CPAP versus BIPAP — What differs?

Sleep apnea is becoming a common problem with adults these days. In the US alone, the numbers reach 22 million. It is a potentially dangerous sleep disorder where a person stops breathing during sleep. It must be said that no cure has been found for this nuisance, but it is treatable. Treatments include CPAP and BiPAP therapies.

Doctors say that a lot of people who opt for CPAP therapy, either don’t use it right or stop it completely. They feel discomfort wearing the CPAP masks to sleep. It should be made known that there is more than one method for dealing with sleep apnea. This might encourage more people to comply with the treatment.

How do they work?

Both CPAP (Continuous Positive Airway Pressure) and BiPAP (Bi-level Positive Airway Pressure) are non-invasive ventilation (NIV) therapies that are prescribed to treat sleep apnea and other respiratory problems interfering with your beauty sleep.

  • Obstructive Sleep Apnea (OSA): This is a condition where breathing stops for a short moment during sleep. Causes are blocking or closing of the airways from excessive fatty tissues in the throat.
  • Central Sleep Apnea (CPA): In this disorder, the brains stop signaling the lungs to keep up the breathing process. This is more of a neurological communication issue than a physical one.
  • Chronic Obstructive Pulmonary Disorder (COPD): COPD obstructs the airflow from the lungs and worsens with time.
  • Congestive Heart-Failure (CHF): A heart-related condition where the heart does not pump enough blood to meet the body’s requirement.
  • Other Pulmonary or Neuromuscular Conditions: Cheyne-Stokes respiration, Parkinson’s, ALS, etc.

The severity of a person’s sleep-apnea is learned by Apnea-Hypopnea Index (AHI). It means how many apneic episodes you experience per sleep. Through PAP therapy doctors try to bring the figure below 5.

Both CPAP and BiPAP are non-invasive therapies providing positive airway pressure (PAP). This pressure keeps the pathway for air to remain open. In look as well, they are similar. Mask is worn on the nose and mouth, connected to a device through a tube. Where they differ is how the air pressure is provided. It must be remembered that none of them disrupt your natural breathing. But the Air pressure you breathe.


Continuous Positive Airway Pressure (CPAP) can be taken as the first line of defense against OSA. As the name suggests, this method delivers a continuous flow of air at a stable pressure.

CPAP machines have ramp-up settings for pressure, that is to say, you start at a lower that prescribes pressure, and it slowly increases as you fall asleep. This had a flaw. The pressure remained same whether you inhaled or exhaled, that made some people uncomfortable exhaling. Now, these devices come equipped with a variability pressure setting called C-Flex, AFLEX, Bi FLEX, EPR, or SensAwake. (manufacturer dependent). This lows down the settings by 3 cm when you exhale.

Your doctor will order you to have a CPAP titration study, for calibrating your machine for you. A mask will be chosen beforehand according to your sleeping position.


Bilevel Positive Airway Pressure (BiPAP) is commonly prescribed to patients with a chronic obstructive pulmonary disorder (COPD) and Congestive Heart-Failure (CHF). For OSA cases, BiPAP only kicks in after CPAP has proved ineffective. It is also called Variable Positive Airway Pressure (VPAP).

CPAP had to come included with C-Flex typesetting to improve exhaling, but that still was not very efficient. BiPAP machine offers two different pressure flows. A higher one for inhaling (iPAP) and a lower setting for exhaling (ePAP). They also have sensors that measure a person’s optimal breaths per minute and self-adjusts the setting to reach that optimal state if the breath count drops.

Both methods offer effective treatment for victims of sleep-apnea. If used properly and regularly, none is worse. Ultimately it boils down to personal preference and health conditions. Comparing costs, BiPAP is much more expensive than CPAP. You require a prescription to get either one of them. Both CPAP and BiPAP require the machines to be cleaned regularly for peak performance.