What Is a BiPAP Machine—And Why Is It Used?

A bilevel positive airway pressure (BiPAP) machine is a non-invasive ventilation tool that helps get oxygen into your lungs. You would use a BiPAP machine if you need assistance breathing.

A BiPAP machine has a tube and mask attached to it. You wear the mask sealed tightly over your face so air cannot escape. 

The machine is commonly used to help you breathe throughout the night if you have obstructive sleep apnea, where there are sudden interruptions in breathing while you are asleep. A BiPAP machine is also used for other diseases that impair your breathing, like chronic obstructive pulmonary disease (COPD) and asthma.

What Does a BiPAP Machine Do?

A BiPAP machine helps deliver air into your lungs through positive pressure breathing. In positive pressure breathing, the air is forced into your lungs and helps in gas exchanges.

The machine supplies the pressure at two levels. When you take air into your lungs, pressure is higher. When you exhale and force the air out of your lungs, there is little to no pressure. The different levels of pressure help keep the process of breathing more natural.  

The BiPAP machine not only maintains the pressure that is required for you to breathe normally, but it also reduces the body's breathing work.

A mask that is placed on your mouth and nose supplies the air. Some smaller face masks may cover only the nose. The mask is fixed tightly so that the air cannot escape the mask; this is important to ensure that the pressure is maintained. The BiPAP machine typically supplies 16 breaths a minute, which is the normal rate for adults.

BiPAP machines also contain a humidifier so that the air going into your lungs is moist. This will help your nose and windpipe remain moist, preventing dryness and irritation from the machine’s air.

As the BiPAP machine is non-invasive, your healthcare provider doesn't have to insert any instrument or do any procedure before prescribing a BiPAP machine.

What Is a BiPAP Machine Used For?

BiPAP machines can be used for a variety of health conditions that impair breathing. They are used at home or in a hospital setting. Your healthcare provider may have you use a BiPAP machine if you have:

• Sleep apnea 
• Decreased air exchange in the lung
• A condition like muscular dystrophy that makes your breathing muscles weak
• COPD
• Respiratory failure
• Heart failure

A BiPAP machine is also used on people in end-of-life (palliative) care and those with advanced respiratory diseases. In these cases, BiPAP generally eases breathing difficulties and provides good oxygen flow to the patients.

Using a BiPAP Machine at Home

Using a BiPAP machine at home can help you manage certain conditions, such as sleep apnea.

A hose connects your face mask to the BiPAP machine. The machine is small and would typically sit on your nightstand.

If your BiPAP machine requires set up, you might need to spend a night at a sleep center. There, the healthcare provider will monitor your sleep overnight and adjust the machine’s settings accordingly. Some newer BiPAP machines are self-adjusting and might not need to be manually set up during a sleep center visit.

Using the machine for the first time, you might feel some discomfort, like pressure on the chest, or irritation. Other symptoms like eye irritation, nosebleeds, and sore or dry mouth may also occur. The symptoms usually go away after some time.

Even once you are used to the machine and use it regularly, you should still periodically follow up with your healthcare provider to check in on your condition and the need for any pressure adjustment.

Who Shouldn't Use BiPAP

Your healthcare provider will do a detailed assessment of whether you should use a BiPAP machine for your health conditions. As there are various methods that can help with breathing, your healthcare provider will talk you through the potential side effects each method carries and the benefits they can provide in the long run.

A BiPAP machine might not be the best option if you have:

• A facial injury or other physical barrier preventing a comfortable fit of the face mask
• A blockage in the airways that wouldn't let the machine’s air get into the lungs
• A need for long-term mechanical ventilation
• Gastrointestinal bleeding
• An altered mental status that makes it so that you are not cooperative with wearing the mask

BiPAP vs. CPAP

A BiPAP machine is the most used type of non-invasive positive pressure ventilation. The second most common type is the continuous positive airway pressure (CPAP) machine.

BiPAP and CPAP both provide air into your lungs via positive pressure breathing. So both generally work by forcing air into your lungs to keep the airways open and make it easier to breathe.

The main difference is that the CPAP machine delivers the same pressure of air on inhale and exhale whereas the BiPAP machine delivers air at two different levels—hence “bilevel.”

A Quick Review

A bilevel positive airway pressure (BiPAP) machine is a commonly used method of ventilation in people with sleep apnea and other health conditions that impair breathing. BiPAP machines use positive pressure ventilation, meaning they force air into your lungs. The machine works on two pressure levels where higher pressure is maintained as you inhale and low pressure is used as the air exits your lungs. 

The machine can be used from the comfort of your own bed. While you might need some time to adjust to wearing the machine’s face mask, you should eventually find yourself getting better nights’ sleep. If your symptoms don’t improve, check with your healthcare provider to see if any settings on the device should be adjusted.