Sleep apnea is a group of sleep disorders that cause frequent pauses in breathing during your sleep. The most common type is obstructive sleep apnea (OSA), which occurs as a result of throat muscle constriction.

Central sleep apnea occurs from a brain signal issue that prevents proper breathing. Complex sleep apnea syndrome is less common, and it means that you have a combination of obstructive and central sleep apnea.

These sleeping disorders are potentially life threatening if left untreated.

If you have a sleep apnea diagnosis, your doctor may recommend breathing machines to help you get the crucial oxygen that you may be missing at night.

These machines are hooked up to a mask you wear over your nose and mouth. They deliver pressure to help your muscles relax so you’re able to breathe. This is called positive airway pressure (PAP) therapy.

There are three main types of machines used in the treatment of sleep apnea: APAP, CPAP, and BiPAP.

Here, we break down the similarities and differences between each type so you can work with your doctor to help choose the best sleep apnea therapy for you.

An auto-adjustable positive airway pressure (APAP) machine is best known for its ability to offer different pressure rates throughout your sleep, based on how you inhale.

It works on a range of 4 to 20 pressure points, which can offer flexibility to help you find your ideal pressure range.

APAP machines work best if you need additional pressure based on deeper sleep cycles, the use of sedatives, or sleep positions that further disrupt airflow, such as sleeping on your stomach.

The continuous positive airway pressure (CPAP) unit is the most prescribed machine for sleep apnea.

As the name suggests, CPAP works by delivering a steady pressure rate for both inhalation and exhalation. Unlike APAP, which adjusts the pressure based on your inhalation, CPAP delivers one rate of pressure throughout the night.

While the continuous rate of pressure can help, this method can lead to breathing discomfort.

Sometimes the pressure may still be delivered while you’re trying to exhale, making you feel like you’re choking. One way to remedy this is to turn down the pressure rate. If this still doesn’t help, your doctor may recommend either an APAP or BiPAP machine.

The same pressure in and out doesn’t work for all sleep apnea cases. This is where a bi-level positive airway pressure (BiPAP) machine can help. BiPAP works by delivering different pressure rates for inhalation and exhalation.

BiPAP machines have similar low range pressure zones as APAP and CPAP, but they offer a higher peak pressure flow of 25. Thus, this machine is best if you need moderate- to high-pressure ranges. BiPAP tends to be recommended for sleep apnea as well as Parkinson’s disease and ALS.

One of the most common side effects of PAP machines is that they can make it difficult to fall and stay asleep.

Like sleep apnea itself, frequent insomnia can increase your risk for metabolic conditions, as well as heart disease and mood disorders.

Other side effects include:

  • runny nose or nasal congestion
  • sinus infections
  • dry mouth
  • dental cavities
  • bad breath
  • skin irritation from the mask
  • feelings of bloating and nausea from air pressure in your stomach
  • germs and subsequent infections from not cleaning the unit properly

Positive airway pressure therapy may not be suitable if you have any of the following conditions:

CPAP is generally the first line of flow generation therapy for sleep apnea.

However, if you want the machine to automatically adjust the pressure based on varying sleep inhalations, APAP may be a better choice. BiPAP works best if you have other health conditions that warrant the need for higher pressure ranges to help you breathe in your sleep.

Insurance coverage can vary, with most companies covering CPAP machines first. This is because CPAP costs less and is still effective for most people.

If CPAP doesn’t meet your needs, your insurance may then cover one of the two other machines. BiPAP is the most expensive choice due to its more complex features.

Even if you do use a CPAP or other machine, you may need to adopt other habits to help treat sleep apnea. In some cases, more invasive treatments are needed.

Lifestyle changes

In addition to using a PAP machine, a doctor may recommend the following lifestyle changes:

Changing your nighttime routine

Since PAP therapy poses the risk of interfering with your sleep, it’s important to take control of other factors that might make it hard to fall asleep at night. Consider:

  • removing electronic devices from your bedroom
  • reading, meditating, or doing other quiet activities an hour before bedtime
  • taking a warm bath before bed
  • installing a humidifier in your bedroom to make it easier to breathe
  • sleeping on your back or side (not your stomach)


If all therapies and lifestyle changes fail to make any significant impact, you may consider surgery. The overall goal of surgery is to help open up your airways so you aren’t dependent on pressure machines for breathing at night.

Depending on the underlying cause of your sleep apnea, surgery could come in the form of:

  • tissue shrinkage from the top of the throat
  • tissue removal
  • soft palate implants
  • jaw repositioning
  • nerve stimulation to control tongue movement
  • tracheostomy, which is only used in severe cases and involves the creation of a new airway passage in the throat

APAP, CPAP, and BiPAP are all types of flow generators that may be prescribed for the treatment of sleep apnea. Each has similar goals, but an APAP or BiPAP may be used if the common CPAP machine doesn’t work.

Aside from positive airway pressure therapy, it’s important to follow your doctor’s advice on any recommended lifestyle changes. Sleep apnea can be life threatening, so treating it now can greatly improve your outlook while also improving your overall quality of life.