BiPAP and VPAP Are Functionally Identical Terms
BiPAP and VPAP are simply different brand names for the same type of device: bilevel positive airway pressure ventilators. BiPAP is manufactured by Respironics (USA), while VPAP is manufactured by ResMed (Australia) 1, 2.
What They Both Do
Both devices deliver bilevel positive airway pressure, meaning they provide:
- Higher pressure during inspiration (IPAP) to assist breathing in
- Lower pressure during expiration (EPAP) to make breathing out easier and maintain airway patency
This differs from CPAP, which delivers a single continuous pressure throughout the entire respiratory cycle 1, 3, 4.
Clinical Equivalence
A head-to-head comparison study demonstrated that BiPAP-S/T and VPAP-S/T are clinically equivalent in patients with stable chronic respiratory insufficiency 2. Both devices:
- Equally support gas exchange during sleep
- Provide comparable sleep quality
- Demonstrate similar triggering reliability with mask leaks up to 30 L/min
- Achieve equivalent control of blood gases
The only practical differences identified were that VPAP is lighter and quieter (31 dB vs 43 dB at comparable settings), and VPAP may handle mouth leak slightly better during REM sleep by avoiding occasional jamming in IPAP that can occur with BiPAP 2.
When to Use Bilevel Devices (Either Brand)
According to clinical guidelines, switch from CPAP to bilevel pressure support when 1:
- Patient is uncomfortable or intolerant of high CPAP pressures
- Obstructive events persist at CPAP ≥15 cm H₂O
- Patient requires pressure support for hypoventilation syndromes 5
The choice between BiPAP versus VPAP is purely a matter of device availability and clinician/institutional preference—not clinical indication. Both deliver the same therapeutic modality with equivalent clinical outcomes.