The PAP machines are commonly divided into the simpler CPAP (continuous positive airway pressure) machine and the more sophisticated BiPAP (bi-level positive airway pressure) machine. The CPAP machines are further divided into fixed pressure machine and auto pressure machine. These machines pumps air through tubings and a nasal mask or face mask to keep our airway open. Other accessories including chin strap and humidifier will give further help in special situations.
The fixed pressure CPAP machine delivered a fixed and usually higher pressure than the patient usually needed constantly. It is a cheaper and yet effective machine that can keep the airway open. To define the fixed pressure to be used, another night of sleep study with the PAP machine attached will be needed.
The auto pressure CPAP machine comes with a computer that can adjust and titrate the airway pressure needed to keep the airway open at that particular time. Thus the patient will not receive a higher than needed pressure most of the time and gives extra comfort and ease, and hence a better compliance.
The BiPAP machine usually comes with auto pressure setting already. It is characterised by capable of delivering the needed pressure when the patient inspired, and then a much lower pressure when the patient expired. This design will poses least resistance to expiration which is a common complaints of patient using CPAP, thus more comfort and better compliance will be expected.
Advantages of PAP Machine
The PAP machine usually can abolish nearly all of the aponea and hypoponea episodes, and thus offer more complete treatment. Avoiding surgical management will also avoids all the post-operative complications like pain and bleeding.
Disadvantages of PAP machine
The patientS of OSA will need to use the PAP machine every night for at least 6 hours a night. In the initial weeks of treatment, majority of the patient prescribed with the PAP machine will be able to use the machines with good compliance. But many studies showed that up to 2/3 of patients will not be able to use the machines satisfactorily after 6 months for various reasons.
This group of patient if remained untreated, will have a much higher mortality and morbidity rate related to heart diseases and strokes, compared with those who could use the machines well and those who received surgical treatment.