BiPAP therapy

Bilevel positive airway pressure (BiPAP) therapy is used to help people with respiratory conditions breathe more effectively without the need for surgery or a breathing tube. A BiPAP machine is about the size of a lunchbox and has a motor that pumps air through a flexible tube connected to a mask or nasal plugs worn over the nose or mouth.

It’s a noninvasive form of breathing assistance (ventilation) that helps maintain adequate airflow, especially during sleep or when oxygen levels drop. More comfortable than mechanical ventilation, BiPAP assists you in breathing on your own rather than breathing for you. BiPAP machines are used both in hospital settings and at home.

Penn Medicine’s pulmonology specialists are highly experienced in treating breathing disorders and provide expert supportive care for people who need respiration therapy, including BiPAP.

BiPAP therapy is used to treat breathing difficulties caused by chronic obstructive pulmonary disease (COPD), obstructive sleep apnea, congestive heart failure, central hypoventilation syndrome, and certain neuromuscular diseases. It also helps manage central sleep apnea, complex sleep apnea, severe asthma, and pneumonia with respiratory distress. BiPAP may be recommended when continuous positive airway pressure (CPAP) therapy isn’t effective or well-tolerated, and in cases of more severe respiratory distress or failure. It may not be suitable if you have very weak breathing, reduced consciousness, or difficulty swallowing.

BiPAP therapy helps you breathe more easily by delivering pressurized air through a mask that fits over your nose, mouth, or both. The machine provides two levels of air pressure (bilevel ventilation), one level when you inhale and a lower level when you exhale, making breathing feel more natural. It’s commonly used during sleep, but you may need it at other times, depending on your condition.

At first, wearing the mask may feel strange, and it can take a few days to adjust. Your respiratory care team will help make sure the settings are right for you and that the mask fits comfortably. You may notice improvements in your breathing, energy levels, and sleep quality as your body gets used to the therapy. Regular check-ins with your provider will help your BiPAP therapy continue to work effectively for your needs.

When recovering from temporary breathing issues, like from pneumonia or post-surgery complications, BiPAP may only be needed for short-term support. You can eventually stop using it as your condition improves.

For ongoing or chronic conditions, BiPAP is a long-term or lifelong therapy. The continuous use of BiPAP therapy can help manage symptoms and improve quality of life.

BiPAP therapy is generally very safe. The continuous airflow can cause dryness or irritation in the nose, throat, or mouth, or congestion or pressure in the sinuses. Some people experience discomfort from the mask, including skin irritation or pressure sores, which can be reduced by improving the fit. The increased air pressure could cause mild stomach bloating due to swallowed air. Your respiratory care team will monitor your progress and adjust your therapy as needed to address any issues.

When you or a family member needs BiPAP therapy, you’ll want to work with experts who have the experience and resources to provide the best possible support. At Penn Medicine, our pulmonologists are leaders in the field. We use advanced imaging and the latest breathing therapies to diagnose and treat people with conditions like COPD, sleep apnea, and hypoventilation syndromes. Our specialists work closely with neurologists, sleep specialists, and respiratory therapists to create treatment plans that improve breathing, enhance comfort, and support long-term health.

The Fishman Program for Home Assisted Ventilation at Penn Medicine is a national leader in noninvasive respiratory care, helping people who rely on BiPAP and other breathing support therapies at home. As one of the only programs in the country offering seamless child-to-adult transitional care, we collaborate with pediatric specialists at Children’s Hospital of Philadelphia (CHOP) to help young patients continue to receive expert care into adulthood.