What Is a BiPAP Machine?

Kairos positive airway pressure, also called KairosPAP (KPAP), is a new, experimental approach to treating sleep apnea that may become a CPAP alternative someday. Like traditional CPAP, KPAP is a form of PAP therapy, which means it treats sleep apnea by delivering pressurized air through a tube and mask sealed on the nose or face to keep the airway open during sleep.

While CPAP therapy delivers air at one constant pressure, KPAP adjusts the air pressure according to where a person is in their breathing cycle. The Greek word kairos means “the right time,” and has been used in medicine as far back as Hippocrates to describe the importance of providing treatment when it is needed most.

The KPAP creators named the treatment KairosPAP to describe their strategic way of increasing air pressure right when doing so would be most beneficial.

KPAP therapy works via a specific algorithm, called the KPAP algorithm, to identify where a person is in their respiratory cycle and adjust air pressure of PAP therapy accordingly. The KPAP algorithm has been found to be just as effective for sleep apnea treatment as standard CPAP, while reducing the overall air pressure delivered to a sleeper by a 5 cm H₂O pressure.

The respiratory cycle or breathing cycle is a scientific way of describing the repeated pattern of inhaling and exhaling. Air pressure exerted by a PAP machine when a sleeper is breathing in is called inspiratory positive airway pressure (IPAP), while pressure exerted when a sleeper is breathing out is called expiratory positive airway pressure (EPAP).

KPAP devices reduce inspiratory pressure and the average pressure delivered with each breath using a variable pressure synced to the respiratory cycle. This approach is able to work by strategically applying pressure at the end of a sleeper’s exhale, when it will have the most impact – this is when the upper airway is most vulnerable to collapsing.

The initial research study comparing KPAP to standard CPAP found multiple potential benefits of the novel treatment.

• KPAP treated obstructive sleep apnea as effectively as CPAP, if not slightly more effectively for the individuals in the study
• KPAP improved participants’ comfort compared to CPAP in 69% to 95% of people, depending on the pressure level at which comfort was measured
• KPAP reduced air leaks by over 50% compared to CPAP

The experts behind KPAP have also implied that its pattern of delivering air pressure may reduce the development of treatment emergent central sleep apnea (TESCA). There have also been improvements in aerophagia, a condition many people on CPAP experience – especially those who use high pressure settings.

TESCA describes when a person being treated for obstructive sleep apnea with PAP therapy develops central sleep apnea. Other sleep experts have noted that more clinical research is required to better understand TESCA, as well as the potential benefits of long-term KPAP use.

CPAP therapy is a commonly prescribed treatment for obstructive sleep apnea, while KPAP is an experimental sleep apnea treatment that’s not yet available to the general public. The difference between KPAP and CPAP treatments lies in the air pressure they provide. 

Standard CPAP therapy releases air at one rate of pressure continuously as a person sleeps. KPAP releases air in a strategic pattern, with pressure dropping at the start of inspiration, or breathing in, and then dropping again at peak inspiratory flow, or the peak of inhaling. Overall, this approach allows sleepers with sleep apnea to receive just as effective treatment, with a lower rate of air pressure compared to CPAP.

Other PAP therapies, like BiPAP, also address comfort by adjusting air pressure throughout the breathing cycle. However, the creators of KPAP point out that these therapies only reduce air pressure during exhales.

The KPAP creators believe that reducing IPAP, or pressure during inhales, may further increase comfort. So far, research confirms the KPAP is more comfortable than standard CPAP in those tested, but it hasn’t yet been compared to other PAP therapies with auto-adjusting pressures.

Is KPAP FDA-approved?

KPAP is not currently FDA-approved or available in the U.S., according to its manufacturer, SleepRes.

When will KPAP be available?

SleepRes hasn’t provided an estimated timeframe for when KPAP might be available to the general public. However, the SleepRes website indicates that the company will be submitting the device for FDA approval.

Are there any known side effects of KPAP?

SleepRes hasn’t yet published information about any known side effects of KPAP. However, early research found that air leaks, a common complication of CPAP therapy that can lead to side effects, was reduced by over 50% with KPAP use in those studied.