Bilevel PAP

Bilevel PAP (Positive Airway Pressure) is similar to CPAP. It uses the same masks and hoses, and the machines look similar as well. With bilevel PAP, the pressure you breathe in is higher than the pressure when you exhale.

There are essentially two different reasons to use bilevel PAP instead of CPAP: Some people may find that the pressure required to keep the airway open makes it difficult to exhale. As long as the pressure is high enough while breathing in, a lower pressure can be used while exhaling. A bilevel Pap machine allows the two pressures to be different.

The more common use of the bilevel PAP machine is in treating non-obstructive breathing disorders. By breathing in more pressure than you exhale, it is sometimes possible to regulate the depth and frequency of breathing. In addition, these devices often have other settings to help control the size and regularity of each breath, both inspiration and expiration.

The bilevel PAP machines are not for everyone: they are many times more expensive than CPAP, and they are unnecessary if breathing is primarily obstructive and the pressure is well tolerated (which is usually the case.) A bilevel study is conducted the same way as a CPAP study, but it is typically much more difficult to find the correct settings. Patience, adequate time and a very experienced technologist are necessary to find optimal pressure settings. Oft times, more than one study may be necessary to provide sufficient time and exposure to all body positions and stages of sleep. In some patients, bilevel PAP alone may not be sufficient to treat all nighttime breathing problems. Your physician may need to order additional therapies to manage your breathing.