VPAP machines are medical devices that help sleep apnea patients get a good night’s rest. They do this by providing variable positive airway pressure (hence the name “VPAP”) through the nose and throat, ensuring that your airway stays open at night so that you can breathe easily.


Technically, VPAP and BiPAP machines are the same thing—different companies may use one name or the other to describe machines that deliver two levels of air pressure rather than just one, as CPAP machines do. Like CPAP machines, VPAP and BiPAP machines help sleep apnea sufferers breathe regularly throughout the night. These two levels of pressure are called “inspiratory positive airway pressure” or IPAP and “expiratory positive airway pressure” or EPAP. IPAP is the pressure used when you inhale, while EPAP is the pressure used when you exhale.

Depending on your needs, your doctor may recommend that you use one of the following VPAP/BiPAP settings:

  • Spontaneous: Spontaneous VPAP relies on the user’s natural breath to switch between IPAP and EPAP. That means that the machine waits until the user begins taking a breath naturally to increase the pressure to the IPAP level. This setting is often recommended for VPAP users with obstructive sleep apnea, or OSA. OSA occurs when the airway collapses during sleep due to overly relaxed throat muscles. With OSA, a patient tries to take in a breath naturally, but can’t because the airway is obstructed. With the spontaneous setting on the VPAP machine, the machine senses the user trying to take in a breath and increases the airway pressure to ensure that the airway doesn’t collapse. When the user exhales, the pressure decreases slightly to make it easier for the user to breathe out.
  • Timed: Timed VPAP does not rely on the user’s natural breath, but instead uses a timed cycle of IPAP and EPAP. This rate is determined by your doctor and usually will reflect a set number of breaths per minute, or BPM. This setting is often recommended for users with central sleep apnea, or CSA. Central sleep apnea occurs when the brain forgets to signal the body to take a breath. Using the timed setting on the VPAP machine ensures that the user is taking the recommended number of breaths per minute throughout the night.
  • Spontanous/timed: The spontaneous/timed VPAP setting combines both settings. The machine starts by using the spontaneous setting but kicks into the timed setting if the user does not take the minimum number of required breaths per minute. This setting may be best for users with complex sleep apnea. Complex sleep apnea is essentially both OSA and CSA combined, where the patient’s airway sometimes becomes obstructed due to relaxed throat muscles, and sometimes the brain forgets to signal the patient’s body to breathe. Using the spontaneous/timed setting on a VPAP machine ensures that the patient is protected from both types of apneas.

Talk to your doctor about which of these settings may be right for you. Over the course of your treatment, your doctor may have you try different settings. Sometimes patients with complex sleep apnea are initially diagnosed with obstructive sleep apnea. If you’ve been using the spontaneous setting on your VPAP machine but still wake up tired in the morning, talk to your doctor about the possibility of complex sleep apnea and the spontaneous/timed setting on your machine.