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MedTech Outlook | Tuesday, March 30, 2021
In most cases of obstructive sleep apnea, CPAP therapy alone is sufficient. However, BiPAP may be a viable alternative in more complicated situations or when CPAP is not tolerated well.
FREMONT, CA: Bi-level positive airway pressure (BiPAP) is a breathing treatment used to treat sleep apnea and other breathing-related health problems. This is a less often used treatment than continuous positive airway pressure (CPAP). However, in some instances, it is more advantageous.
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For instance, although CPAP maintains constant air pressure, BiPAP maintains variable air pressure. BiPAP's differential air pressure can be beneficial for individuals who have difficulty exhaling compared to CPAP's continuous pressure.
Both CPAP and BiPAP devices are positive airway pressure therapy that utilizes compressed air to open and maintain the airway while a person sleeps. The pressurized air is generated on a portable machine and directed to the user's airway via a hose and mask system. Both systems make use of identical masks, hoses, and other components.
The greatest CPAP machines include an adjustable pressure setting ranging from 4 to 20 cm H2O (a unit of air pressure equal to centimeters of water pressure), independent of whether the user is inhaling or exhaling. BiPAP devices have two pressure settings—inhalation positive airway pressure (IPAP) and exhalation positive airway pressure (EPAP)—allowing lower exhalation pressures. The transfer between IPAP and EPAP may be timed or automatic, depending on the BiPAP machine's settings. BiPAP machines typically operate at a 4–25 cm H2O pressure range.
While most CPAP machines only have one setting, specific models now include sensors for gentler exhale air pressure. Unlike the EPAP setting on BiPAP devices, the user cannot adjust the exhalation pressure, which is slightly less than the overall pressure setting.
Portable CPAP machines are built for travel, while BiPAP machines are intended for use at home. The additional sensors and settings required by BiPAP equipment are typically twice the price of a comparable CPAP machine.
Different types of PAP therapy are more effective for specific illnesses, while some overlap exists. CPAP is generally suggested for patients with obstructive sleep apnea (OSA), and sleep doctors are unlikely to offer BiPAP unless the patient cannot tolerate CPAP. While some insurance companies cover both CPAP and BiPAP for OSA, those that do typically need proof of insufficient CPAP treatment before reimbursing for a BiPAP machine. BiPAP is generally used to treat central sleep apnea (CSA) and cardiovascular, respiratory, and neurological problems that require controlled airway support during sleep.
Both CPAP and BiPAP devices are available with various integrated and aftermarket accessories. Data collecting and climate control devices such as humidifiers and heated tubing are the most often used features.
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