When shopping for a positive pressure device for treating sleep apnea, some sleepers might benefit from a bilevel or BiPAP machine rather than a traditional CPAP machine that delivers one, continuous pressure throughout the night. BiPAP machines work in a similar fashion, but they alternate between two sets of pressures: one while the sleeper is breathing in, and one while breathing out.
The BiPAP Machine vs. Exhalation Relief
Some CPAP machines come with an option that reduces pressure on exhalation, which may seem to accomplish the same task as a BiPAP machine, but they are quite different. Exhalation relief offers a slight, temporary reduction in pressure as the sleeper breathes out, so that the sleeper has to work less to exhale against the incoming air stream. This pressure drop is not a fixed amount and may vary from breath to breath.
The BiPAP machine has two distinct and preset pressures: inhalation pressure and exhalation pressure. They take the concept of exhalation relief to a new level, becoming non-invasive ventilators. If the sleeper does not take a breath within a set time, the machine will ramp up pressure and force a breath to prevent an apnea. This is not the same as a true ventilator that breathes for the patient, but the increased pressure will trigger the sleeper to take in a breath automatically.
Advantages of a BiPAP Machine
By reducing the pressure upon exhalation, the machine enables the sleeper to work less and sleep more deeply. However, most who suffer from sleep apnea will find equivalent benefits from an exhalation relief system.
The BiPAP machine has proven especially effective for patients with serious cardiopulmonary disorders such as congestive heart failure. It can also be helpful for patients with neuromuscular disease or those who need greater breathing assistance than a standard CPAP machine can provide.
Your doctor will let you know if your sleep apnea and associated medical conditions warrant the use of a BiPAP machine.
Using a BiPAP Machine
If your doctor decides that a BiPAP machine is right for you, you’ll find that it works very similarly to regular CPAP. The BiPAP machine is small, designed to fit right on your nightstand, and it runs quietly so as not to disturb your sleep. It uses the same masks and tubing as a CPAP and requires the same level of care. BiPAP machines are more likely to include options like humidifiers as standard, as they are at a higher-level than CPAP machines.
The only real difference you are likely to see in your BiPAP machine is the initial setting. While a CPAP is set for only one pressure, a BiPAP machine is set for two pressures: the IPAP (inhalation pressure) and the EPAP (exhalation pressure). Machines with a spontaneous breath timing feature will also need a target BPM (breaths per minute). All of these settings will be provided by your physician after a sleep test.
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