When we breathe in we take oxygen (fuel) out of the air to keep us alive; the body uses the oxygen and produces carbon dioxide (a waste gas), which we then breathe out.
Some people with breathing problems only have a problem getting enough oxygen in to the body. If the oxygen level drops below a certain level it is easy to give extra oxygen for patients to breathe.
Other people, however, cannot get rid of carbon dioxide. This is more difficult to deal with. A ventilator or breathing machine is needed. In the past, in hospital, you needed a tube to be inserted into the windpipe through the mouth or through the nose. This is still what happens when people are very seriously ill. For people needing help with their breathing at home the only options used to be a tracheostomy (a hole made into the windpipe through the front of the throat) or an iron lung.
Breathing can now be helped using a cushioned mask that fits over your nose alone, or over both the nose and mouth. A strap holds the mask firmly in place, but it can easily be removed, e.g. for eating and drinking. This is described as non-invasive ventilation - NIV for short. It can be used both in hospital and at home.
Some people may get a temporary worsening of their oxygen and carbon dioxide - for instance, with a chest infection - and if this is severe enough for them to be admitted to hospital they may need to use NIV for a few days.
NIV helps you take bigger breaths by blowing in extra air when you breathe in; this increases the oxygen level and also makes you breathe out more carbon dioxide. It also takes some of the effort out of breathing and helps to ease the feeling of breathlessness. To begin with you may need the ventilator most of the time but as you get better the time spent on the ventilator becomes less and less. Most people stop using the ventilator completely after three to five days.
In a small minority of people NIV is required longer term at home. It is then usually used each night during sleep. After a period of adjustment, most people become accustomed to sleeping with the machine, find that they feel better and that the advantages of the machine far outweigh its disadvantages. It’s quiet and doesn’t usually disturb the bed partner’s sleep. The machine is not heavy and can be taken on holiday, either in this country or abroad (check voltages, though!). But you will need to discuss with your health professional whether you might need oxygen during any air travel (for more information on travel, please go here).
Page last medically reviewed: Feb '05
