to dry mouth.
Some patients may also benefit from chin straps to keep the mouth closed when using a nasal mask. Others might switch mask types seasonally (e.g., using a full-face mask during allergy season). Your CPAP/BiPAP provider can help you trial different options to find the most comfortable and effective setup.