Table of ContentsView AllTable of ContentsCPAP TherapyBiPAP TherapyBiPAP vs. CPAPOther OptionsASV TherapyFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
CPAP Therapy
BiPAP Therapy
BiPAP vs. CPAP
Other Options
ASV Therapy
Frequently Asked Questions
Continuous positive airway pressure (CPAP) andBiPAP (bi-level)therapy are used to treatsleep apnea.CPAP is the most common and effective therapy, and it’s often recommended as a treatment option when you are diagnosed with obstructive sleep apnea.
BiPAP may be preferred in more severe cases of sleep apnea or when another diagnosis, such as chronic obstructive pulmonary disease (COPD), is present. Both BiPAP and adaptive servo-ventilation(ASV) therapy are used to treatcentral sleep apnea, which occurs when the brain temporarily stops sending signals to the respiratory muscles.
This article explains the differences between CPAP, BiPAP, and ASV and provides information about various reasons for their use, how BiPAP and CPAP machines work, their cost, and more.
Verywell / Ellen Lindner
The standard treatment for obstructive sleep apnea is the use of a machine that provides support to keep your airway open while you are asleep. This can be accomplished with continuous positive airway pressure (CPAP).
In CPAP, a constant flow of pressurized room air is provided via aface mask. There are also portabletravel CPAPdevices available.
An effective pressure setting is meant to prevent both apnea and snoring and should reduce theapnea-hypopnea index (AHI)below five, as well as improve the other symptoms associated with sleep apnea.
What Is Sleep Apnea?
BiPAP or Bilevel Therapy
A similar therapy is called bilevel, or BiPAP, but it differs in important ways.
The “bilevel” component refers to the fact that there are two pressures, which the machine is able to alternate between. This allows you to breathe in with higher pressure and breathe out against a slightly lower pressure.
Bilevel may be required when pressures are higher to improve comfort, especially at PAP pressures that are 15 centimeters (cm) of water pressure or higher.
BiPAP vs. CPAP MachineAside from a label or different color, from the outside, the BiPAP machine may not look significantly different from a CPAP. It still requires the same tubing and face mask that is used in CPAP therapy. However, it can be more effective in select circumstances, such as those described above.
BiPAP vs. CPAP Machine
Aside from a label or different color, from the outside, the BiPAP machine may not look significantly different from a CPAP. It still requires the same tubing and face mask that is used in CPAP therapy. However, it can be more effective in select circumstances, such as those described above.
How Does a CPAP Machine Work to Treat Sleep Apnea?
Do I Need CPAP or BiPAP?
Whether or not you use CPAP or BiPAP for sleep apnea will likely depend on the results of a sleep study.
Central sleep apnea may occur more often in people who have had heart failure, or a stroke, or in those who chronically use narcotic pain medications.
Some devices are quite sophisticated, varying the airflow that is delivered to compensate for respiratory and neuromuscular disorders that affect breathing as well. These disorders include chronic obstructive pulmonary disease (COPD), amyotrophic lateral sclerosis (ALS), and other conditions.
What Is Amyotrophic Lateral Sclerosis (ALS)?
Setting Options
Auto devices can be of both the CPAP or bilevel variety. The device is able to respond to subtle collapses in the airway and can turn up the pressure as needed during the night. This may be helpful if sleep apnea worsens due to changes in sleep position (such as lying on one’s back) or due to REM sleep causing increased events.
There is also a type of bilevel that can deliver timed breaths (often called bilevel ST). This can ensure that a minimum number of breaths per minute are occurring. This may be important in central sleep apnea.
Sleep Apnea Treatment Costs: Inspire Therapy, CPAP Machines, and More
What Is ASV Therapy?
Finally, there is another sophisticated machine called auto or adaptive servo-ventilation (ASV) that has even more features to maintain normal breathing in sleep. It can vary the volume of air delivered as well as the speed at which the lungs are inflated and deflated, among other settings.
These devices are often reserved for people who need extra ventilatory support due to systolic heart failure, complex central sleep apnea, and high altitude.
When Should I Switch From CPAP to BiPAP?Some people move from CPAP treatment to BIPAP. If changes in your therapy are required, they can be arranged when your healthcare provider sees you for routine follow-up. It is sometimes necessary to arrange a titration study in which the various treatment options and settings can be explored in a controlled fashion.
When Should I Switch From CPAP to BiPAP?
Some people move from CPAP treatment to BIPAP. If changes in your therapy are required, they can be arranged when your healthcare provider sees you for routine follow-up. It is sometimes necessary to arrange a titration study in which the various treatment options and settings can be explored in a controlled fashion.
A Word From Verywell
You don’t have to sort this out on your own. Your sleep specialist should be able to make the proper determination of your therapy needs based on the results of your sleep study and your assessment in the clinic. Discuss your options at your visit and be in close contact if you experience any difficulties with the treatment of your sleep apnea.
Frequently Asked QuestionsBoth CPAP and BiPAP can be used to treat sleep apnea, depending on your specific needs. CPAP is most often used to treat obstructive sleep apnea. BiPAP is used to treat more severe cases of sleep apnea, often in people with central sleep apnea associated with other underlying health issues.Learn MoreSleep Apnea Treatment: Everything You Need to KnowCPAP has been used successfully to treat people with COVID-19.BiPAP may be used in more severe COVID-19 cases, as it offers more breathing support unless or until intubation is needed. BiPAP also may be a treatment endpoint for people who don’t want intubation.Learn MoreCPAP Therapy May Help Treat Early-Stage COVID-19
Both CPAP and BiPAP can be used to treat sleep apnea, depending on your specific needs. CPAP is most often used to treat obstructive sleep apnea. BiPAP is used to treat more severe cases of sleep apnea, often in people with central sleep apnea associated with other underlying health issues.Learn MoreSleep Apnea Treatment: Everything You Need to Know
Both CPAP and BiPAP can be used to treat sleep apnea, depending on your specific needs. CPAP is most often used to treat obstructive sleep apnea. BiPAP is used to treat more severe cases of sleep apnea, often in people with central sleep apnea associated with other underlying health issues.
Learn MoreSleep Apnea Treatment: Everything You Need to Know
CPAP has been used successfully to treat people with COVID-19.BiPAP may be used in more severe COVID-19 cases, as it offers more breathing support unless or until intubation is needed. BiPAP also may be a treatment endpoint for people who don’t want intubation.Learn MoreCPAP Therapy May Help Treat Early-Stage COVID-19
CPAP has been used successfully to treat people with COVID-19.BiPAP may be used in more severe COVID-19 cases, as it offers more breathing support unless or until intubation is needed. BiPAP also may be a treatment endpoint for people who don’t want intubation.
Learn MoreCPAP Therapy May Help Treat Early-Stage COVID-19
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.BiPap.National Library of Medicine: MedlinePlus.Central sleep apnea.Johns Hopkins Medicine.Obstructive sleep apnea.National Heart, Lung, and Blood Institute.Sleep apnea treatment.Sands SA, Owens RL.Congestive heart failure and central sleep apnea.Crit Care Clin. 2015;31(3):473-495. doi:10.1016/j.ccc.2015.03.005American Thoracic Society.What Is adaptive servo-ventilation (ASV)?Kofod LM, Nielsen Jeschke K, Kristensen MT, Krogh-Madsen R, Monefeldt Albek C, Hansen EF.COVID-19 and acute respiratory failure treated with CPAP.Eur Clin Respir J. 8(1):1910191. doi:10.1080/20018525.2021.1910191Bonnesen B, Jensen JUS, Jeschke KN, et al.Management of Covid-19-associated acute respiratory failure with alternatives to invasive mechanical ventilation: high-flow oxygen, continuous positive airway pressure, and noninvasive ventilation.Diagnostics (Basel). 2021;11(12):2259. doi:10.3390/diagnostics11122259Additional ReadingYeghiazarians Y, Jneid H, Tietjens JR, et al.Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association.Circulation. 2021;144(3):e56-e67. doi:10.1161/CIR.0000000000000988
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.BiPap.National Library of Medicine: MedlinePlus.Central sleep apnea.Johns Hopkins Medicine.Obstructive sleep apnea.National Heart, Lung, and Blood Institute.Sleep apnea treatment.Sands SA, Owens RL.Congestive heart failure and central sleep apnea.Crit Care Clin. 2015;31(3):473-495. doi:10.1016/j.ccc.2015.03.005American Thoracic Society.What Is adaptive servo-ventilation (ASV)?Kofod LM, Nielsen Jeschke K, Kristensen MT, Krogh-Madsen R, Monefeldt Albek C, Hansen EF.COVID-19 and acute respiratory failure treated with CPAP.Eur Clin Respir J. 8(1):1910191. doi:10.1080/20018525.2021.1910191Bonnesen B, Jensen JUS, Jeschke KN, et al.Management of Covid-19-associated acute respiratory failure with alternatives to invasive mechanical ventilation: high-flow oxygen, continuous positive airway pressure, and noninvasive ventilation.Diagnostics (Basel). 2021;11(12):2259. doi:10.3390/diagnostics11122259Additional ReadingYeghiazarians Y, Jneid H, Tietjens JR, et al.Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association.Circulation. 2021;144(3):e56-e67. doi:10.1161/CIR.0000000000000988
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.BiPap.National Library of Medicine: MedlinePlus.Central sleep apnea.Johns Hopkins Medicine.Obstructive sleep apnea.National Heart, Lung, and Blood Institute.Sleep apnea treatment.Sands SA, Owens RL.Congestive heart failure and central sleep apnea.Crit Care Clin. 2015;31(3):473-495. doi:10.1016/j.ccc.2015.03.005American Thoracic Society.What Is adaptive servo-ventilation (ASV)?Kofod LM, Nielsen Jeschke K, Kristensen MT, Krogh-Madsen R, Monefeldt Albek C, Hansen EF.COVID-19 and acute respiratory failure treated with CPAP.Eur Clin Respir J. 8(1):1910191. doi:10.1080/20018525.2021.1910191Bonnesen B, Jensen JUS, Jeschke KN, et al.Management of Covid-19-associated acute respiratory failure with alternatives to invasive mechanical ventilation: high-flow oxygen, continuous positive airway pressure, and noninvasive ventilation.Diagnostics (Basel). 2021;11(12):2259. doi:10.3390/diagnostics11122259
Johns Hopkins Medicine.BiPap.
National Library of Medicine: MedlinePlus.Central sleep apnea.
Johns Hopkins Medicine.Obstructive sleep apnea.
National Heart, Lung, and Blood Institute.Sleep apnea treatment.
Sands SA, Owens RL.Congestive heart failure and central sleep apnea.Crit Care Clin. 2015;31(3):473-495. doi:10.1016/j.ccc.2015.03.005
American Thoracic Society.What Is adaptive servo-ventilation (ASV)?
Kofod LM, Nielsen Jeschke K, Kristensen MT, Krogh-Madsen R, Monefeldt Albek C, Hansen EF.COVID-19 and acute respiratory failure treated with CPAP.Eur Clin Respir J. 8(1):1910191. doi:10.1080/20018525.2021.1910191
Bonnesen B, Jensen JUS, Jeschke KN, et al.Management of Covid-19-associated acute respiratory failure with alternatives to invasive mechanical ventilation: high-flow oxygen, continuous positive airway pressure, and noninvasive ventilation.Diagnostics (Basel). 2021;11(12):2259. doi:10.3390/diagnostics11122259
Yeghiazarians Y, Jneid H, Tietjens JR, et al.Obstructive sleep apnea and cardiovascular disease: a scientific statement from the American Heart Association.Circulation. 2021;144(3):e56-e67. doi:10.1161/CIR.0000000000000988
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