Written by Lisa Bowman, Content Writer
A BiPAP machine is a type of medical device that’s used to help people with certain medical conditions breathe more normally, and it’s often used in the treatment of sleep-related breathing disorders like sleep apnea. The machine can be used at home or in a medical facility.
BiPAP stands for bilevel positive airway pressure’ which means that it delivers air at two different levels of pressure; a higher level when inhaling, and a lower level when exhaling1.
This guide will help you understand how the machine works, who it might be suitable for, how it differs from other positive airway pressure (PAP) devices, and how you can improve your BiPAP experience.
What Is a BiPAP Machine?
A BiPAP machine is a type of positive airway pressure device that’s often prescribed to people with sleep-related breathing disorders to be used at home while they’re sleeping. It consists of a small motorized unit, a flexible tube, and a mask, which is worn by the sleeper. The unit filters and pressurizes air that it takes in from the room, which it then delivers via the tube and mask.
Browse our picks for the Best BiPAP Machines
What Is the Purpose of a BiPAP Machine?
The purpose of a BiPAP machine is to assist a patient in breathing, via non-invasive ventilation, which means that air is delivered through a face mask rather than intubation2. This type of ventilation is used when a person can breathe on their own but needs help to get enough oxygen or remove carbon dioxide.1
The BiPAP machine delivers airflow at two set levels of pressure, which are pre-programmed by your doctor; a higher pressure to assist when breathing in, and a lower pressure to aid in breathing out. The air pressure is meant to help keep the airway open so that people can breathe easier when they sleep.
Who Would Need a BiPAP Machine?
BiPAP machines are often used to treat patients with obstructive sleep apnea (OSA) and central sleep apnea (CSA)3. In some cases, BiPAPs may be helpful for those with complex sleep apnea4, which is a combination of OSA and CSA. These machines can also be helpful for people experiencing other respiratory issues, such as chronic obstructive pulmonary disorder (COPD), obesity hypoventilation syndrome, pneumonia, asthma flare-ups, breathing complications after surgery, heart failure, and hypercapnic respiratory failure.1, 3
BiPAP vs. CPAP
What is the Difference Between a CPAP and a BiPAP?
A continuous positive airway pressure (CPAP) machine looks similar to a BiPAP machine. However, a CPAP delivers air at the same pressure, regardless of whether you’re inhaling or exhaling, whereas a BiPAP provides higher air pressure when you inhale and lower air pressure when you exhale.1 BiPAP machines can also be programmed to deliver air to the sleeper if they haven’t taken a breath within a set timeframe5.
More Information: BiPAP vs. CPAP
Why Would You Use BiPAP Instead of CPAP?
A CPAP machine is a common treatment for people diagnosed with obstructive sleep apnea6. This is a condition in which the muscles in your throat relax too much while sleeping, causing constriction of your windpipe, which can then lead to problems with breathing. The continuous air pressure provided by the machine helps to keep the airway open.
A BiPAP machine can be used to treat patients with obstructive sleep apnea who struggle to exhale7 against the constant pressure of a CPAP, and as mentioned above, BiPAP therapy might be prescribed for those with central or complex sleep apnea.3, 4
Need a CPAP Machine? Discover our picks for the Best CPAP Machines.
BiPAP vs. Other Forms of PAP Therapy
APAP
APAP stands for automatic positive airway pressure. The machine looks similar to a BiPAP machine and like a BiPAP, it can be used as treatment for obstructive sleep apnea.
However, while a BiPAP machine delivers a set dual pressure – an APAP adjusts the level of pressure throughout the night according to the patient’s breathing patterns8. The APAP stays at the same pressure for when you inhale and exhale.
ASV
ASV stands for adaptive servo-ventilation and is a newer, more complex type of PAP device. It’s similar to the BiPAP in that it delivers different levels of pressure for inhaling and exhaling. However, while a BiPAP provides pre-programmed fixed pressures, the ASV auto-adjusts pressure throughout the night.
The ASV tracks a patient’s breathing patterns and customizes different pressure levels9 to best suit the sleeper. Like BiPAP, it can also be programmed to deliver air if the user hasn’t taken a breath within a set period.5
BiPAP Therapy Benefits
- Better sleep – One of the problems with sleep apnea is that you can wake up multiple times throughout the night, which translates to poor sleep quality and tiredness the next day. By facilitating better breathing, BiPAP therapy (like other forms of PAP treatment) could lead to improved sleep.
- Less risk of health problems – Another benefit of BiPAP therapy is that it could lower your risk of health complications associated with sleep apnea10, such as cardiovascular problems, type 2 diabetes, metabolic syndrome, and problems with medication and/or surgery.
- Noninvasive – A major benefit of BiPAP therapy is that it’s noninvasive. According to the Cleveland Clinic, this means BiPAP treatment carries fewer risks to the patient than invasive forms like intubation.1 In the case of intubation, a tube is inserted into the windpipe via the nose or mouth11, which can cause infection or injury.
- Could be more effective than CPAP – BiPAP can also be useful for patients who aren’t finding a CPAP machine effective.1 This is especially true for those who’d prefer something less powerful when they exhale.
- May help transition you off life support – According to health experts, a BiPAP device may help people transition off of life support.1
What Are the Potential Risks of Using a BiPAP Device?
BiPAP machines are generally considered safe, but they still carry some risks.
- Skin irritation or air leaks – Ill-fitting masks can cause skin irritation or air leaks. In the case of air leaks, this can lead to the device not working effectively.
- Bacteria growth from poor cleaning – Not cleaning your BiPAP mask properly or regularly can also lead to bacteria growth12. Learn more about how to clean CPAP devices.
- Stomach bloating – You might end up swallowing too much air from higher air pressure settings, which could lead to stomach bloating.3
- Nasal dryness and headaches – Some people might experience nasal dryness and headaches due to sinus congestion from using their BiPAP, but a humidifier might be able to help with this.3
- May feel claustrophobic – Some people may also find using the device uncomfortable, or feel claustrophobic while wearing the mask.1
How to Use a BiPAP Machine
Your healthcare provider will prescribe you a BiPAP that has been calibrated for your needs. General steps in setting up your machine include1:
- Find a stable surface to place your machine. If it’s being used to treat sleep apnea, it should be close to your bed and a power socket. A nightstand is typically a good choice.
- Check that the humidifier (if applicable) and filter are inserted correctly, as per the manufacturer’s instructions. Attach the tubing to the device, then attach the mask to the tubing.
- While sitting upright, place the mask over your face.
- Turn the machine on.
- Adjust the mask so that it’s snug but comfortable, with no air leaks. If you’re using the machine for sleep apnea, lie down before adjusting the mask.
You will be advised how long you should use your BiPAP machine, depending on which condition it’s being used to treat, but it’s generally considered that consistent use of PAP machines delivers the best results.1
Additional Tips for Using a BiPAP
- Find a mask that works for you – We all have different face shapes and sizes, so work with your healthcare provider until you find a mask that’s both comfortable and effective.
- Ease yourself in – If you’re using a BiPAP for sleep apnea, it may feel strange wearing a mask while sleeping. Practice wearing your mask (without the machine attached) for short periods during the day to help yourself get used to it.
- Be consistent – Using your BiPAP machine intermittently will disrupt any improvements in your symptoms, so it’s important to use the BiPAP as instructed by your healthcare provider.
- Keep it clean – PAP machines can be breeding grounds for bacteria and mold if not cleaned properly, which can cause infection, illness, and skin irritation13. Clean the machine on a regular schedule, as per the manufacturer’s instructions.
Frequently Asked Questions
Is a BiPAP machine the same as a ventilator?
A BiPAP machine is a type of non-invasive mechanical ventilator that’s used to help people who can breathe on their own, but who need assistance in getting enough oxygen or reducing carbon dioxide.1People can use BiPAPs at home or in a hospital, and they involve wearing a mask that’s connected to the BiPAP device via a tube.
Invasive mechanical ventilators14 are used in hospitals, and patients use them when can’t breathe on their own. These involve having a tube inserted into the windpipe via the mouth, nose, or neck.
What does BiPAP stand for?
BiPAP stands for bilevel positive airway pressure. This means that the patient receives two levels of air pressure, typically a higher level for inhaling and a lower level for exhaling.1
How long can a person stay on BiPAP?
This will depend on why the person has been prescribed BiPAP treatment. For those with sleep apnea, BiPAP might be used indefinitely. For other conditions, the machine is usually only used until the patient is able to breathe normally again.1
Lisa Bowman
Content Writer
About Author
Lisa is a content writer for Sleep Advisor, which combines two of her greatest passions – writing and sleeping. She can also be found writing about fitness, sustainability, and vegan food.
Combination Sleeper
- 1. “BiPAP”. Cleveland Clinic. Last modified May 10, 2023. –
- 2. Gong, Yiran., et al. “Noninvasive ventilation”. StatPearls. 2022. –
- 3. “BiPap”. Johns Hopkins Medicine. Webpage accessed January 4, 2024. –
- 4. Pal’man, A.D. “Complex Sleep Apnea”. Neuroscience and Behavioural Physiology. 2018. –
- 5. “Central sleep apnea: Diagnosis & treatment”. Mayo Clinic. Last modified July 11, 2023. –
- 6. “Sleep Apnea”. Cleveland Clinic. Last modified November 15, 2022. –
- 7. Girouard, Ayla. “CPAP vs. BiPAP vs. APAP: What’s the Difference?”. National Council on Aging. 2023. –
- 8. “Positive Airway Pressure Treatment”. University of Florida Health. Last modified January 1, 2022. –
- 9. “What Is Adaptive Servo-Ventilation (ASV)?” American Thoracic Society. Webpage accessed November 6, 2023. –
- 10. “Sleep Apnea”. Mayo Clinic. Last modified April 6, 2023. –
- 11. “Intubation”. Cleveland Clinic. Last modified September 24, 2021. –
- 12. “CPAP Machine Cleaning: Ozone, UV Light Products Are Not FDA Approved”. U.S. Food and Drug Administration. 2023. –
- 13. Godman, Heidi. “Can your CPAP make you sick?”. Harvard Health Publishing. 2019. –
- 14. “Mechanical Ventilation”. Cleveland Clinic. Last modified December 2, 2022. –