What is a BiPAP Machine?

Published September 21st, 2021 by Chris Riley
Fact Checked by
Jacqueline Hensler
Medically Reviewed:
Dr. Angel Rivera

What is a BiPAP Machine? | When do you need a BiPAP Machine? | Side Effects | BiPAP vs CPAP

BiPAP machines, also known as BPAP, are often used to treat sleep apnea, a disorder that causes people to stop breathing during their sleep, and several other medical conditions that can affect your breathing too. Sleep apnea can lead to many other conditions such as daytime drowsiness and high blood pressure so it is important to mitigate these factors if at all possible. BiPAP stands for bilevel positive airway pressure therapy. This type of treatment is different from CPAP machines, which are short for continuous positive airway pressure. We’ll take a look at what BiPAP machines do and how they work.

What is a BiPAP machine?

BiPAPs are usually small and portable so they are used in both the home and hospitals. Like most modern ventilators, they consist of a small ventilator machine that connects to a hose that can be placed over your mouth and nose. Oxygen is then pumped through the breathing hose for you to inhale through the mouth and nose pieces. 

A BiPAP machine works by providing steady airflow into the lungs. The bilevel part means that it provides two different levels of flow: one during inhalation and another for exhalation. This is why some people call them BiPAP instead of bilevel positive airway pressure or BPAP because this can get confusing. You will experience increased energy, restful sleep, better concentration, less snoring (for those who live with someone who has obstructive sleep apnea), decreased daytime fatigue, drowsiness, or sleepiness, and an overall improved quality of life. 

A bilevel positive airway pressure device, also called bilevel PAP or bilevel therapy, has two pressure settings for inhalation and exhalation. These are usually labeled as IPAP for inhaling pressure, which is the higher of the two levels, and EPAP for exhaling pressure. The difference between these two levels can be thought of like this: Imagine that you are blowing up an inflatable pool toy with your lungs–when you take in a breath to blow it up, there needs to be enough force behind that inflation to push out all of the previously exhaled air but then once all that old air is cleared out, you can breathe in normally. That additional pressure you feel once the majority of the old air has been pushed out is your IPAP, or inhalation pressure level. When it's time to exhale, that force needs to be reduced down to normal atmospheric levels so that you don't have an uncomfortable buildup of CO2, or carbon dioxide, when breathing out but then need enough pressure behind each breath while inhaling again. This second setting on bilevel PAP devices which reduces the amount of pressure needed for exhalation is called EPAP or expiratory positive airway pressures.

When do you need to use a BiPAP machine?

There are several conditions that bilevel positive airway pressure machines can help with. For example, the bilevel machine is a great way to treat people who have obstructive sleep apnea, chronic heart failure, and other breathing problems which affect their quality of life.

When bilevel therapy is prescribed, it's usually because your doctor thinks that the level of pressure needed to keep your airway open when breathing in (IPAP) needs to be higher than normal during sleep. Alternatively, bilevel devices are sometimes used for people with obstructive sleep apnea who have difficulty exhaling against high levels of pressure while sleeping. This type of setting would generally only happen if there was already some form of assistance given by using continuous positive airway pressure or CPAP. 

Some of the other common conditions that may warrant looking into getting treatment with bilevel therapy include:

  • Heart problems like congestive heart failure, or CHF
  • Neuromuscular diseases such as multiple sclerosis and amyotrophic lateral sclerosis or ALS
  • Central nervous system injuries  
  • Chronic obstructive pulmonary disorder, or COPD

People who have undergone neck surgery should also consider using bilevel therapy because it helps keep your throat open during sleep.

It is also helpful for people who have suffered from heart attacks or other types of cardiac problems that cause breathing issues. This type of therapy can help with preventing serious health complications like pneumonia and chronic pulmonary disease (COPD). BiPAP machines can also be used in treating COPD. Bilevel therapy has also been proven to be very effective in helping treat sleep apnea, especially if it's severe. Although bilevel therapy has been shown to be very effective for treating these types of respiratory disorders there are some side effects associated with using the BiPAP machine, as well as contraindications that need to be considered before starting treatment. 

Please talk to your healthcare provider should you suffer from any of these conditions and think a BiPAP machine can help you.

What are the side effects of using a BiPAP machine?

One of the most common side effects of using this type of bilevel device is claustrophobia, or an increased fear related to being in enclosed spaces such as tunnels or elevators from the mask being on your face. 

Other common side effects from using a BiPAP machine include, but are not limited to, the following:

  • Stomach bloating
  • Irritation and discomfort from the mask on your skin
  • Dry nose
  • Dry mouth 
  • Nasal congestion 
  • Sinus pain and congestion

Usually, these side effects are very mild although rare serious side effects can occur. It is also important to keep your device clean by disinfecting it to avoid infection. 

What is the difference between a BiPAP machine and CPAP machine?

Two of the most common noninvasive ventilation machines, or INV, are BiPAP and CPAP machines. But what exactly are the differences?

The main difference between the two is very simple. BiPAP machines use bilevel positive airway pressure, which means it uses two different air pressures, while CPAP machines use continuous positive airway pressure or one continuous air pressure. BiPAPs can also require more setup than CPAPs because of the two pressures, but bilevel is usually better for people with complex issues like central sleep apnea or obesity hypoventilation syndrome. 

Summary 

BiPAP machines have been proven to be very effective in treating sleep apnea, respiratory disorders, and other health issues related to breathing problems. Although there can be side effects, they are usually mild. BiPAPs also are similar to CPAP machines although they are a bit more sophisticated due to having multiple levels of air pressure instead of just one continuous stream. If you suffer from a condition that you believe a BiPAP may help, please consult your doctor to see if this treatment is right for you.

Sources: 

UC San Diego Health – What is a BPAP?

Johns Hopkins Medicine – BiPAP 

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