APAP vs BPAP: What's the Difference?
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If you are comparing sleep apnea treatment options, you may have seen both APAP and BPAP machines mentioned. While both are positive airway pressure devices, they are designed to deliver therapy in different ways.
Understanding the difference between APAP and BPAP can help you better understand your prescription, your therapy options, and the questions to ask your healthcare provider.
Quick Overview
Both APAP and BPAP machines deliver pressurized air through a mask to support breathing during sleep.
The primary difference is how the machine adjusts pressure.
APAP
APAP stands for Automatic Positive Airway Pressure.
An APAP machine automatically adjusts pressure within a prescribed range based on your breathing patterns throughout the night.
BPAP
BPAP stands for Bilevel Positive Airway Pressure.
A BPAP machine delivers two separate pressure levels:
- A higher pressure when you inhale
- A lower pressure when you exhale
How APAP Therapy Works
An APAP machine monitors your breathing while you sleep and adjusts pressure automatically as your needs change.
Instead of delivering one fixed pressure all night, the machine operates within a pressure range set by your healthcare provider.
For example, if your prescribed APAP range is 6 to 14 cmH₂O, the machine can increase or decrease pressure within that range based on your breathing patterns.
Advantages of APAP
- Automatically adjusts pressure throughout the night
- May provide lower pressure when higher pressure is not needed
- Can adapt to changes in sleep position
- Can respond to changes in breathing patterns
- May feel more comfortable for some users
Considerations
APAP is not automatically the best choice for every patient. Some users may require a different type of therapy depending on their diagnosis, pressure needs, or breathing patterns.
How BPAP Therapy Works
A BPAP machine delivers two different pressure levels during therapy.
The higher pressure supports inhalation, while the lower pressure supports exhalation.
These two pressure settings are commonly referred to as:
IPAP
Inspiratory Positive Airway Pressure, the pressure delivered when you inhale.
EPAP
Expiratory Positive Airway Pressure, the pressure delivered when you exhale.
This pressure difference can make breathing feel more natural for some users, especially those who require higher therapy pressures or additional breathing support.
Advantages of BPAP
- Provides separate inhalation and exhalation pressures
- May improve comfort for users who struggle with higher pressures
- Can provide additional respiratory support
- May be prescribed for more complex therapy needs
Considerations
BPAP machines are generally prescribed based on specific medical needs. They are not simply an upgraded version of APAP. The correct therapy depends on your healthcare provider's evaluation and prescription.
APAP vs BPAP Comparison
| Feature | APAP | BPAP |
|---|---|---|
| Pressure Delivery | Automatically adjusts within a prescribed range | Uses two separate pressure levels |
| Inhalation Pressure | Varies within prescribed range | Higher prescribed pressure |
| Exhalation Pressure | Varies within prescribed range | Lower prescribed pressure |
| Main Purpose | Adapts to changing pressure needs | Supports separate inhale and exhale pressures |
| Common Use | Obstructive sleep apnea therapy | Higher pressure needs or specialized therapy support |
| Prescription Required | Yes (U.S.) | Yes (U.S.) |
Is BPAP Better Than APAP?
BPAP is not automatically better than APAP.
They are different types of therapy designed for different needs.
APAP may be appropriate for patients whose pressure needs change throughout the night. BPAP may be prescribed when a patient needs separate inhalation and exhalation pressures or additional respiratory support.
Your healthcare provider will determine which therapy is appropriate based on your diagnosis, sleep study results, prescribed pressure requirements, and overall treatment needs.
Why Would Someone Use an APAP?
A healthcare provider may recommend APAP therapy for patients who benefit from automatic pressure adjustments.
APAP may be useful when breathing patterns or pressure needs vary during sleep.
Why Would Someone Use a BPAP?
A healthcare provider may recommend BPAP therapy for patients who:
- Require higher therapy pressures
- Have difficulty exhaling against higher pressures
- Need additional breathing support
- Have certain sleep-related breathing disorders
The decision to prescribe BPAP therapy should always be made by a qualified healthcare provider.
Similarities Between APAP and BPAP
Although APAP and BPAP machines work differently, they share several similarities.
Both:
- Deliver positive airway pressure therapy
- Use a mask and hose
- Require a prescription in the United States
- May include heated humidification
- Can help support healthier breathing during sleep
- Should be used according to your healthcare provider's instructions
Do APAP and BPAP Machines Require a Prescription?
Yes.
In the United States, both APAP and BPAP machines are regulated medical devices and require a valid prescription.
Customers outside the United States should check local prescription and import requirements before purchasing a machine.
For more information, read our guide: Do You Need a Prescription for a CPAP Machine?
Related Resources
Learn more about sleep therapy equipment:
Final Thoughts
APAP and BPAP machines are both forms of positive airway pressure therapy, but they are not the same. APAP machines automatically adjust pressure within a prescribed range, while BPAP machines deliver separate pressure levels for inhalation and exhalation.
The best option depends on your diagnosis, prescription, comfort needs, and healthcare provider's recommendations. If you are unsure which therapy is right for you, speak with your healthcare provider or sleep specialist before purchasing a machine.