A woman lies in bed while attaching a BiPAP machine band over her head to secure the mask in place. Share on Pinterest
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Breathing difficulties can impact your quality of life. Fortunately, a variety of machines can help you breathe better.

You may have heard of CPAP and APAP machines, but there are also bilevel positive airway pressure (BPAP) machines. “BiPAP” is a trade name, while BPAP is the type of device.

In this article, we’ll take a closer look at what BPAP machines are, how they work, and what to expect if you use one.

A BPAP is a form of non-invasive ventilation (NIV) therapy used to facilitate breathing.

BPAP machines can be used in hospitals, and are also available for those who need them at home.

Home BPAP machines are compact — about the size of a toaster. The machine features a tube that connects to a mask which is worn over your nose and mouth.

Like other ventilators, BPAP machines use pressure to push air into your lungs. Depending on the settings, this opens the lungs, improving the level of oxygen in the blood and decreasing the carbon dioxide.

These machines are called “bilevel” because they have two air pressure settings:

  • When you breathe in, BPAP machines deliver more air pressure. This is also known as inspiratory positive airway pressure (IPAP).
  • When you breathe out, the machine reduces the air pressure. This is called expiratory positive airway pressure (EPAP).

Some BPAP machines have a timer that can be programmed to maintain a certain number of breaths per minute.

BPAP machines can be used at home to treat medical conditions that make it difficult to breathe. Some conditions that it may be helpful for include:

BPAP machines may be used in hospitals to treat breathing emergencies. Because they’re non-invasive, they’re often a preferable treatment to intubation.

Doctors tend to use them in cases that aren’t severe enough to require intubation. For instance, a BPAP machine might be used to treat respiratory failure caused by a COPD flare up, pulmonary edema, or pneumonia.

They’re also used to ensure proper breathing after taking someone off intubation.

A 2020 article suggests that BPAP ventilators might be an effective therapy for people experiencing moderate breathing difficulties caused by COVID-19.

However, there’s little published data about BPAP machines for this purpose and best practices are evolving.

BPAP and CPAP machines have a lot in common. They both deliver positive air pressure (PAP) via a tabletop device connected to a tube and a mask. They can sometimes be used to treat the same conditions, and have similar side effects.

The main difference between a BPAP and CPAP machine is how the air pressure is delivered:

  • BPAP machines deliver two levels of air pressure.
  • CPAP machines deliver a continuous level of air pressure.

CPAPs are typically the first treatment option for people with obstructive sleep apnea. The continuous pressure holds the airway open and there’s no need for two pressures.

But BPAPs are an alternative when a CPAP machine isn’t working or well tolerated. They deliver a higher air pressure on inspiration, and drop the pressure on exhalation. This makes them more effective or more comfortable for some people with obstructive sleep apnea.

According to the American College of Physicians, BPAPs are the preferred treatment for some people with COPD. This is because people with COPD tend to have trouble exhaling; some may find breathing out against a continuous pressure from a CPAP machine difficult.

Another difference is that BPAP machines deliver two pressures. The more of a difference there is between the IPAP and EPAP, the more the machine helps with taking deeper breaths. This makes them well-suited to treat breathing challenges caused by neurological conditions such as ALS and muscular dystrophy.

Some BPAP machines have a timer so that the machine will deliver pressure even if the person stops breathing or is too weak to breathe. This makes them good for central sleep apnea or severe neurologic conditions.

If you’re asked to use a BPAP machine, a respiratory specialist will typically set up the machine for you. The machine needs to be calibrated and the settings adjusted according to your prescribed treatment.

Your healthcare provider will help you understand what to expect when using your BPAP machine at home, and how to use it the right way.

Depending on the condition it’s being used for, you might be asked to use it all the time, some of the time, or only when you sleep. It’s important to follow these instructions and to use it as your doctor or healthcare provider instructs you to.

The parts of a BPAP machine include a tabletop unit with a motor, tubing, and a mask. You should be familiar with all the parts, how they fit together, and how they work. The machine will come with clear instructions on how often to clean the mask and tubing.

You may find a BPAP machine uncomfortable to use at first. With time, you’ll likely find yourself getting used to wearing the mask and the airflow from the machine. If you don’t, speak to your healthcare provider to see if the settings can be adjusted, or if there’s a different option that may work well for you.

BPAP machines aren’t loud, but the sound may still take some getting used to. You may want to consider wearing earplugs if the machine disrupts your sleep.

BPAP machines are fairly safe, and pose a low risk of side effects. Most side effects are mild. They may include:

  • bloating
  • general discomfort
  • mouth dryness
  • nasal dryness
  • runny nose
  • sinus pressure
  • skin irritation from the mask

Talk to your healthcare provider about your symptoms. Often, adjustments can be made to alleviate side effects such as mouth or nasal dryness, and congestion.

If the mask’s too tight on your face and causes redness or indentation, try loosening it. If this doesn’t help, there are mask liners that you can try, but the best option is often to try another size or style of mask.

It’s important that the mask isn’t too loose on your face, since this can reduce the pressure that’s needed for the BPAP to work properly.

You can prevent this by checking the edges of the mask to make sure air isn’t escaping. Some machines even display a “mask leak” warning so you can see if it’s working the way it should.

Although infections are rare, they’re possible. You’ll need to clean the mask and tubing regularly to reduce the risk of infection.

A BPAP machine is a type of ventilator used to treat chronic conditions that affect your breathing.

It’s similar to a CPAP machine, but unlike a CPAP, which delivers a continuous level of air pressure, a BPAP delivers two levels of air pressure.

BPAP machines are typically recommended for people who have certain types of sleep apnea, as well as COPD, obesity-hypoventilation syndrome, and neurological conditions that affect breathing, like ALS.