resmed aircurve on nightstand with mask

What is a BiPAP Machine?

Some patients who have been prescribed CPAP therapy may have difficulties tolerating it. Oftentimes, they experience 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 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 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 on 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 breaths 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.

what is a bipap machinewhat is a bipap machine

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 are BiPAP Machines?

A BiPAP machine is used when someone has a severe case of sleep apnea. They are mainly used when a person need more pressurized air than what a standard CPAP machine can offer. A BiPAP machine includes two different pressurized air options, one for inhalation and one for exhalation. 

What Do CPAP Machines Offer?

CPAP machines offer just one air constant air pressure as a patient inhales. These machines are also prescribed by healthcare providers and offer patients an effective treatment every night to help them with their sleep apnea. 

What Do BiPAP Machines Offer?

Similarly to CPAP machines, BiPAP machines also offer treatment to those with sleep apnea. They are can be used for:

  • Heavily Impaired Natural Breathing
  • Obstructive, Central, or Complex Sleep Apnea
  • Pneumonia
  • Chronic Obstructive Pulmonary Disorder (COPD)

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.

What BiPAP Machines are Most Popular?


There are top-rated ResMed BiPAP machines that work well for those who have trouble tolerating CPAP therapy.

The ResMed AirCurve 10 VAuto is an auto-pressure PAP device designed for added comfort with features like the quiet Easy-Breathe motor and waveform that provide 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 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 ResMed AirCurve 10 VAuto BiLevel Machine - Card-to-Cloud offers ultra-quiet therapy with all the same features as the popular AirCurve 10, minus cellular connectivity. This BiPAP uses the renowned AutoSet algorithm that has been further enhanced by now including central sleep apnea detection, recognition of a wider range of flow limitation shapes, and hypopnea qualification. It is also equipped with a lung compliance feature that is designed for patients with normal lung function, allowing VAuto to reduce the amount of work necessary for inhalation by providing a gentle pressure profile.

  • The ResMed AirCurve 10 VAuto Card-to-Cloud BiPAP Machine features all the same components and power as an AirCurve 10 minus the cellular communication modem. Instead, the ResMed AirCurve 10 Card-to-Cloud supports an SD card that stores sleep data. Those sleep apnea reports can be uploaded to the cloud to be shared with a provider. 
  • The built-in humidification remains constant throughout the night to provide more comfort to users.
  • The ultra-quiet operation is from the easy-breathe motor installed in this device. This motor reduces the noise significantly coming from the machine, ensuring a more peaceful sleeping environment for both you and your bed partner. 
  • This machine is compatible with up to 15 L/min of supplemental oxygen in S and CPAP mode and 4 L/min in VAuto mode. 

The ResMed AirCurve 11 VAuto BiPAP Machine includes both HumidAir™ 11 and ClimateLineAir™ 11 for enhanced comfort during BiPAP therapy. This device brings together the trusted algorithms of the AirCurve 10 with the support features of ResMed Air Solutions, an integrated sleep therapy system of PAP devices, masks, and digital health offerings engineered to work together so you experience the benefits of therapy as soon as possible and enable better coordination of care among your care team.

  • The ResMed AirCurve 11 continually monitors your unique breathing pattern on a breath-by-breath basis and makes automatic adjustments to provide therapy most comfortably throughout the night.
  • It offers ResMed's companion app, myAir, which is a sleep therapy system with online support, tips, and daily sleep tracking. 
  • This device has a sleek design, easy to pack and travel with, and is FAA-approved for in-flight use. 
  • The built-in humidification with settings you can personalize is designed to provide comfortable therapy and help prevent dry mouth and congestion.

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

This machine includes many similar features, including AutoRamp, Advanced Event Detection, and more. 
Its Easy-Breathe motor is ideal for light sleepers, as this machine does not disturb a peaceful sleeping environment for you and your bed partner.
It includes integrated humidification and an optional heated tube for even more comfort and compliance. 
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.

 This machine features four operational modes - spontaneous (S), spontaneous/timed (S/T), timed (T), and conventional CPAP mode to provide users with any type of therapy that will suit their needs. 
It provides constant, comfortable temperature and humidity levels during therapy. 
It has a lightweight and compact design, ideal for most nightstands. 

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.

How Do You Clean a BiPAP Machine?

BiPAP machines should be cleaned by disassembling and washing the parts of the machine that can be exposed to water. You can use warm water with a soft cloth and gently wipe the surface of the BiPAP machine for the removal of excessive dirt or dust. 

Its parts must also be cleaned frequently to ensure optimal performance every night. You should clean your BiPAP machine’s hoses and tubing once a week with of mild liquid dish soap and distilled water. Let them air dry completely after rinsing thoroughly before reassembling and using them again. 

Is a BiPAP a Ventilator?

Yes, the BiPAP machines fall under the category of ventilators. Ventilators and BiPAPs alike are used to treat those conditions which affect your breathing.

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 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! The CPAP Shop would be happy to help you.

This post was originally posted on January 18, 2019, and updated on February 22, 2024. . 

Chris Vasta

Chris Vasta is the president of The CPAP Shop and an expert in sleep and respiratory therapy. He often provides insights on product design and functionality on various manufacturers’ prototypes and is frequently tapped to provide reviews on new releases.