|Seen here is a nasal mask strapped to a patient's face.|
First of all we need some definitions:
CPAP: This is continuous positive airway pressure. It's a pressure when you exhale that helps keep your air passages open so that the next breath comes in easier. Sometimes this is all that's needed to help you get a good nights sleep so that you feel better the next day.
BiPAP: BiLevel (or Biphasic) Positive Airway Pressure. It provides a combination of IPAP and EPAP. This term is generally considered a registered name, although it is usually used as a generic term. The other term for this is NIPPV.
|Seen here is a full face mask.|
IPAP: It's Inspiratory Positive Airway Pressure. It's a boost of pressure that helps you take in a comfortable sized breath. It helps improve your ventilation and decrease your work of breathing (it can make your breathing easier). This is generally applied to help with ventilation. It is generally applied to help blow off carbon dioxide (CO2), although it can also help you improve oxygenation.
EPAP: It's the same as CPAP just under a different name. I believe it's called EPAP just so that when caregivers are referring to it they know you are talking about CPAP given with IPAP.
Ventilation: IPAP helps with ventilation. It makes sure you take in a deep enough breath to inhale enough air or oxygen, and to exhale enough CO2. It is determined by your rate and depth of breathing.
Rate: On both CPAP and BiPAP machines the patient determines the rate (although a minimal setting may be dialed into newer models)
|Seen here is the mouth-nose mask.|
Carbon dioxide (CO2): It is the waste product of cellular metabolism inside your body. If your ventilations are not adequate, it will build inside your body, thus making you sick. IPAP can help improve ventilation and help you blow off enough CO2 so you continue to feel good.
Oxygen: It is the product inside the air you need to stay alive. If your air passages collapse, perhaps while you are relaxed, sedated, or sleeping, you may have a difficult time getting in a breath. This often causes you to wake up several times during the night. CPAP or EPAP helps keep your air passages open so the next breath comes in easier. Sometimes this is all that is needed (usually only at night) to help you live a normal, functioning life during the day.
Sleep study: A study to determine if you have a problem ventilating while you are sleeping, and to test to see what machine (BiPAP or CPAP), and what settings, remedies the problem.
Home health care provider: They usually provide the equipment you use at home. They make sure you understand the equipment, and help you find a mask that works great for you. When your equipment needs servicing, these are the people you will deal with.
Respiratory Therapist: These are the caregivers who manage this equipment in the hospital settings. If you come into the hospital suffering from shortness of breath, they may work under the direction of a doctor to set you up on a CPAP or BiPAP machine. Usually he sets up the machine short term for one of several reasons. If your doctor feels you need continued use of the machines for home use, he can help you qualify and refer you to a home care provider.
|This is an example of a home BiPAP machine.|
They are generally quiet, and come with a built
in humidifier for comfort.
There are a variety of situations that would cause you to require the aid of such devices. Some of which include:
Sleep Apnea: Your airways collapse when you are in a deep sleep, and therefore you stop breathing. This causes you to be very tired the next day. This is diagnosed during a sleep study, and the remedy is CPAP while sleeping.
- Chronic Obstructive Lung Disease (COPD): A disease process prevents you from taking in an adequate breath to take in oxygen and blow of carbon dioxide. The result is your COPD gets worse. BiPAP may remedy this situation by making sure you get a
- Heart Failure (CHF): This is a disease process whereby your heart isn't working effectively, and fluid backs up in your lungs, thus making it hard to breath. Pressure from a BiPAP machine will help decrease the amount of blood returning to the heart, thereby decreasing the work of heart. The machines will also help you take in a deep enough breath to improve ventilation, and keep your lungs open to improve oxygenation. The machine, when used for this reason, is only temporary. It essentially improves work of breathing until the physician figures out what's wrong with you and fixes the problem.
This is the Respironics 460, a newer version of the Vision.
It's ideal for the hospital setting. The mask shown here is
generally the type we use in the hospital settings.
I assure you that if your doctor or caregiver recommends that you try one, then you need it. By working with your caregiver, be it a respiratory therapist, sleep study specialist, home care provider, or physician, the experience should be a good one for you. By being compliant, such machines may help improve your present medical condition, and improve the quality of your life long term.
Note: This post was originally published 8/4/08 and rewritten 9/18/13