What is the difference between the Cpap, xPAP, bipap

donnadabb68 wrote:

What is the difference between the Cpap, xPAP, bipap

One continuous pressure versus a separate pressure for inspiration/expiration (so long as the pressures are not the same).

For example, Bipap of 8/8 is actually Cpap of 8.  ;)

xPAP is the generic for all of them.  When we are not talking about one type in particular.  
Bi Levels..or BiPAPs are used for those with lung problems, high pressure needs, central apnea and such.  

To break down into more layman terms for you.....

CPAP has one pressure...the dr writes the script for the pressure...say 11 and it blows constant at 11cm's  This stents the airway open...and you breathe in from that pressure and have to breathe out against that pressure.

BiLevel/BiPAP (same thing just called different by different companies)  Using the same setting say of 11cm.  The 11 cm stents your airway open and you breathe in from that pressure.  But the pressure you breathe out against is much lower...say 7.  Makes it easier to breathe out against the pressure.

APAP is Automatic positive air pressure...with this the air pressure self adjusts to the amount needed to open the airway.  These can be set as a  CPAP  if needed.

Using for example the same pressure needed of 11cm... The machine would bet set to blow air in at a range..say 8cm to 14cm...if you have apneas that only need 9cm to stop them then the machine will blow up to that 9cm then go back down to the 8cm...then another apnea may need 13 to stop it...so the machine blows the pressure of 13 then it goes back down to 8cm until you have another apnea....then it adjusts for that one.

APAP sounds like the ultimate machine however, some people do better on a regular CPAP then they do on an APAP...so the APAP can be set to act as a regular CPAP does...and so can the BiPAP (can be set to work as a CPAP)

Then there are Auto BiPAP's...to confuse it all more.  Those are the same thing as a regular biPAP...has 2 pressure levels that can be set...one for inhalation and one for exhalation...but in the AUto Mode...those pressures can be set in a range like the APAP can be...but still have a pressure for inhaling and a different one for exhaling....Seeing stars yet?

Oh and terms from some companies call the BiPAP .... VPAP


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Just to add to Mrs Rip's explanation: it CAN be confusing for newbies as some CPAPs do have a form of expiration pressure relief, Resmed refers to theirs as EPR and Respironics refers to theirs as C-Flex. But it is limited to 1-3 cms of pressure relief on exhalation. Some occasionally get this confused w/a bi-level.

And some autoPAPs provide for expiration pressure relief, again of 1-3 cms of pressure. In their autoPAPs Respironics refers to theirs not only as C-Flex but also as A-Flex.

VPAP is Resmed's name for their bi-levels whilst Bi-PAP is Respironics name for their bi-levels and Respironics again changes the name for their expiration pressure relief in their bi-levels by calling it Bi-Flex.

Clear as mud, right?

And the manufacturers don't always use much imagination when naming their various xPAP models, for instance:
Resmed S8 Compact, Resmed S8 Escape, Resmed S8 Elite (w/EPR), Resmed S8 AutoSet Vantage, etc.,etc.
Respironics is even worse: Respironics RemStar M Series Plus, Respironics RemStar M Series Pro w/C-Flex; Respironics RemStar M Series Auto w/C-Flex, Respironics RemStar M Series Auto w/A-Flex, etc., etc.
Puritan Bennett is worse yet w/their Puritan Bennett GoodKnight 420C, Puritan Bennett GoodKnight 420G, Puritan Bennett GoodKnight 420E.
DeVilBiss has come out w/their new DeVilBiss IntelliPAP and DeVilBiss IntelliAuto.
Covidian (Puritan Bennett) has come out w/their Covidian SandmanIntro, Covidian SandmanInfo and Covidian Sandman Auto.

Sheesh! And they wonder why patients get confused?? And why it is so easy for the local DME suppliers to foist barebone CPAPs off on first time xPAP users?? It is important to keep in mind that just because an xPAP has a data card does NOT mean it is fully data capable!

The important thing to keep in mind is that autoPAPs (as opposed to auto bi-levels) are classified as CPAPs for insurance purposes. They are all classified as insurance HCPCS code E0601. Not all CPAPs, nor all autoPAPs, are fully data capable. Of course, the costs of each is different. But insurances almost always contract for one set price for HCPCS code E0601 regardless of their actual cost. So many local DME suppliers prefer to provide their new patients w/a bare bone CPAP than a fully data capable CPAP to enhance their profit margin.

NO PATIENT should accept a less than fully data capable CPAP unless they have no insurance coverage and limited financial means. If one is FIRM, but DIPLOMATIC and TACTFUL, one can almost always convince the local DME supplier to provide them w/a fully data capable CPAP at no extra charge. This is especially true if the patient has talked to their insurance company and has the option of more than one local DME supplier contracted w/their insurance.

One last tidbit! You will occasionally see someone refer to IPAP and EPAP. These are not models of xPAPs. These terms are exclusive to the various models of bi-levels. IPAP just means Inspiratory Positive Airway Pressure and EPAP just means Expiratory Positive Airway Pressure and the pressure each is set at, i.e. IPAP 13/EPAP 8 would mean 13 cms of pressure on inhalation and 8 cms pressure on exhalation.

There! Now have I managed to REALLY confuse you?  


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Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.