BiPAP: Bilevel Positive Airway Pressure

Man trying on a cpap mask

Bilevel Positive Airway Pressure (BiPAP) may improve breathing in people who suffer from breathing impairment. Obstructive sleep apnea, chronic obstructive pulmonary disorder (COPD), and pneumonia are some of many health conditions that may be improved with a BiPAP machine. You may be an ideal candidate for BiPAP if you suffer from obstructive sleep apnea, but cannot tolerate continuous positive airway pressure (CPAP) or aren’t seeing improvements in your condition with CPAP.

Here’s more about how BiPAP works to improve breathing, a brief look at BiPAP vs CPAP, and potential dangers of BiPAP machines.

What is BiPAP?

BiPAP is a type of ventilator designed to help with breathing. The machine comes with a face mask or nasal plugs connected by tubes to a ventilator that pushes pressurized air into the lungs. The air pressure produced by a BiPAP machine prevents throat muscles from collapsing and causing common symptoms of sleep apnea such as snoring and pauses in breathing.

BiPAP delivers air at two alternating levels as opposed to the same level for both incoming and outgoing air. BiPAP produces a higher level of inspiratory positive airway pressure (IPAP), and a lower level of expiratory positive airway pressure (EPAP). This allows patients to comfortably breathe out without having to fight against a higher EPAP when exhaling. 

IPAP and EPAP settings are pre-chosen by your doctor and designed to alternate in a fashion similar to natural breathing. BiPAP machines may also be set to measure the number of breaths you should be taking each minute and deliver breaths at times during the night when pauses in breathing occur.

What’s the Difference Between CPAP and BiPAP?

The main difference between CPAP and BiPAP is that CPAP machines deliver the same level of pressurized air to the lungs and airways when you breathe in and when you breathe out, while the level of air pressure provided by a BiPAP machine is higher when breathing in than with breathing out. According to the Journal of Clinical Sleep Medicine, BiPAP treatment is shown to significantly improve respiratory disturbances during sleep in patients with obstructive sleep apnea who are not responsive to CPAP.

closeup of cpap nasal pillows

When Should BiPAP Be Used?

BiPAP machines are commonly used by patients who cannot tolerate CPAP machines. Some patients report difficulty when exhaling with a CPAP machine, as machines set to a high-pressure level can make patients feel as if they’re working harder than they should to exhale and breathe out. This effect compromises sleep apnea treatment, since patients may not benefit from quality sleep due to difficulties with exhaling against the CPAP.

The Journal of Thoracic Disease reports that patients who use CPAP often experience nasal discomfort and congestion to result in low rates of long-term compliance.

Your doctor may suggest using a BiPAP machine if you have sleep apnea and require a high-pressure setting, or you have not responded to treatment with a CPAP machine. According to Johns Hopkins Medicine, a BiPAP machine may also be ideal if you have comorbid disorders along with obstructive sleep apnea, such as:

  • Congestive heart failure
  • COPD
  • Pneumonia
  • Asthma
  • Obesity hypoventilation syndrome (a condition in which people who are obese cannot breathe quickly or deeply enough to cause low oxygen levels and high blood carbon dioxide levels)
  • Difficulty breathing following a surgery
  • A neurological disease that affects breathing, such as ischemic stroke
  • Another type of lung disorder

How to Use a BiPAP Machine

Most BiPAP machines work similarly to one another in that they require you to wear a face mask, nasal mask, or nasal plugs connected to a ventilator with tubes. Your doctor will provide you with instructions on how to wear the equipment, and how to activate and turn off the device when you go to sleep and wake up.

Just like with CPAP machines, sleeping with a BiPAP machine may feel awkward and uncomfortable at first. If you feel as though your BiPAP machine isn’t improving your breathing, talk to your doctor as soon as possible. The pressure settings on your BiPAP device may need adjusting to help you sleep better and reduce your sleep apnea symptoms.

Most BiPAP machines are designed to be soft, quiet, and rhythmic while you sleep so as not to disturb you or your partner during the night. Some patients wear earplugs to drown out any excess noise made by the BiPAP machine.

What Are the Dangers of BiPAP Machines?

BiPAP machines are generally very safe, though some risks do exist just like with any other medical treatment. Consuming food or drinks while wearing the BiPAP machine is not recommended, since doing so may cause you to inhale food particles and liquid into the lungs.

Other potential risks and dangers of BiPAP machines include:

  • Discomfort due to a tightly fitting face mask
  • Skin damage from wearing the mask
  • Less airway pressure delivery due to a poorly fitting mask that leaks air
  • Mild abdominal bloating
  • Eye irritation
  • Sinus pain or congestion

BiPAP machines aren’t typically dangerous, but if you experience problems while using the device, talk to your doctor immediately. Your doctor may be able to adjust its settings or work with you to find another treatment for your obstructive sleep apnea.

If you think you may be suffering from sleep apnea, a sleep study test and a proper diagnosis from a doctor can bring you one step closer toward achieving a quality night’s sleep. Consider using an at-home sleep test to help your doctor diagnose sleep apnea. A doctor can also discuss the differences between BiPAP vs CPAP, along with other available treatment options.

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8 thoughts on “BiPAP: Bilevel Positive Airway Pressure

  1. Susan Skipper-Alvarez Reply

    Have Bi Pap machine that is like new
    Hoses machine is in original carry case mask sealed in opened lines .
    Also nebulizer unit
    Diabetes test units
    Disabled son died from internal injuries related to auto crash.
    Would like to donate All Equipment

    • Kristina Jackson Reply

      I am so sorry for your loss, prayers for healing. Is this still available?

    • Wayne Reply

      Do you still have the Bi Pap unit ? I need one and Phillips recalled my CPAP machine and I have nothing to use.

  2. John Crowe Reply

    I just received my BIPAP and I’m breathing so deep that I cannot fall alseep and I’ve been trying for an hour. This is rediculous. I don’t breath this deeply when I’m awake!

  3. Anonymous Reply

    My husband needs a bi-pop machine he had apnea study test on 2018 he refuse at that time but now The problem is worse increase during the night is worse oxigen saturation gets to 88 and get very confused and he could NO sleep. Please if someone could donate a bi-machine you can reach me at [email protected]

  4. Dale Reply

    Looking to sell 3 Never used DeVilbiss bipap machines. 0 hrs on blower! Slightly older models 2) models 9055D 1) DV55D still in original packages and bags. Like NEW!

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