resmed aircurve on nightstand with mask

What is a BiPAP Machine?

January 16, 2022 | |

This post was originally posted on January 18, 2019 and updated on January 17, 2022.

Some patients who have been prescribed CPAP therapy may have difficulties tolerating it. Oftentimes, they experience difficulties breathing normally against their current pressure settings. If breathing becomes too difficult, the patient may require a BiPAP machine.

BiPAP, or Bilevel Positive Airway Pressure, therapy machine offers dual pressure settings. Offers two prescribed pressure levels – one for inhalation (IPAP) and a reduced pressure for exhalation (EPAP). These dynamic settings help patients move more air in and out of their lungs. 

The Bilevel machine’s inspiratory pressure makes breathing in easier while the expiratory pressure makes it easier to exhale. This is especially important when pressures are in the high teens or low twenties. Breathing against a pressure in those ranges can be very difficult. Pressure settings are determined by a sleep test and the BiPAP machine provider sets the pressure levels based upon the physician’s prescription.

About BiPAP Machines  – They Have Three Different Modes

Depending on the type of Bilevel machine, it may have up to three modes of operation. A Bilevel ST machine is the most advanced and acts similarly to a ventilator. It is used for more serious respiratory illnesses.

  • Spontaneous – switching between inspiratory and expiratory as the BiPAP machine senses the switch in breathing. (standard auto Bilevel)
  • Timed – switching between inspiratory and expiratory at a programmed rate to ensure the prescribed breaths per minute rate is maintained. (Bilevel ST)
  • Spontaneous/Timed – switches as it senses the change in breathing. Timed mode functions as a fail-safe to ensure breathing at the required breathes per minute rate is maintained. (Bilevel ST)

Based on your sleep study, your physician will determine which mode your Bilevel machine should operate in.

We have created a quick BiPAP comparison chart so that you can make “at a glance” comparisons about BiPAP machines based on their size and features that are most important to you.

Example of ResMed's Vauto Aircurve BiLevel PAP (BiPap) machine on a beside table

What is the Difference Between a BiPAP Machine and a CPAP Machine?

Some sleep apnea patients cannot tolerate CPAP machines. Patients who have difficulty with continuous flow pressure or even the auto adjust flow option may need the more advanced BiPAP technology. BiPAP provides more precise settings for both inhalation and exhalation, providing a more comfortable therapy experience. 

What Do CPAP Machines Offer?What Do BiPAP Machines Offer?
Fixed Continuous Flow PressurePrecise Pressure for Inhalation (ipap)
Auto-Adjusting PressurePrecise Pressure for Exhalation (epap)

Are Refurbished BiPAP Machines Worth it?

There are certainly refurbished machines available and being sold by dealers on places like eBay. However, unless the manufacturer refurbishes the BiPAP machine, a warranty might not be available. If you purchase a BiPAP outside of the normal channels, you might end up being disappointed. As with any purchase for non-typical suppliers, buyer beware!

Do They Treat More Severe Sleep Apnea? Do Some People Graduate Down from BiPAP to CPAP?

In general, a BiPAP machine is for people who cannot tolerate a standard CPAP. There are a number of reasons that standard CPAP therapy is hard to tolerate, including difficulty breathing at the current pressure setting, or a more complex disorder. BiPAP users typically do not step down to a CPAP from a BiPAP machine unless there have been some significant changes in their diagnoses.

What Do BiPAP Settings Mean?

The settings for CPAP and BiPAP are slightly different. CPAP pressure starts much lower than BiPAP at around 5 cmH2O and increase in increments of 2 cmH2O. When patient comfort cannot be met with the limited settings of a CPAP machine, Sleep doctors usually prescribe a BiPAP. 

Initial settings on a BiPAP machine usually start around 8-10 (and can go up to 24) cmH2O for inhalation and 2-4 (up to 20) cmH2O for exhalation. With BiPAP, the inhalation pressure must be higher than the exhalation pressure so that the Bilevel air flow can be maintained.

There are three very popular ResMed BiPAP machines that work well for those who have trouble tolerating CPAP therapy.

The AirCurve 10 S BiPAP machine is a fixed pressure PAP device designed to make therapy more comfortable for non-compliant CPAP users.

The AirCurve 10 VAuto is an auto pressure PAP device designed for added comfort with features like the quiet Easy-Breathe motor and waveform that provides a more peaceful therapy environment. Its sleek design and intuitive LCD screen make it easy to use and customize, including setting time limits. 

The VAuto algorithm adjusts the baseline pressure to always keep the airway open while also maintaining a fixed pressure, automatically adjusting pressure levels to deliver the lowest pressure necessary. Built in wireless communication helps patients stay connected to their sleep apnea care team.

This machine is also travel friendly and comes with an integrated, heated humidifier. Some of the other unique features of this machine include AutoRamp and Advanced Event Detection.

AutoRamp delivers a low pressure to help patients fall asleep easily. When it detects that the patient is sleeping, it gradually ramps or increases the pressure to the prescribed setting.

Advanced event detection: This BiPAP is very effective for people who also suffer from central apneas because it can differentiate between obstructive and central apneas and deliver the appropriate therapy.

The AirCurve 10 ST machine is not only a BiPAP machine, but it also provides ventilation in order to reduce the work of breathing. This makes it a very cost effective and reliable alternative when ventilation without alarms is required.

Are There Programs for People Who Need a BiPAP Machine and Have No Insurance?

While there are no specific programs we are aware of that provide free BiPAP machines, The CPAP Shop has partnered with Bread to help patients get the equipment they need with simple payment plans and financing options. You may also want to take a look at this post we have written on the subject.

Can you Use Breathe Right Nasal Strips with a BiPAP Machine?

There is no reason not to use nasal strips while on CPAP or BiPAP therapy. In fact, if you have nasal congestion, it can be difficult to use your nasal or nasal pillow mask. Using a nasal strip might help by opening up airways thereby reducing the negative impact from nasal congestion.

Which Masks Work Best with a BiPAP Machine?

All CPAP masks work with all CPAP and BiPAP machines. A CPAP mask is one of the most important aspects of CPAP therapy. If the CPAP mask is not comfortable, fitted properly or is the wrong style for your facial features, frustration will set in and compliance will drop. 

When choosing a CPAP mask, make sure you understand the choices and try many on your face. A CPAP mask is a personal preference. Although opinions from friends and suppliers are useful, understand that your facial features might not work with that particular mask. But whatever CPAP mask you choose, it will work on any CPAP or BiPAP machine.

What is the Cost of a BiPAP Machine?

A BiPAP machine is generally more expensive than a standard CPAP machine due to the technology within the machine. The BiPAP machine is a more complex and sophisticated machine which, in severe OSA cases, can actually assist the patient’s breathing. 

A BiPAP machine typically starts around $1000 and can rise as high as $5000 for the most sophisticated and essential machines.  Of course new technology is always being developed, so check our product pages for the most up-to-date pricing.

Which BiPAP Machines Come with Humidifiers?

All new CPAP and BiPAP machines have optional humidifiers which are quite sophisticated. Humidifiers are designed to deliver the optimal temperature and humidification for CPAP users to provide additional comfort during therapy. Humidifiers typically have a few settings which increase the warmth of the air. It can also be turned off so air remains at room temperature. Humidification has also been proven to significantly reduce dryness and soreness in the nasal passages

More recently, manufacturers have added a heated CPAP tube to their humidification systems. These heated CPAP tubes help to reduce rainout which is caused by the buildup of condensation within the tube itself. Rainout can become a nuisance as it typically runs into the face of the CPAP user. 

If you want to discuss which BiPAP machine is right for you, or if you have any questions not covered in this article, you can always email or call our knowledgeable customer service representatives!