CPAP vs. APAP
Doctors prescribe CPAP and APAP machines as an effective way to treat various sleep disorders. The systems are similar in that they deliver continuous air pressure through tubing to the nose or mouth, enabling people to sleep for long periods because they no longer gasp for air.
Many people struggle with health conditions like apnea that can impact breathing well while sleeping. Both Automatic Positive Airway Pressure (APAP) and Continuous Positive Airway Pressure (CPAP) machines are practical, effective solutions that can ensure airways remain open throughout the night.
Understanding the differences between APAP and CPAP machines is essential for choosing the right option for you. While both APAP and CPAP machines incorporate masks and sensors, there are differences in how they operate and the functionality they facilitate.
What Is APAP?
Automatic Positive Airway Pressure (APAP) systems deliver continuous air pressure to the nose or mouth to help people diagnosed with sleep apnea get extended periods of deep sleep. The air pressure is automatically adjusted to keep the throat from collapsing or closing, enabling a clean passageway for breathing and sleeping.
APAP machines measure breath-by-breath resistance, detect slight decreases in pressure and accommodate for them. As resistance changes, the computerized machine adjusts its pressure up or down, ensuring appropriate pressure throughout various sleep stages.
The ability of APAP machines to differentiate pressure make them more comfortable for people who need them. Automatic pressure adjustments ensure that users won’t wake up gasping for air or feeling out of breath.
Because APAP systems adjust automatically, they stay in tune with an individual’s day-to-day health, such as when you have the flu, are exhausted physically or have another condition that reduces or increases your respiratory rate.
What Is the Difference Between APAP and CPAP?
Neurologists, the physicians who usually diagnose sleep disorders, prescribe both APAP systems and Continuous Positive Airway Pressure (CPAP) systems to treat apnea. CPAPs and APAPs provide the same basic help for people in need of sleep because they provide external pressurized air to make long, peaceful rest periods possible. But they do so in different ways.
While APAP machines automatically adjust pressure, CPAP machines deliver one steady pressure throughout a sleep period. Doctors can adjust a CPAP’s pressure settings, but the setting remains unchanged until the doctor adjusts it again. This can make CPAPs less comfortable — and potentially less effective — than APAPs over extended use.
APAP machines are well-suited to treat sleep disordered breathing, thus making them an ideal choice if the individual experiences multiple changes in breathing patterns during sleep. Conversely, people with an established pattern of continuous events may find a CPAP machine to be more effective.
The flexibility with APAPs come with a price: APAPs cost a little bit more (about 20%) than CPAPs.
While doctors can prescribe either one — and both are readily available in the U.S. market — physicians more often set up their patients with CPAPs. Many insurance companies include CPAPs in their coverage plans but do not include APAPs. Some insurers may require you to use a CPAP first before they will approve coverage of an APAP.
CPAP machines have proven effective and well-tolerated by most patients, while APAP machines are still relatively new. So far, there isn’t a sufficient body of research comparing the two.
- Some people who have a machine and should use it do not because they don’t feel comfortable sleeping with a mask covering their mouth or nose. Anywhere from 46 to 83% of people with sleep system machines are “non-adherent” in their use.
- When not fitted properly, masks and nose pillows irritate the skin, nose and mouth. The systems’ continuous air pressure can also cause a sore throat.
- Noise from the machine can also be a detriment, although proponents of sleep systems argue that any machine-created noise is less than that of someone’s snoring, a hallmark symptom of a sleep disorder.
Scientists and sleep specialists constantly measure the success rates of both systems. They have much more evidence about the effectiveness of CPAPs than they do of APAPs.
One study found that CPAP systems have a 56% success rate for people with non-severe obstructions and a 75% success rate for people who have severe obstructions. The study found that CPAPs were more effective than oral appliances, particularly for people who are obese.
Obesity is closely associated with the occurrence of apnea, as is weight loss and the ability to reduce a person’s sleep dependence on CPAP and APAP systems. Because of APAP machines’ ability to adjust pressures when in use, people who are actively losing (or gaining) weight might find them preferable.
Ultimately, the effectiveness of APAPs and CPAPs depends on using a system best suited to treat the individual’s specific respiratory conditions, breathing patterns and desired comfort. While there are inherent side effects to both systems, both have proved highly effective at helping users achieve a better night’s rest.
How Much Do APAP Machines Cost?
Cost is always a consideration when it comes to medical care. APAP machines cost more than CPAP machines. APAP systems typically range from $400 to $1,000, while CPAP systems can range from $300 to $800.
Most medical insurance providers recognize the seriousness of sleep disorder and the benefits of CPAPs. Insurance coverage for the devices is lumped in with regular healthcare coverage and is subject to the same annual deductible and out-of-pocket maximum coverages.
However, not many insurers cover APAP systems in the same way. Medicare covers CPAPs (typically at 80%) but not APAPs.
Neurologists are hopeful this will change with more of a proven record of APAP machines’ effectiveness and greater adoption.
Philips CPAP Recall
In June 2021, Philips Respironics recalled several million CPAP machines because of an incorporation of a PE-PUR sound abatement foam that degrades over time. Most of the recalled CPAP devices are in the DreamStation line manufactured between 2009 and 2021.
As foam within the CPAP degrades, it can release particles and toxic gases into the airstream, which are then inhaled or swallowed. This design defect is potentially linked to significant negative health outcomes, raising concerns about a possible CPAP cancer risk.
The U.S. Food and Drug Administration (FDA) identified this device problem as a Class I recall, the most serious type of recall, in July 2021 because of the potential for serious injury or death posed by using one of the defective devices.
The known health hazards caused by the inhalation or ingestion of Pe-PUR foam resulted in multiple class-action lawsuits against Philips Respironics. Plaintiffs claim in court filings that the devices have caused significant personal injuries, wrongful deaths and other adverse health effects.
- Brain cancer
- Breast cancer
- Lymphatic cancer
- Thyroid cancer
- Lung disease
- Liver disease
- Heart failure
- Renal failure
Depending on the Philips CPAP lawsuit, plaintiffs are seeking compensation for personal injuries, wrongful death, as well as the cost of replacing their CPAP machine with a safer alternative.
APAP or CPAP: Which Is Best for You?
APAP or CPAP? Individuals who require continuous pressure are better served by choosing a CPAP machine, while individuals whose breathing patterns change throughout the night will find APAP machines more comfortable and effective because of their ability to automatically adjust the pressure the machine applies. Of course, CPAP machines have a proven track record of effectiveness, while APAP machines are relatively new, so it’s difficult to make a comprehensive comparison. However, this should not be interpreted to mean they are not as effective; it simply means that their full advantages and benefits are still under evaluation. Finally, while cost is a consideration most users will factor in, it should be the least important deciding factor.
Both APAP and CPAP machines are effective at helping individuals achieve a better night’s rest. Both provide reliable respiratory support.
Because of their ability to adjust pressure settings mid-sleep, APAP systems are sometimes considered the better option for people who tend to toss and turn at night. People who move around while sleeping have periods when they need more air pressure.
Not everyone qualifies for an APAP system. People who are diagnosed with chronic heart failure or obesity hypoventilation syndrome should not be considered for APAP therapy.
Consult with your physician to determine which system is right for you based on your overall health, your sleep patterns, and the type of respiratory support you require throughout the night.
How can we improve this page?
Thank You for Your Feedback
We appreciate your feedback. One of our content team members will be in touch with you soon.
We appreciate your feedback. One of our content team members will be in touch with you soon.
Calling this number connects you with a Drugwatch representative. We will direct you to one of our trusted legal partners for a free case review.
Drugwatch's trusted legal partners support the organization's mission to keep people safe from dangerous drugs and medical devices. For more information, visit our partners page.