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What Is a BPAP (BiPAP) Machine? How It Differs from CPAP and Who Uses It
When is BPAP preferred? Home non-invasive ventilation in COPD, obesity hypoventilation syndrome and neuromuscular diseases, and how it is monitored.
BPAP (bilevel positive airway pressure, often called "BiPAP") delivers two different pressures for breathing in and out. Like CPAP it is used with a mask, but besides keeping the airway open it can also support breathing, making it a core device for home non-invasive ventilation.
| Feature | CPAP | BPAP |
|---|---|---|
| Pressure | Single fixed (or auto range) | Separate inspiratory (IPAP) and expiratory (EPAP) pressures |
| Main aim | Keep the upper airway open | Keep it open and support breathing |
| Breathing out | Against a constant pressure | Easier at lower pressure |
| Backup breaths | Usually none | Available in some modes |
| Use | Obstructive sleep apnoea | Respiratory failure, hypoventilation, some apnoea patients intolerant of CPAP |
Who may need it?
COPD with chronic respiratory failure and high carbon dioxide, obesity hypoventilation syndrome, neuromuscular diseases such as ALS, chest wall deformities such as severe scoliosis, some apnoea patients who cannot tolerate high CPAP pressures, and some types of central sleep apnoea. Need, mode and settings are set by the doctor based on blood gases, lung function and sleep studies.
| Mode | Description |
|---|---|
| S (spontaneous) | Supports the patient's own breaths |
| S/T (spontaneous/timed) | Gives backup breaths if the patient pauses |
| T (timed) | Delivers a set number of breaths |
| Volume-targeted | Adjusts pressure to target a breathing volume |
Only the doctor and authorised technicians should change settings.
At home
- Mask fit: leaks reduce effectiveness; full-face masks are common.
- Humidification improves comfort.
- Hours of use as prescribed, usually night sleep and sometimes naps.
- Supplemental oxygen may be added at a prescribed flow.
- Skin care: protective pads on the nose bridge.
- Power plan: batteries or backup power for highly dependent users.
Monitoring: less morning headache and daytime sleepiness, less breathlessness, periodic blood gases, and review of device data on usage, leaks and breathing.
Seek urgent help for increasing breathlessness, excessive drowsiness, confusion, blue lips or deterioration despite the device.
We supply BPAP devices on prescription across Yalova with mask fitting, installation and training, supported by respiratory physiotherapy and nursing, and deliver to Bursa, Istanbul and Kocaeli–Gebze.
