Bilevel Positive Airway Pressure (BiPAP or BPAP) machines, also referred to by the brand name VPAP (Variable Positive Airway Pressure) machines, are a type of breathing machine that delivers two different levels of pressure to treat sleep apnea and/or help with the movement of air in and out of the lungs. The first pressure, inspiratory positive airway pressure (IPAP), helps the user inhale while the second pressure, expiratory positive airway pressure (EPAP), helps the user exhale.
VPAP machines are used at home to treat sleep apnea and/or to improve carbon dioxide removal for individuals with certain lung and neuromuscular conditions. They are also used in hospitals during asthma and COPD (chronic obstructive pulmonary disease) exacerbations and for heart or lung conditions that affect the movement of air in and out of the lungs. The terms BiPAP and VPAP usually refer to Auto BiPAP or BiPAP S (Spontaneous) machines unless a particular type of BiPAP such as BiPAP ASV or BiPAP ST is specified. Auto BiPAP and BiPAP S devices do not deliver backup breaths to the user and the IPAP and EPAP are either fixed (BiPAP S) or adjusted automatically (Auto BiPAP) by the machine’s algorithm.
Why do I need a BiPAP/VPAP machine?
BiPAP machines are typically prescribed for one or more of the following conditions.
- Chronic Obstructive Pulmonary Disease (COPD)
- Obstructive Sleep Apnea (OSA) requiring high pressures on CPAP
Since BiPAP devices provide a lower pressure on exhalation, they are more comfortable than CPAP machines when a very high pressure (usually greater than 15 cm H2O) is required to keep the upper airway open during sleep.
How do I choose a BiPAP/VPAP machine?
When buying a BiPAP machine, it is important to keep the following factors in mind to ensure you get the best return on your investment.
- Prescription: A medical professional will provide you with a prescription specifying the appropriate pressure settings for your BiPAP machine. If you are unsure which BiPAP can accommodate your specific pressure requirements, our medical staff can help. Get in touch with us and we will point you in the right direction. Alternatively, read our comprehensive guide on the different types of CPAP and BiPAP machines to learn how they work and view sample prescription settings for each device.
- Noise level: Everyone has a different tolerance for noise so we recommend checking the decibel levels of different devices for an objective comparison.
- Humidification: Many BiPAP machines come with a built-in humidifier or can be connected to an external one. Humidification helps alleviate dryness and discomfort in the nose and throat and is important when using a BiPAP machine because BiPAP pressure settings can be quite high.
- Price: BiPAP machines have a higher price point than CPAPs due to their more complicated technology. Costs range from $1000 to around $1500 depending on the type and brand. If you don’t have insurance coverage, you may want to look into renting or purchasing through a payment plan.
- Compatibility with other accessories: Make sure you know what masks and power options are available with your BiPAP machine to avoid buyer’s regret.
BiPAP/VPAP machine features to look for
Here is a list of standard machine features you should expect from any BiPAP/VPAP machine purchased in 2023.
- Data Tracking and Reporting: Most modern BiPAPs can track data such as usage hours, pressure settings, and the frequency of apneas and hypopneas. Some BiPAPs are compatible with smartphone apps that allow users to access data remotely and may also have the ability to transmit data to medical professionals.
- Leak compensation: BiPAP machines can compensate for minor leaks around the mask, ensuring that the pressure remains consistent and therapy remains effective.
- Heated Humidifier: All BiPAP breathing machines come with heated humidifiers, whether built-in or external, that add moisture to the air for enhanced comfort. Some BiPAPs that support external humidifiers may require you to purchase the humidifiers separately.
- Heated Tube: Most BiPAPs with humidifiers support heated tubing which prevents condensation by keeping the temperature consistent along the length of the tube. Heated tubing is almost always an optional add-on.
- Supports Supplemental Oxygen: BiPAP machines allow you to add oxygen to supplement your therapy via a machine specific hose or a generic oxygen enrichment adapter. Even if you don’t require oxygen, it is a good idea to look for a BiPAP that supports supplemental oxygen because this is a standard/basic BiPAP feature. If you do use oxygen with BiPAP therapy, keep in mind that machines differ in the recommended maximum amount of oxygen that should be added into the circuit so it is a good idea to check the machine specifications regarding oxygen use.