Private BiPAP (Bilevel Positive Airway Pressure)

What is BiPAP?

BiPAP (bilevel positive airway pressure) is a form of non-invasive ventilation. It supports breathing by delivering pressurised air through a mask worn over the nose, or nose and mouth, while you sleep.

Unlike continuous positive airway pressure (CPAP), which delivers air at one constant pressure, BiPAP uses 2 different pressure levels:

• a higher pressure when you breathe in to support inhalation
• a lower pressure when you breathe out to make exhalation more comfortable

This difference in pressure makes BiPAP easier to tolerate for some people and more effective for certain breathing conditions.

BiPAP is most often used when the body doesn’t remove carbon dioxide properly during sleep. This is known as nocturnal hypoventilation. When carbon dioxide builds up, it can disrupt sleep, reduce oxygen levels, and place extra stress on the heart, lungs, and brain.

Conditions where BiPAP may be recommended include:

• sleep-related hypoventilation syndromes
• neuromuscular conditions that affect the breathing muscles
• chest wall disorders
• chronic lung disease
• sleep-disordered breathing where CPAP has not been effective or tolerated

To determine if BiPAP is suitable for you, you’ll usually need to undergo overnight carbon dioxide monitoring, most commonly with a TOSCA sleep study carried out at your home. 

This test measures oxygen levels, carbon dioxide levels, breathing patterns, and heart rate while you sleep. It allows your consultant to identify whether your body is retaining too much carbon dioxide and whether BiPAP is the most appropriate treatment. 

At Welbeck, your care will be coordinated by our specialist respiratory and sleep consultants within our Lung Health centre. You’ll have rapid access to assessment and at-home machine setup, with ongoing support that focuses on improving your breathing, sleep quality, and wellbeing.

What does BiPAP involve?

Before BiPAP is prescribed, you’ll have a consultation with a Welbeck respiratory or sleep consultant. This appointment focuses on understanding your symptoms, sleep quality, breathing patterns, and overall health.

Diagnosis is usually based on an overnight carbon dioxide monitoring sleep study, known as a TOSCA study, carried out at your home. This test measures carbon dioxide and oxygen levels while you sleep, and helps confirm whether hypoventilation is present.

Your consultant will review:

• your medical history
• current symptoms, such as morning headaches, daytime sleepiness, or breathlessness
• results from the TOSCA study
• any previous sleep or breathing treatments

Once BiPAP has been prescribed, our specialist provider will arrange delivery and setup of the BiPAP machine and mask.

The equipment includes:

• a BiPAP machine that delivers bilevel airway pressures
• a mask chosen to suit your face shape, and breathing needs
• tubing and filters
• settings programmed to your individual requirements

During the setup visit, you’ll be shown how to:

• put on and remove the mask
• turn the machine on and off
• clean and maintain the equipment
• recognise common issues and when to seek advice

Once the machine is set up and you understand how to use it, you’ll use BiPAP each night while sleeping. The machine supports each breath, helping maintain stable oxygen levels and preventing carbon dioxide buildup overnight.

Follow-up appointments will be arranged with your consultant to review your symptoms and adjust the machine settings if needed. 

What are the risks of BiPAP?

BiPAP is a well-established and safe treatment. Most side effects are mild and manageable, and your team will support you through any adjustments.

Possible side effects include:

• dryness of the nose or mouth
• mild bloating from swallowed air
• mask discomfort, or skin irritation
• difficulty adjusting to the sensation of pressurised air

Rarely, some people may feel claustrophobic or anxious when first using the mask. Your team will be able to support you with this, and mask adjustments, and gradual acclimatisation usually help. 

Serious complications of BiPAP are extremely rare. 

How to prepare for BiPAP

Before you can start BiPAP therapy, you’ll need to have an assessment with one of our respiratory and sleep consultants, and usually a TOSCA sleep study. 

On the day of your home setup:

• choose a quiet space for the appointment
• wear comfortable clothing
• allow enough time to learn how the device works

If you have concerns about comfort, anxiety, or mask fit, you can talk to your consultant beforehand or the team on the day of setup.

Recovery and aftercare

When you start BiPAP, there’s usually an adjustment period as you get used to sleeping with the machine.

In the first few nights, it’s normal to notice the mask or the sensation of airflow. This usually improves as your body adapts. Many people report better sleep quality, improved alertness, and fewer morning symptoms within days.

At Welbeck, you’ll have follow-up appointments with your consultant to:

• review how you’re feeling
• check usage data from the machine
• adjust pressure settings if needed
• address comfort or mask issues

If you experience new symptoms, discomfort, or problems with the equipment, our team is available to help resolve these promptly.

You can continue normal daily activities, including work and exercise, unless advised otherwise. BiPAP is intended for long-term use, and consistency is key to gaining full benefit.

How much does private BiPAP cost?

The self-pay cost for private BiPAP therapy at Welbeck is £4,550.

This includes the machine, all equipment, including a mask, and the coordination of a home setup. Please contact the Lung Health centre for more pricing information.