APAP Machines Improve Compliance and Reduce Sleepiness

Automation is the dream of modern life. Just take driving a car for example – an automatic transmission makes for a much more pleasant drive than a manual transmission. Automatic doors. Automatic clocks. Remember winding your watch? – Of course you don’t, because now it’s automatic. When it comes to CPAP treatment, the same thing applies. Automotive positive airway pressure, or APAP, machines offer a versatile and adaptable therapy option compared to CPAPs, which provide only a single and continuous stream of pressurized air. Now, a study stays that APAPs can improve compliance and reduce sleepiness.

CPAP therapy is the most common therapy option for treating obstructive sleep apnea, but what doctors and sleep specialists kept noticing is that patients were having a hard time complying with treatment. This is why APAPs, or auto-titrating, machines were introduced to the market – as an answer to the problem of compliance. But are APAP machines really that much more effective? In 2009, The Cochrane Collaboration – an internationally recognized and lauded research group – surmised that auto-PAPs were nominally more effective. A few years later, researchers from Tufts University School of Medicine wanted to expand on that study – to find out more about the effectiveness of APAP versus CPAP.


Automatic positive airways pressure is unique because it incorporates advanced algorithmic technology to measure breathing patterns, body movements and even sleeping positions. What in the world does algorithmic mean? An algorithm is basically like the smartest person in the room – it is able to count to infinity in a nanosecond and it can predict the future. Plug one into a CPAP machine and magic happens. Based on the resistance of your breath and a number of other factors, an auto-titrating machine can provide the user with the optimal pressure setting at exactly the right moment throughout the entire night.

Researchers at Tufts, working with the information from the Cochran Collaboration and a number of other studies, wanted to not only find out if APAP was more effective than CPAP, but also if APAP improved quality of life, compliance and even sleepiness. So, researchers used numerous methods and poured over thousands of studies. Data was extracted. Data was analyzed. Data was broken down. Researchers covered all the bases – from the frequency of nightly arousals to multiple sleep latency, which is a measure used to determine how long it takes for someone to fall asleep during the middle of day. They also calculated compliance ratios.

At the end of all their data crunching, the researchers had all the information they needed. The results were surprising, but not shocking. For one thing, APAP improved compliance – patients were able to stick to APAP longer than CPAP across the board. Moreover, the test results revealed that people who use APAP machines also had decreased levels of sleepiness upon waking. While the researchers of this empirical study are making no suggestions, it is clear that if you want to adhere better to treatment and have a much more comfortable therapy experience, an APAP machine may be your best option.  There are a few APAPs to choose from.  We recommend the S9 AutoSet by ResMed because it’s the lightest and quietest auto-titrating machine on the market – patients love it!


Source: D’Ambrosio C, Patel K, Obadan N, Kitsios GD, Chung M, Balk EM. “Auto-titrating versus fixed continuous positive airway pressure for the treatment of obstructive sleep apnea: a systematic review with meta-analyses.” Institute of Clinical Research and Health Policy Studies, Tufts University School of Medicine, Tufts Medical Center, Boston, MA, USA. March 8th 2012.