Table of ContentsView AllTable of ContentsHow It WorksUsesBiPAP vs. CPAPBiPAP vs. Bilevel vs. VPAPUsage InstructionsSide EffectsFAQ

Table of ContentsView All

View All

Table of Contents

How It Works

Uses

BiPAP vs. CPAP

BiPAP vs. Bilevel vs. VPAP

Usage Instructions

Side Effects

FAQ

This article explains how BiPAP is used to treatobstructive sleep apnea(OSA) andcentral sleep apnea(CSA). It also covers how to get used to wearing a BiPAP machine and the possible risks of the treatment.

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Man sleeping with BiPAP mask on his face

How Does a BiPAP Machine Work?

A BiPAP machine is used when you can breathe on your own, but still need some help pushing air into your lungs to maintain healthy oxygen levels in your body. BiPAP can be used in medical settings (like hospitals) and at home.

There are a couple of pressurized air settings your provider can prescribe for your BiPAP machine. These settings alternate just like your breathing pattern:

There are also a few other important BiPAP settings:

1:35Click Play to Learn About BiPAP

1:35

Click Play to Learn About BiPAP

When BiPAP Therapy Is Used

BiPAP with a backup respiratory rate is a form of breathing support used to treat CSA—a condition that happens when the brain does not send signals to the muscles that control breathing. The result is prolonged gaps in breathing.

The cause of CSA is not always known but is sometimes seen in people who have:

Providers may prescribe it for severe cases of OSA, a more common type of sleep apnea that happens when your upper airway is partially or completely blocked.

BiPAP is beneficial when there is mixed sleep apnea, meaning that there are components of both CSA and OSA.

In certain cases ofCOVID-19, BiPAP can be used to delaymechanical ventilation.

In addition to treating central sleep apnea, BiPAP is also helpful for:

What Is a Sleep Study (Polysomnogram)?

A BiPAP machine is similar to a standard CPAP machine—for example, it requires a face mask and tubing connected to the device. However, there are some differences betweenBiPAP and CPAP:

There is often confusion about the words “BiPAP,” “bilevel,” “biphasic," “BPAP,” and “variable positive airway pressure” or “VPAP." All these terms basically mean the same thing, but the names of the devices are different depending on who makes them:

How to Use BiPAP

If you’re just starting with a BiPAP machine, you might want to try using it during the day while you’re resting so you can get used to how it feels, looks, and sounds. If you can get more comfortable with it while you’re awake, that can help you adjust to sleeping with it. Running it while you’re taking a nap can also help, even if it’s just for an hour.

What Are the Side Effects of BiPAP Use?

There are some side effects that can happen with a BiPAP, including:

It’s also possible that a BiPAP machine can leak or not work correctly, which means you won’t be getting the help breathing that you need.If you notice any problems with the machine, let your provider know right away.

Summary

BiPAP machines can help you if you’re struggling to breathe well on your own, especially while you’re asleep. BiPAP can be an alternative to CPAP for people with conditions like OSA and CSA who either do not benefit from or do not want to be on a ventilator.

Working with asleep specialistcan help you find out if BiPAP would be a beneficial option.

Frequently Asked QuestionsIn theory, you can be on BiPAP indefinitely. Even so, the device is not intended to be used full-time in the same way assupplemental oxygen therapyfor people with COPD. Using BiPAP continuously for longer than 24 hours can causepressure ulcers, severe nasal tissue injury, and eventissue death.Lung injury is not a recognized complication of BiPAP.BiPAP is a machine used to treat sleep apnea and other conditions in which a person is still able to breathe but needs assistance. Mechanical ventilation is used when a person cannot breathe well enough on their own to support the body’s need for oxygen.

Frequently Asked Questions

In theory, you can be on BiPAP indefinitely. Even so, the device is not intended to be used full-time in the same way assupplemental oxygen therapyfor people with COPD. Using BiPAP continuously for longer than 24 hours can causepressure ulcers, severe nasal tissue injury, and eventissue death.

Lung injury is not a recognized complication of BiPAP.

BiPAP is a machine used to treat sleep apnea and other conditions in which a person is still able to breathe but needs assistance. Mechanical ventilation is used when a person cannot breathe well enough on their own to support the body’s need for oxygen.

10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Moga AM, de Marchie M, Saey D, Spahija J.Bi-level positive airway pressure (BiPAP) with standard exhalation valve does not improve maximum exercise capacity in patients with COPD.COPD. 2015;12(1):46-54. doi:10.3109/15412555.2014.908830Guan L, Wu W, Huo Y, et al.Efficacy of bilevel positive airway pressure and continuous positive airway pressure therapy in patients with obesity hypoventilation syndrome: protocol for systematic review and meta-analysis.BMJ Open.2018;8(5):e020832. doi:10.1136/bmjopen-2017-020832Mansukhani MP, Kolla BP, Olson EJ, Ramar K, Morgenthaler TI.Bilevel positive airway pressure for obstructive sleep apnea.Expert Rev Med Devices. 2014;11(3):283-294. doi:10.1586/17434440.2014.900435Berbenetz N, Wang Y, Brown J, et al.Non‐invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema.Cochrane Database Syst Rev.2019;4(4):CD005351. doi:10.1002/14651858.CD005351.pub4Carter C, Aedy H, Notter J.COVID-19 disease: non-invasive ventilation and high frequency nasal oxygenation.Clin Integr Care.2020;1:100006. doi:10.1016/j.intcar.2020.100006BMC BPAP.How to use BiPAP machines correctly.University of Rochester Medical Center.BiPap.Johns Hopkins.BiPap.Rathore FA, Ahmad F, Zahoor MUU.Case report of a pressure ulcer occurring over the nasal bridge due to a non-invasive ventilation facial mask.Cureus.2016 Oct;8(10):e813. doi:10.7759/cureus.813Katira BH.Ventilator-induced lung injury: classic and novel concepts.Respir Care. 2019;64(6):629-637. doi:10.4187/respcare.07055

10 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Moga AM, de Marchie M, Saey D, Spahija J.Bi-level positive airway pressure (BiPAP) with standard exhalation valve does not improve maximum exercise capacity in patients with COPD.COPD. 2015;12(1):46-54. doi:10.3109/15412555.2014.908830Guan L, Wu W, Huo Y, et al.Efficacy of bilevel positive airway pressure and continuous positive airway pressure therapy in patients with obesity hypoventilation syndrome: protocol for systematic review and meta-analysis.BMJ Open.2018;8(5):e020832. doi:10.1136/bmjopen-2017-020832Mansukhani MP, Kolla BP, Olson EJ, Ramar K, Morgenthaler TI.Bilevel positive airway pressure for obstructive sleep apnea.Expert Rev Med Devices. 2014;11(3):283-294. doi:10.1586/17434440.2014.900435Berbenetz N, Wang Y, Brown J, et al.Non‐invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema.Cochrane Database Syst Rev.2019;4(4):CD005351. doi:10.1002/14651858.CD005351.pub4Carter C, Aedy H, Notter J.COVID-19 disease: non-invasive ventilation and high frequency nasal oxygenation.Clin Integr Care.2020;1:100006. doi:10.1016/j.intcar.2020.100006BMC BPAP.How to use BiPAP machines correctly.University of Rochester Medical Center.BiPap.Johns Hopkins.BiPap.Rathore FA, Ahmad F, Zahoor MUU.Case report of a pressure ulcer occurring over the nasal bridge due to a non-invasive ventilation facial mask.Cureus.2016 Oct;8(10):e813. doi:10.7759/cureus.813Katira BH.Ventilator-induced lung injury: classic and novel concepts.Respir Care. 2019;64(6):629-637. doi:10.4187/respcare.07055

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Moga AM, de Marchie M, Saey D, Spahija J.Bi-level positive airway pressure (BiPAP) with standard exhalation valve does not improve maximum exercise capacity in patients with COPD.COPD. 2015;12(1):46-54. doi:10.3109/15412555.2014.908830Guan L, Wu W, Huo Y, et al.Efficacy of bilevel positive airway pressure and continuous positive airway pressure therapy in patients with obesity hypoventilation syndrome: protocol for systematic review and meta-analysis.BMJ Open.2018;8(5):e020832. doi:10.1136/bmjopen-2017-020832Mansukhani MP, Kolla BP, Olson EJ, Ramar K, Morgenthaler TI.Bilevel positive airway pressure for obstructive sleep apnea.Expert Rev Med Devices. 2014;11(3):283-294. doi:10.1586/17434440.2014.900435Berbenetz N, Wang Y, Brown J, et al.Non‐invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema.Cochrane Database Syst Rev.2019;4(4):CD005351. doi:10.1002/14651858.CD005351.pub4Carter C, Aedy H, Notter J.COVID-19 disease: non-invasive ventilation and high frequency nasal oxygenation.Clin Integr Care.2020;1:100006. doi:10.1016/j.intcar.2020.100006BMC BPAP.How to use BiPAP machines correctly.University of Rochester Medical Center.BiPap.Johns Hopkins.BiPap.Rathore FA, Ahmad F, Zahoor MUU.Case report of a pressure ulcer occurring over the nasal bridge due to a non-invasive ventilation facial mask.Cureus.2016 Oct;8(10):e813. doi:10.7759/cureus.813Katira BH.Ventilator-induced lung injury: classic and novel concepts.Respir Care. 2019;64(6):629-637. doi:10.4187/respcare.07055

Moga AM, de Marchie M, Saey D, Spahija J.Bi-level positive airway pressure (BiPAP) with standard exhalation valve does not improve maximum exercise capacity in patients with COPD.COPD. 2015;12(1):46-54. doi:10.3109/15412555.2014.908830

Guan L, Wu W, Huo Y, et al.Efficacy of bilevel positive airway pressure and continuous positive airway pressure therapy in patients with obesity hypoventilation syndrome: protocol for systematic review and meta-analysis.BMJ Open.2018;8(5):e020832. doi:10.1136/bmjopen-2017-020832

Mansukhani MP, Kolla BP, Olson EJ, Ramar K, Morgenthaler TI.Bilevel positive airway pressure for obstructive sleep apnea.Expert Rev Med Devices. 2014;11(3):283-294. doi:10.1586/17434440.2014.900435

Berbenetz N, Wang Y, Brown J, et al.Non‐invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema.Cochrane Database Syst Rev.2019;4(4):CD005351. doi:10.1002/14651858.CD005351.pub4

Carter C, Aedy H, Notter J.COVID-19 disease: non-invasive ventilation and high frequency nasal oxygenation.Clin Integr Care.2020;1:100006. doi:10.1016/j.intcar.2020.100006

BMC BPAP.How to use BiPAP machines correctly.

University of Rochester Medical Center.BiPap.

Johns Hopkins.BiPap.

Rathore FA, Ahmad F, Zahoor MUU.Case report of a pressure ulcer occurring over the nasal bridge due to a non-invasive ventilation facial mask.Cureus.2016 Oct;8(10):e813. doi:10.7759/cureus.813

Katira BH.Ventilator-induced lung injury: classic and novel concepts.Respir Care. 2019;64(6):629-637. doi:10.4187/respcare.07055

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