A BiPAP machine, or Bilevel Positive Airway Pressure, is used to treat obstructive sleep apnea (OSA), a condition where the airway repeatedly collapses during sleep. This collapse causes the loud, disruptive sound known as snoring. The goal of BiPAP therapy is generally to eliminate snoring completely. However, snoring can persist for some users even with diligent machine use, leading to questions about the therapy’s effectiveness. This article explores how BiPAP prevents snoring and the common reasons why this goal might not be achieved.
How BiPAP Works to Stop Snoring
The mechanism by which BiPAP suppresses snoring is maintaining an open upper airway. Snoring occurs when relaxed throat tissues vibrate as air passes through a narrowed passage. The BiPAP machine delivers pressurized air through a mask, creating an “air splint” that prevents these tissues from collapsing and vibrating.
Unlike Continuous Positive Airway Pressure (CPAP), which delivers a single, constant pressure, BiPAP offers two distinct pressure levels. A higher pressure, Inspiratory Positive Airway Pressure (IPAP), is delivered when the user inhales, providing maximum force to push the airway open. A lower pressure, Expiratory Positive Airway Pressure (EPAP), is maintained during exhalation, making it easier for the user to breathe out against the pressure.
The dual-pressure setting ensures the throat remains adequately supported during the breathing cycle. By maintaining airway patency throughout the night, the machine eliminates the tissue vibration that causes snoring. This mechanical support resolves the physical obstruction that is the primary source of sound in obstructive sleep apnea.
Causes of Persistent Snoring While Using BiPAP
The persistence of snoring often indicates a mechanical or physiological mismatch between the therapy and the user’s needs. One of the most common issues is an improper seal or a significant air leak from the mask. When air escapes, the actual pressure delivered to the airway is reduced, which is insufficient to keep the throat fully open and prevent vibration.
Snoring can also continue if the prescribed pressure settings are no longer adequate for the user’s current physical state. Weight gain, for instance, can increase the amount of soft tissue around the neck, requiring a higher pressure than the original setting to prevent airway collapse. Conversely, if the pressure is too high, air can leak from the mouth, creating a sound that mimics snoring.
Another factor involves snoring not strictly caused by obstructive sleep apnea but by other upper airway issues. Persistent nasal congestion from allergies, a cold, or a deviated septum can force a user to breathe through the mouth, causing snoring even with the machine running. Furthermore, the use of alcohol or sedatives before bed can excessively relax the throat muscles, potentially requiring a pressure increase beyond the current setting.
Troubleshooting and Next Steps for Ongoing Snoring
Users experiencing residual snoring should first focus on simple equipment checks to ensure the therapy is being delivered as intended.
Equipment Checks
- The fit of the mask should be checked nightly.
- A mask that whistles, hisses, or shifts frequently is likely leaking and needs adjustment or replacement.
- Cushions and headgear wear out over time.
- Replacing cushions and headgear every few months can restore an effective seal.
If the equipment appears sound, the next step involves reviewing the therapy data, which can often be accessed through the machine or a provider’s software. This data shows the average leak rate and the Apnea-Hypopnea Index (AHI), which helps determine if the machine is effectively treating the underlying condition. If the AHI remains elevated, it suggests the current pressure settings are insufficient.
The most important action is to consult with the sleep physician or specialist who manages the BiPAP therapy. They can analyze the usage data and determine if a pressure change is necessary. Never attempt to adjust the machine’s pressure settings independently, as this compromises the effectiveness of the treatment and safety. If self-troubleshooting and minor adjustments are unsuccessful, a follow-up sleep study may be required to recalibrate the pressure prescription based on the user’s current physiological needs.