APAP vs CPAP | Sleep Foundation (2023)

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If you are wondering what the difference between an APAP and CPAP machine is, you or someone close to you has likely been diagnosed with sleep apnea. Sleep apnea is a potentially serious disorder that causes the body to repeatedly stop breathing during sleep. There are three types:

  • Obstructive Sleep Apnea (OSA): The muscles in the throat relax during sleep, in general or in a specific sleeping position, blocking the airway.
  • Central Sleep Apnea (CSA): The brain doesn’t send the proper signals to the muscles that control breathing during sleep.
  • Complex Sleep Apnea Syndrome: Sleepers experience a combination of obstructive sleep apnea and central sleep apnea.

Apneas, or pauses in breathing during sleep, often cause microarousals from sleep. Frequent waking from sleep, even if only for a small amount of time, can prevent a person from getting the healthy, restorative sleep that they need.

Sleep apnea affects approximately 2% to 9% of adults. Millions of Americans have been diagnosed with sleep apnea and are actively seeking treatment, while others may have undiagnosed or untreated sleep apnea.

(Video) Home CPAP Set Up

If left untreated, sleep apnea can cause short-term symptoms such as intrusive snoring, morning headaches, sore throats, daytime fatigue, irritability, and disordered sleep patterns. It can also lead to long-term negative health outcomes such as an increased risk of cardiovascular disease, metabolic syndrome, type 2 diabetes, and liver disease, as well as potential surgery complications.

Once a doctor establishes that you are suffering from sleep apnea, they may initially suggest lifestyle changes, such as losing weight, quitting smoking, or discontinuing the use of alcohol or certain sleep medications. They may also treat underlying conditions like allergies. In addition to these potential changes, a doctor will usually prescribe the use of a device that can help open the airway during sleep. In some cases, other interventions, such as surgery, are necessary.

In the majority of sleep apnea cases, treatment usually includes one of two devices: a continuous positive airway pressure (CPAP) machine, or an automatic positive airway pressure (APAP) machine. There are similarities between CPAP and APAP machines, as both devices are designed to promote airflow to help relieve symptoms of sleep apnea. A CPAP machine is the standard treatment option in most cases, but some sleepers may respond better to an APAP machine.

What Is the Difference Between CPAP and APAP?

The main difference between a CPAP and an APAP machine is that an APAP machine automatically adjusts its settings as you sleep. This allows it to meet changing pressure needs throughout the night.

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A CPAP machine is adjusted to one setting, usually during a PAP titration study at home or in a sleep study center, or by trial and error while using the machine. If the pressure is too high and causes exhalation discomfort, the CPAP can be manually adjusted to a new setting, but it will not adjust automatically.

Understanding the differences between these two machines can help sleep apnea sufferers work with a medical professional to find the right fit.

Common Applications
  • Experts recommend using a CPAP machine for a minimum of 6 hours each night, with regular use required for results
  • Users wear a mask over the nose and secure it with straps
  • The face mask is connected to the machine by a hose
  • Older machine models were bulkier and made more noise, but newer machines are smaller and quieter
  • APAP machines should be used for at least 6 hours each night, with consistent use
  • Similar to a CPAP machine, APAP machine include the machine, a hose, and a face mask
  • APAP machines tend to be small and make minimal noise
Usage and Appearance
  • Experts recommend using a CPAP machine for a minimum of 6 hours each night, with regular use required for results
  • Users wear a mask over the nose and secure it with straps
  • The face mask is connected to the machine by a hose
  • Older machine models were bulkier and made more noise, but newer machines are smaller and quieter
  • APAP machines should be used for at least 6 hours each night, with consistent use
  • Similar to a CPAP machine, APAP machine include the machine, a hose, and a face mask
  • APAP machines tend to be small and make minimal noise
  • Widely available and commonly prescribed
  • Increasingly common treatment for sleep apnea, but not as widely available as CPAP machines
Typical Cost
  • Average cost of $500 to $800
  • Most insurance plans cover CPAP machines
  • Reduced-rate CPAP machines and rebates may be available through manufacturers, Medicaid, Medicare, or state-funded programs
  • Typically more expensive than CPAP machines, averaging $800 or more
  • Many insurance companies will ask you to try a CPAP first, unless your doctor specifies your particular need for an APAP
  • Individual insurance companies may not approve coverage
Success Rate
  • Most consistently successful treatment for sleep apnea, as well as the most extensively researched
  • Success rate depends on consistency of use
  • Though there is still a need for more research on the success rate of APAP machines, the existing research is promising, particularly for people with sleep apnea related to sleeping position
  • May reduce swelling in the nose and throat
  • Can help reduce or eliminate the vibration that causes loud snoring
  • May clear out congestion along the top of the upper airway
  • Can respond appropriately to temporary airway blockages like allergies and colds
  • May reduce disruptive snoring
  • Can help clear congestion and reduce swelling
  • The mask may cause skin irritation
  • The nose, mouth, and throat may feel dry or irritated
  • May cause a choking sensation in some people, since air continues to blow while the sleeper exhales
  • Pressure sores or other skin irritation may occur
  • Users may experience a dry mouth, throat, or nose
  • Not programmed to respond effectively to certain sorts of sleep apnea
Generally Recommended For:
  • Those with sleep apnea, particularly OSA
  • People whose apnea symptoms are disturbing their sleep
  • Sleepers who have trouble exhaling with the CPAP machine
  • People who have specific forms of sleep apnea, as prescribed by a doctor
Generally Not Recommended For:
  • People who may be intolerant of wearing a face mask while sleeping
  • People with CSA, COPD, congestive heart failure, or apnea caused by opioid use
  • Those who do not want to wear a mask when sleeping

CPAP Basics

CPAP machines are the most commonly prescribed treatment for sleep apnea, and have been in use since the 1980s. CPAP machines, which stands for continuous positive airway pressure machines, work by pushing a steady stream of pressurized air through the nostrils, opening up the muscles that improperly relax in people with sleep apnea.

The machine takes in air through a filter, often passing it through a heated humidifier so that it’s easier on the nose and throat. It then uses a built-in motor to push the filtered, humidified air through a tube attached to the machine. At the end of the tube is a CPAP mask that is worn over the nose and affixed to the head with straps.

When the mask is placed over the nose, the steady stream of air goes into the upper airway, essentially creating a cushion or air splint that prevents the throat muscles and tissues from relaxing and collapsing the airway. The continuous airflow also helps keep the soft palate, the uvula, and the tongue from blocking the airway. This helps prevent the pauses in breathing that cause many sleep apnea sufferers to wake up throughout the night.

(Video) Short and Simple: CPAP vs BiPAP

For people with mild to moderate sleep apnea, particularly OSA, the CPAP can have immediate benefits. Studies have shown that CPAP machines can be effective for many people in reducing or eliminating the risk of both short-term symptoms and long-term health complications.

That said, there are several factors that may impede someone’s ability to benefit from a CPAP machine. Since the air continues to flow in a steady stream, it can cause an uncomfortable choking feeling when users try to exhale. If this happens, the machine can be set to a lower pressure.

Additionally, some users find it hard to get comfortable enough to fall asleep or stay asleep while wearing the mask. In many cases, this is because the mask has not been sized or adjusted to fit them properly. This can cause discomfort, in addition to air leaks, which may decrease the machine’s overall effectiveness. Users should find the best CPAP machine for them because an improperly fitting CPAP mask can cause other complications, such as irritation and pressure sores where the mask is rubbing against the skin.

APAP vs CPAP | Sleep Foundation (3)

APAP Basics

An APAP is an automatic positive airway pressure machine. Like CPAP machines, APAP machines work by taking in air through a filter (often with heating and humidification), and then using a motor to push the air through a tube that is connected to a face mask. APAP machines create an air splint by cushioning the airway and propping it open, while keeping the soft palate, uvula, and tongue from obstructing or collapsing the airway.

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While a CPAP has one continuous setting, an APAP is able to respond to changing pressure needs by constantly measuring how much resistance is present in your breathing. The technology in an APAP machine allows it to remain on a low setting until a change in breathing is detected and more airflow is needed.

APAP machines are often prescribed to people who do not get the desired results from a CPAP machine, or to those who have specific issues with the CPAP’s unchanging pressure level. They may be prescribed before CPAP machines in specific instances, such as sleep apnea that is comorbid with other sleep disorders, or sleep apnea that only occurs when the body shifts into a specific position. APAPs may work better for those who are prone to allergies, colds, or other temporary airway blockages, as they can adjust pressure as needed and then return to a lower setting when the flare-up has passed.

Additionally, APAP machines can be set to perform like a CPAP by setting the machine to a continuous mode.

APAP machines do have some drawbacks that should be considered. Like CPAP machines, they may cause skin irritation, especially if the mask is not properly fitted. They are not recommended for people with CSA, chronic heart failure, COPD, or obesity hypoventilation syndrome, nor are they recommended for use in people who have sleep apnea related to opioid use.

APAP vs CPAP: Which is Best for You?

When it comes to choosing between a CPAP and an APAP, you can start by performing an at-home sleep study or consulting with a sleep specialist or doctor to find the right machine for you. In many cases, finding the right PAP machine is a matter of trial and error. Many people start with a CPAP machine as prescribed by a doctor, but may switch to an APAP if they are not getting the desired results. Others may find that neither PAP machine is the right choice for them, and go with an alternative treatment. Discussing your symptoms and needs with your doctor will help you determine the best treatment plan for your individual case.

(Video) How to use a CPAP machine: setting up your machine


Should I buy a CPAP or an APAP? ›

APAP or CPAP? Individuals who require continuous pressure may choose a CPAP machine. Individuals whose breathing patterns change throughout the night may find APAP machines more comfortable and effective because of their ability to automatically adjust the pressure the machine applies.

Is an APAP and CPAP the same thing? ›

What is APAP technology in comparison to CPAP? While CPAP delivers one continuous pressure level of air, APAP automatically adjusts to meet each specific person's breathing needs, which often change throughout the night as we move in and out of different stages of sleep.

Does ResMed make a APAP? ›

ResMed is a pioneer of positive airway pressure (PAP) treatment, offering a wide variety of continuous positive airway pressure (CPAP), automatic positive airway pressure (APAP) and bilevel therapy devices.

Why CPAP over APAP? ›

Among those who tolerated CPAP, it was found that CPAP was as effective as APAP in controlling the AHI and improving sleepiness. Adherence to treatment was also similar, with CPAP having fewer adverse effects than APAP.

Can I switch from CPAP to APAP? ›

Some patients do very well in general with the continuous airway pressure delivered with CPAP. Others begin their treatment with a CPAP machine and find that that they cannot tolerate continuous airflow or that CPAP does not help them manage their symptoms enough, so they move on to an APAP machine.

Does an APAP machine stop snoring? ›

Be sure to consult your doctor or CPAP provider before making any adjustments to your equipment. Remember, when used properly, a CPAP or AutoPAP should eliminate snoring problems. So make sure you're getting great, snore-free sleep with the correct air pressure settings on your machine.

Do you need a sleep study for an APAP? ›

While PAP is the gold standard for OSA, buying an APAP from Craigslist without having had a sleep apnea study could be a major fail. Here's why: If you have really severe sleep apnea, chances are you are going to need high pressures to keep your airway open.

How much does an APAP cost? ›

How Much Does an APAP Cost? On average, you can expect to pay between $400 to $1,000 for an APAP machine, depending on the features included. A comparable fixed-pressure CPAP with the same features would typically run between $300 to $800.

Is APAP better? ›

APAPs may work better for those who are prone to allergies, colds, or other temporary airway blockages, as they can adjust pressure as needed and then return to a lower setting when the flare-up has passed. Additionally, APAP machines can be set to perform like a CPAP by setting the machine to a continuous mode.

Is there a lawsuit against ResMed? ›

ResMed Corp., a manufacturer of durable medical equipment (DME) based in San Diego, California, has agreed to pay more than $37.5 million to resolve alleged False Claims Act violations for paying kickbacks to DME suppliers, sleep labs and other health care providers, the Department of Justice announced today.

Does Medicare pay for APAP? ›

Medicare will also cover different types of PAP machines, such as BiPAP or APAP, and even alternative treatment options like oral appliances and mouthguards. However, this coverage does require that you meet certain requirements and follow certain guidelines.

Is APAP worse than CPAP? ›

Since APAP machines can be set as CPAP machines (by setting both the higher pressure setting and low pressure setting at the same number), the APAP machine has an advantage over CPAP devices. In the long run, APAP may be the better and more cost-effective machine for long-term use.

Is Autopap better than CPAP? ›

A CPAP machine may be adequate if your breathing patterns do not change much throughout the night or with changes in position. APAPs are often better than CPAPs because they can detect subtle changes in your sleep behavior and sleep positions that require different pressure settings.

Why is my APAP pressure so high? ›

Try a New CPAP Mask. If your CPAP mask is incorrectly fitted, worn out, or dirty it may lead to leaks and discomfort. You may also have the incorrect type of mask for higher pressure settings. New CPAP masks are continuing to be developed in order to meet the individual needs of a variety of sleep apnea patients.

How loud is an APAP machine? ›

The sound from a CPAP machine is best described as 'continuous and comfortable white noise. ' Treatment should not be louder than a whisper - after all, you're supposed to be sleeping. If your equipment is making loud noises, some of the parts might not be connected properly, causing air to escape (or 'leak' out).

Does APAP work for central sleep apnea? ›

The breathing devices that are most commonly used to treat obstructive sleep apnea – such as continuous positive airway pressure (CPAP), automatic positive airway pressure (APAP) or variable positive airway pressure (VPAP) – may be prescribed as central sleep apnea treatment options, as well.

What is the average pressure on a CPAP machine? ›

For most people, an appropriate CPAP pressure is between 6 and 14 cmH2O, with an average of 10 cmH2O. Your sleep specialist can help you determine what specific level is right for you. Over time, your CPAP device pressure may require adjusting.

What is the permanent solution for snoring? ›

Continuous positive airway pressure (CPAP) To eliminate snoring and prevent sleep apnea, your doctor may recommend a device called a continuous positive airway pressure (CPAP) machine. A CPAP machine delivers just enough air pressure to a mask to keep your upper airway passages open, preventing snoring and sleep apnea.

Why do I snore if I don't have sleep apnea? ›

Snoring can be caused by a number of factors, such as the anatomy of your mouth and sinuses, alcohol consumption, allergies, a cold, and your weight. When you doze off and progress from a light sleep to a deep sleep, the muscles in the roof of your mouth (soft palate), tongue and throat relax.

What is the best thing to block out snoring? ›

How to block out snoring: Wear foam earplugs. Listen to a white noise machine. Distract your ears.

How long does it take to get used to APAP? ›

Some people feel better after the first night that they use them. Others find that they take a week or two to get used to using the CPAP therapy. This is dependent upon a few factors, one of which is how much your sleep apnea was affecting your sleep.

How do you sleep with an APAP machine? ›

Wearing the mask alone for some time during the day may help you get used to how it feels and make it easier to fall asleep at night. Machines with the ramp feature that slowly and gradually increase the air pressure to your prescribed pressure setting as you fall asleep may make you more comfortable at bedtime.

How long does it take APAP to work? ›

Getting used to CPAP

But people who stick with it soon find their symptoms improve significantly – within a week of using it consistently. About a third of people we asked said it had taken over six months to get used to it.

How often does insurance pay for CPAP supplies? ›

Certain supplies need be replaced anywhere from every two weeks to every six months. Generally, insurance companies will authorize replacement of CPAP masks, tubing and filters every 90 days. Many insurance plans follow the guidelines from Medicare for regular replacement of supplies.

What are the symptoms of needing a CPAP? ›

The most common symptoms of obstructive and central sleep apneas include:
  • Loud snoring.
  • Episodes in which you stop breathing during sleep — which would be reported by another person.
  • Gasping for air during sleep.
  • Awakening with a dry mouth.
  • Morning headache.
  • Difficulty staying asleep, known as insomnia.
Dec 23, 2022

Does APAP help you sleep? ›

Why Use APAP? Studies show that all types of positive airway pressure may work equally well to help you sleep normally. Standard CPAPs have a long track record and are the most widely used. They're also simpler and less expensive than the other machines.

Is it worth getting a CPAP machine? ›

Green said CPAP is by far the most effective and least invasive cure for sleep apnea. “The gold-standard treatment for sleep apnea is the CPAP machine. If you can wear it, it's 100% effective. If you can sleep with a CPAP machine, it can provide a 100% correction,” Green said.

What is the newest treatment for sleep apnea? ›

For years, the most common treatment for millions of people with sleep apnea involved wearing a continuous positive airway pressure (CPAP) mask. That is, until the U.S. Food and Drug Administration recently approved a new, maskless treatment option -- the Inspire upper airway stimulation device.

How many hours of sleep do you need with a CPAP? ›

If you're wondering, “how many hours per night should CPAP be used?” the answer is, for the entire night while you sleep, ideally 7+ hours. CPAP compliance measures how many hours and nights you use your therapy and if you use it often enough for effective treatment.

When should I stop using CPAP? ›

As long as you have sleep apnea, you will continue to need to use CPAP therapy. That being said, you can discontinue the use of your CPAP machine if your sleep apnea becomes cured or enters remission.

How long does it take for APAP to work? ›

Studies have examined how CPAP therapy gradually eliminates the daytime sleepiness and fatigue that is associated with obstructive sleep apnea. The research revealed that patients started to achieve optimum results after about two weeks of using their CPAP machine.

What is the downside to CPAP? ›

Common problems with CPAP include a leaky mask, trouble falling asleep, a stuffy nose and a dry mouth.

What is the disadvantage of CPAP? ›

What Are the Disadvantages of CPAP? The CPAP device needs to be used every night for the entire duration of sleep. Some patients complain of mask discomfort, nasal congestion, and nose and throat dryness when using CPAP. Others find the device to be too constrictive and cumbersome, particularly when traveling.


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