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How Does a BiPAP Machine Work?

author image Sandy Keefe
Sandy Keefe, M.S.N., R.N., has been a freelance writer for over five years. Her articles have appeared in numerous health-related magazines, including "Advance for Nurses" and "Advance for Long-Term Care Management." She has written short stories in anthologies such as "A Cup of Comfort for Parents of Children with Special Needs."
How Does a BiPAP Machine Work?
A young woman sleeps with a BiPAP machine on. Photo Credit: mcbworld/iStock/Getty Images

People diagnosed with obstructive sleep apnea, OAS, seldom get a good night’s sleep. As the muscles at the back of their throats relax, the upper airways may narrow or collapse during inspiration. Snoring, followed by airway collapse, leads to periods of intermittent pauses in breathing known as apnea. When the pauses are long enough or frequent enough, the brain is deprived of oxygen and it signals the body to cough, choke or gasp to re-start the breathing cycle. The person may awaken and resume normal breathing, only to repeat the cycle, according to the Mayo Clinic. A bilevel positive airway pressure, or BiPAP, machine can effectively stop this dysfunctional sleep cycle.

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Although many people are familiar with CPAP, or continuous positive airway pressure, machines, BiPAP therapy is less known. Both types of machines have a programmable unit that compresses air, masks, headgear that attaches to the face and tubing to connect the mask and machine. A BiPAP machine delivers compressed air, as a CPAP unit does, but it features two different pressures.


BiPAP machines are programmed to deliver air at an inhalation pressure, or IPAP, when the person inhales through the mask and tubing. When the person exhales, the BiPAP unit senses the change and switches to a lower exhalation pressure, or EPAP, according to Emedicine. By providing constant yet variable resistance within the upper airways, BiPAP therapy prevents the airway collapse that leads to snoring and apnea.


People who use CPAP have to breathe against constant resistance from the pre-programmed setting, but those who use BiPAP technology don’t have to work as hard to exhale against the lower EPAP. People with significant respiratory disease or those who aren’t able to acclimate to the constant pressure of CPAP may be more comfortable with BiPAP therapy, the Mayo Clinic says.


BiPAP users appreciate a more normal sleep cycle, uninterrupted by apnea and snoring, and their bed partners enjoy a better night’s sleep, too. People who use BiPAP machines say they are more alert, less drowsy, more productive and in a better mood during daytime hours. In addition, MedlinePlus reports, these people say their concentration and memory skills improve with BiPAP therapy. Untreated OAS can cause high blood pressure, stroke, cardiovascular disease and even death. According to the American Association of Oral and Maxillofacial Surgeons, BiPAP therapy reduces these long-term risks.


It takes time for new BiPAP users to feel comfortable with the sounds of the air compressor, the feel of the mask and headgear and the sight of machinery on the bedside table. The Mayo Clinic recommends that people collaborate with a doctor or sleep care professional to get the best possible fit and most comfortable BiPAP arrangement.

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