Hello Nannette:
Anytime I Am Faced with Something New I go to Joel's webpage. But let me add this, I consider bi-pap To Be My Best treatment so far for ALS. My wife and I joke that it is my "fix". It gives me energy during an afternoon nap, and when I wake up in the morning(following bi-pap) I feel hungry, rested and strong despite the progression in my arms and legs and chest. The proper mask is crucial, and I found a nasal one to be the least restrictive. That being said, if your brother is having trouble make sure the mask is fitted properly, that the device ramps up slowly and that he is tired when he goes to bed. Also if his head is propped up on the right type of pillows and he is very comfortable it will be easier to get used to it. Encourage him not to give up as it is a little scary at first. If all that fails, consider going back to the therapist or pulmonologist for help. Sometimes it takes a while to get used to, and there are several varieties of masks as well. Let us know how works out, there is a lot of help here for you.
Good luck.--JK