How to Set Pressure on a Respironics BiPAP

Written by sandy keefe
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If you have obstructive sleep apnoea, you know you spend your sleeping hours snoring, gasping for breath and then resuming normal breathing before restarting the cycle again. A bilevel positive airway pressure (BiPAP) machine, such as the Harmony model from Respironics, compresses room air for delivery by way of a snug-fitting nasal or facial mask and tubing. It delivers air at a higher pressure when you inhale and a lower pressure when you exhale to treat sleep apnoea. You can change some pressure settings to improve your comfort at night.

Skill level:
Moderately Challenging


  1. 1

    Find the standby and monitoring screens. You can adjust various BiPAP settings from either of these two screens. Plug the BiPAP in and watch the display on the top of the unit until you see the standby screen, which will show the words "Apnea," "Light" and "Hours". Hold down the "Pressure on/off" button on the control panel until you see the monitoring screen on the display. It will read "Apnea," "Light" and "S/T."

  2. 2

    Set the flex pressure. From the standby or monitoring screen, use the right and left arrow keys to scroll through display screens until you locate the one labelled "Flex." Use the "Heat" and "Ramp" keys on the control panel to adjust the amount of pressure relief desired when you exhale: least (1), medium (2) or highest relief (3).

  3. 3

    Establish the rise time. This determines how long it takes your machine to change from the exhalation pressure to the inhalation pressure. From the standby or monitoring screen, press the right "User" button on the control panel until the display reads "Rise time." Use the "Heat" button to increase the number and the "Ramp" button to decrease it. You can choose a rise time from 1 (fastest) to 6 (slowest).

  4. 4

    Set the ramp start pressure. This option tells the BiPAP to deliver a lower air pressure while you're falling asleep and to gradually increase (ramp) the pressure over a period of time. Go to the standby or monitoring screen, and press the right "User" button until the display read "Ramp start." Press the "Heat" button to raise the number and the "Ramp" button to lower it. Choose a ramp start pressure between 4 and your preprogrammed exhalation pressure.

Tips and warnings

  • You can also change other parameters on the Harmony BiPAP machine. You can alter the degree of humidity in the air delivered through the system and set the LED backlighting to be on or off.
  • Your Harmony BiPAP machine will come preprogrammed with some settings determined by your doctor based on the results of your sleep study. If you make significant changes, you may find your machine doesn't give you a good night's sleep.

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