Man taking a BiPAP mask off his face
BiPAP machines are used in the hospital to treat a wide variety of conditions, such as COPD, asthma and sleep apnea.


People who have chronic obstructive pulmonary disease (COPD) often have trouble getting the air out of their lungs. The damage to their small air sacs leads to air trapping. Air trapping, along with narrowing and inflammation of the airways, can make breathing difficult. Sometimes people with COPD need a little assistance breathing by using BiPAP therapy.

What is BiPAP Therapy?

BiPAP stands for bilevel positive airway pressure. Bilevel means it delivers two separate pressures to help assist with breathing, including:

  • Inhalation positive airway pressure (IPAP)
  • Exhalation positive airway pressure (EPAP)

BiPAP machines can also be set to initiate a breath if a person does not breathe adequately on their own. A set respiratory rate on a BiPAP machine is considered a backup rate because people placed on BiPAP should have some spontaneous respirations.

BiPAP is delivered through a mask placed over the patient’s nose and mouth. The mask attaches to tubing, which is connected to the BiPAP machine.

The inspiratory pressure is delivered when a person breathes in. The expiratory pressure is delivered to the airways when the person exhales. The inspiratory pressure is set higher than the expiratory pressure to make it easier to exhale.

BiPAP machines have additional features built in that adapt to a person’s breathing patterns to make using it more comfortable. BiPAP machines are used in the hospital to treat a wide variety of conditions, such as COPD, asthma and sleep apnea. Smaller tabletop machines are also available for home use.

How Does BiPAP Therapy With COPD Work?

BiPAP assists a person’s breathing. The pressure delivered to the airways makes it easier to breathe. Easing breathing can be helpful for people with COPD during a flare-up of symptoms or if their condition becomes severe.

BiPAP therapy for COPD helps in the following ways:

Decreases Work of Breathing

Wheezing and inflammation in the lungs can make it difficult to breathe. In some cases, people with COPD work hard to get air into their lungs. The pressure from BiPAP helps decrease the work of breathing to make it easier to get air in and out.

Improves Oxygen Levels

Some people with COPD may have decreased oxygen levels either when they sleep or periodically. BiPAP increases the volume of air moving into the lungs, which results in improved oxygen levels.

Reduces Carbon Dioxide Levels

Since COPD may lead to air trapping, carbon dioxide levels can climb in people with COPD. BiPAP helps during both the inhalation and exhalation phases of breathing and assists in removing carbon dioxide from the lungs.

Benefits and Risks of BiPAP for COPD

As with most medical procedures and treatments, there are risks and benefits to using BiPAP. It’s important to work with your doctor to determine if BiPAP therapy is a good option for you.

BiPAP can be beneficial for people with COPD by making it easier for them to breathe in times of a flare up of symptoms. When breathing becomes difficult, eventually it may lead to fatigue.

Breathing may not be sufficient to remove carbon dioxide from the lungs, and respiratory failure can develop, which is life-threatening. BiPAP therapy can be used to assist with breathing and remove carbon dioxide from the lungs and treat respiratory failure.

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BiPAP is a form of non-invasive ventilation. Invasive ventilation requires intubation, which involves inserting an endotracheal tube into the lungs. Intubation and invasive ventilation have more risks and side effects than BiPAP. Using BiPAP may prevent the need for intubation while still assisting with breathing.

But there are also risks and possible side effects when using BiPAP therapy for COPD. One of the main risks is aspiration pneumonia. BiPAP delivers pressure to the lungs. If a person vomits while wearing the BiPAP mask, the pressure can force the vomit into the lungs, which can lead to pneumonia.

BiPAP can also cause side effects, including the following:

  • Dry mouth
  • Stomach pain and bloating
  • Sinus congestion
  • Feelings of claustrophobia
  • Local skin irritation from the mask

Many of the side effects of BiPAP can be reduced by taking certain precautions. For example, most BiPAP machines have built-in humidifiers. The humidifier can decrease dryness in the mouth and nose. Using a mask to cushion the face may reduce pressure sores. Feelings of claustrophobia might be reduced by using a nasal mask that only covers the nose.

If the pressure from BiPAP is uncomfortable, you can talk with your doctor about decreasing either the IPAP or the EPAP settings.


CPAP stands for continuous positive airway pressure. It also delivers pressure into the lungs. Similar to BiPAP, the pressure is delivered through a mask worn over the nose, or the nose and mouth.

The main difference is CPAP only delivers one set pressure while BiPAP delivers two different pressure settings. CPAP tends to be used for sleep apnea to prevent the airway from collapsing when sleeping. BiPAP can also be used to treat sleep apnea. But it is also used to treat respiratory distress, which may occur in people with COPD.

BiPAP therapy can be an effective treatment for people with COPD. It may prevent the need for intubation and help treat respiratory failure. But as with all therapy, it’s essential to weigh the risks versus the benefits.