CPAP vs. Auto vs. BiPAP

[stevenmahoney]

If you want to know the difference between these machines in a short paragraph, here it is.

The CPAP machine is the basic ventilation therapy system. CPAP means continuous positive airway pressure. Being the standard breathing therapy utility, the CPAP machine is less expensive but also less convenient than more advanced models. Because CPAP sends a constant air stream to the patient, it is more comfortable during inhalation than during exhalation, when the user must exhale against the constant stream of air. This system can cause breathing difficulties for some users, and can wake patients periodically during the night.

AutoPAP (also known as AutoSet) includes an algorithm that tracks patient breathing patterns and lowers air pressure during exhalation. Because of this, it can be substantially more comfortable than standard CPAP (and even more so with BiPAP), but takes time to analyze patient breathing patterns and adjust accordingly. Thus, breathing can be somewhat difficult in the beginning as the machine attempts to predict when inhalation and exhalation will occur, which can take about  2-3 minutes for the adjustment. Also, when breathing patterns change during the night, whether slowing or speeding up, the AutoPAP system takes a moment to adjust. As patients wait between adjustments, the machine will maintain the previous rhythm. In general, the AutoPAP system can keep patients comfortable enough for sustained periods of uninterrupted sleep, but still may wake them during adjustments. 

BiPAP machines are the most advanced breathing therapy devices available (for obstructive apnea). The BiPAP system has two different pressure settings - one for inhaling and one for exhaling - and it continues to monitor patient breathing patterns on a breath-by-breath basis. Thus, the BiPAP system makes immediate adjustments upon first breath, and is practically unnoticeable to the patient. Due to this level of real-time response and accommodation, BiPAP offers a very natural feeling that is easy for most users to become accustomed to. Once you try BiPAP for yourself, you may find it difficult to return to the more basic systems.

[Gideon]

A caution to the above.  The BiPAP includes several different classes of machines which are NOT interchangeable, and are specific to the type of apnea that the user has. The above describes only the basic BiPAP which has a higher pressure capability and a higher PS (>3 cmw) (pressure support) than is possible with either the straight single pressure CPAP or the Auto CPAP mentioned above.

[stevenmahoney]

You are absolutely right. The description I posted is just a very general information. It is patent's doctor who decides what machine to use anyway.

[Fats Drywaller]

That summary is misleading in one or two ways. Some modern machines that don't do APAP do include what Resmed calls EPR and Philips calls Flex, to reduce pressure on exhalation. In other words, you don't need to get an APAP machine to get that feature. I haven't looked back past the current generation, but for instance the basic "Airsense 10 CPAP" model has it:

https://www.resmed.com/us/en/consumer/pr...-cpap.html

Within a manufacturer's family of machines, generally the machines themselves in that lowest tier (everything lower than bilevel) are the same electromechanically, but the firmware for the less expensive ones has been recompiled to omit some features. Usually those features are APAP and full data reporting via SD card.

The wrong information from also illustrates my pet peeve about the misuse of the term "CPAP": "Because CPAP sends a constant air stream to the patient, it is more comfortable during inhalation than during exhalation, when the user must exhale against the constant stream of air." Wrong. The "C" in "CPAP" does not mean "constant"; it means "continuous", which in turn means "uninterrupted", not "unvarying". An APAP machine is a CPAP machine; it's just a different type of CPAP machine. A bilevel machine is also a CPAP machine, of yet another type.

fyi, fwiw, hth, etc.

[stevenmahoney]

I have heard that Amazon purchased an online pharmacy with licenses in all 50 states and to comply with FDA rules so they do not loose those licenses they kick out sellers who sold CPAP Machines on Amazon. It is subject to verification though...

[mesenteria]

Words are important in that they intend for the speaker, or offer the listener, meaning.  When used carelessly, they can convey erroneous or misleading context, and meaning and make further inquiry go off in the wrong directions.

The term 'convenient' appears in the quoted text at the OP.  Used in the context given, it is misleading because it makes no allowances for '...but sufficient'.  I use a basic AS 10 Elite model which affords me more utility than what we call a 'brick'.  If I had wanted, but not needed, the Auto version, would it still have been 'convenient', especially with its greater cost?  I don't believe so because I don't need what the Autoset offers me.  If I had only needed, and wanted, a brick, would it not be convenient for me if it performs as designed and serves me well?  How would an Autoset have been more convenient with its other capabilities that I don't need, and don't foresee needing in the foreseeable future?

I know, that's another level of 'critical thinking' above merely being skeptical about what is presented for us on the internet.  Someone less skeptical than I might be led to think that only the more expensive machines are convenient, and that's simply not the case necessarily, and true for everyone.

[Gideon]

The Auto CPAP such as the AirSense 10 AutoSet is typically the initial machine of choice for treatment of obstructive apnea and hypopnea
Just to clarify The VAUTO, ASV and the ST are all BiLevel machines for treating three different conditions, they are NOT interchangeable. They are not a choice between the three to treat a single condition.
They should be chosen to treat the specific condition that the user has,

• To treat obstructive apnea and minor hypopnea a Straight CPAP, though we prefer the Auto CPAP because they are more flexible and likelihood that you will have the machine for 5+ years
  
  
• To treat obstructive apnea and minor hypopnea and for most initial treatments a standard Auto CPAP such as AirSense AutoSet (or for her) is appropriate.  Can also be used in CPAP mode with a single pressure if needed.
  
  
• To treat obstructive apnea and hypopnea, and a standard Auto CPAP is insufficient the treatment of choice is the Aircurve 10 Vauto (has higher pressure and greater Pressure Support (PS) (similar to EPR) available (BiPAP)
  
  
• To treat central apnea, the only appropriate therapy would be the Aircurve 10 ASV (BiPAP)
  
  
• To treat obstructive or pulmonary restriction including hypoventilation, would be the Aircurve 10 ST (BiPAP)
  

Note: though Resmed models are referenced other manufacturers have quality products.

[OpalRose]

I have heard that Amazon purchased an online pharmacy with licenses in all 50 states and to comply with FDA rules so they do not loose those licenses they kick out sellers who sold CPAP Machines on Amazon. It is subject to verification though...

May I ask how you are affiliated with Sistemma Cpap?  And is this the same seller (Vendor) that once sold Cpap machines on Amazon? Are you the owner?