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What Are the Different Breathing Therapies?

January 26, 2023


What are the different breathing techniques 2

When diagnosed with sleep apnea, your doctor will likely give you several options for treating the disorder, which can often be overwhelming. These options include breathing therapies like CPAP, BiPAP, APAP, ASV, EPAP, and Oxygen. Here are how each of these is used and the differences between them.

Introducing the Types of Breathing Therapies


Continuous positive airway pressure (CPAP) is often considered the gold standard when prescribing breathing therapies for obstructive sleep apnea (OSA). CPAP uses a mask to push slightly pressurized air to prevent your airway from collapsing. This pressurized air prevents apnea and snoring. There are a variety of masks that can be used with CPAP machines to help ensure comfort. 


Bilevel positive airway pressure (BiPAP) is a machine that works similarly to CPAP. It offers continuous pressurized air but slightly increases pressure on an inhale. This feature is suited for patients who find it hard to exhale into the pressurized air stream of the CPAP. BiPAP is often the favorite among breathing therapies for central sleep apnea (CSA). BiPAP is also prescribed for patients with other health conditions like chronic obstructive pulmonary disease or hypoventilation. 


Auto-adjustable positive airway pressure (APAP) monitors changes in airflow and responds to varying pressures. This breathing device is considered the most comfortable for those who dislike exhaling into pressurized air and is primarily used in patients with OSA.


Adaptive servo-ventilation (ASV) is very similar to APAP in that it monitors and responds to changes in breathing to deliver the pressure that a patient needs. The main difference is that ASV was explicitly developed for Cheyne-Stokes respirations, a condition involving hyperventilation followed by breathing lapses. ASV is usually used in patients with CSA who don’t respond to BiPAP treatment. 


Expiratory Positive Airway Pressure (EPAP) is a breathing therapy that limits airflow and creates sufficient pressure within the airway to prevent it from collapsing when the patient exhales. Unlike other PAP therapies, EPAP doesn’t use a mask to deliver pressurized air; it uses two valves that cover the nostrils. 

Oxygen for Breathing Therapy

For patients who can’t use PAP machines, oxygen is often prescribed to prevent a drop in oxygen levels while asleep. The downside of this treatment is that you still experience sleep apnea and its other symptoms, like carbon dioxide retention and fragmented sleep. Oxygen therapy is also not guaranteed to work because a blocked airway can prevent oxygen from making it to the lungs. 

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