Written by Dr. Yasmin Aghajan, MD
Reviewed by Dr. Robert S. Rosenberg, MD
CPAP (continuous positive airway pressure) is the gold standard treatment for obstructive sleep apnea (OSA). The positive airway pressure works to keep the airway open in the back of the throat so the airway does not collapse and obstruct breathing. Sleep apnea, when untreated, significantly raises the risk of heart disease, diabetes, high blood pressure, and stroke. In addition, sleep apnea results in daytime sleepiness and fatigue. Sleep apnea is diagnosed with a sleep study, which can be ordered by your clinician or by a referral to a sleep specialist. CPAP doesn’t cure sleep apnea but can treat its symptoms and reduce the risk of health complications from OSA.
CPAP is a home medical device that many people use to treat their OSA. It is used as a face mask or a nasal mask to deliver positive pressure while asleep. More than 18 million Americans use CPAP. It is a positive experience for most users, however, requires some level of commitment to maintain the machine at its optimum. One of the important tasks is to ensure the machine is clean. Dirty CPAP can be uncomfortable and lead to complications such as mold or fungus growth, and possibly bacterial infections.
CPAP and Infections
Researchers have studied the occurrence of upper respiratory infections in people using CPAP. A study was done1 to evaluate the presence of infections in people with OSA used CPAP compared to controls (people not using CPAP). Upper respiratory infections were common, but higher in patients using CPAP. People who did not clean their hot water bath humidifier had significantly more infections (57% vs. 20%) compared to patients who regularly cleaned their machines and tubing. This suggests that inadequately cleaned tubing in CPAP is a risk factor for infectious diseases.
Bacteria are everywhere in our environment. Most of the time, they do not cause harm. However, if the wrong type of bacteria grows it can become pathogenic (ie, cause disease). Specifically, for CPAP users, researchers are looking at the risk of pneumonia, upper airway infections, sinus infections, and eye infections. In fact, researchers have been studying the potential of CPAP humidification and its effect on bacterial growth. In one study, researchers contaminated the humidifier water of 11 CPAP devices with bacteria2. They found bacteria in the breathing tube in 9 out of the 11, suggesting that the humidifier may be aerosolizing (spreading through the air and vapor) the bacteria to the tubes. CPAP is still very safe to use, but it is wise to be aware of the potential for bacteria to grow in an unclean system.
Some rare reports of CPAP related to eye infections have been published in medical journals3, but doctors cannot say for sure yet if CPAP truly raises the risk of eye infection.
Mold is also present in our environment, and it loves to grow in warm and damp places such as a CPAP machine. Mold can be harmful as it can irritate the airways and lungs, causing cough or even bronchitis or pneumonitis (inflammation of the lungs). In addition, people with allergies often find their allergies or asthma exacerbated by mold. This can be avoided by keeping the CPAP clean and dry as much as possible.
CPAP and its link to infection has not been yet fully clinically studied, however these preliminary reports suggest bacterial infections may be more frequent in CPAP users and especially if the machine is not cleaned regularly.
If you frequently experience, congestion, runny nose, sore throat, skin irritation, or respiratory infections, a dirty CPAP may be contributing.
Signs of a Dirty CPAP
- You keep getting sickBacteria are everywhere in our environment, but if the wrong kind of bacteria (pathogenic bacteria, ie causing disease) gets in the CPAP system, it may cause frequent sinus infections. Common symptoms of sinus infections include headaches, pressure in the sinuses (face, forehead), post-nasal drainage, productive cough, fevers. If you are having fevers, severe headaches, or vision problems you must seek healthcare immediately.
- You notice a foul smellIf the CPAP machine smells like mildew or has any other bad odor, there may be mold or bacteria in the equipment. Because mold and bacteria grow in damp and warm environments, CPAP machines can become a breeding ground for growth.
- Your skin is irritatedIf your skin around where the CPAP mask fits is irritated, it may be from a dirty CPAP machine. Alternatively, this could be from a poorly fitting mask, for which you should speak to your provider to adjust the mask for comfort.
Keeping CPAP Equipment Clean
While the CPAP machine itself is a sterile (clean) device when purchased, it can pick up bacteria and viruses from the skin or even from contact inside your home, increasing your chances of getting sick. For this reason, it’s critical that you clean your CPAP equipment regularly. There are a few different ways to go about doing this, such as hand washing with soap and water, chemical cleaning or using CPAP wipes for on-the-go quick cleaning. However, one of the easiest and most effective ways to clean your equipment is with an automated device called the SoClean® 2 CPAP Cleaner and Sanitizer, which kills 99.9% of CPAP germs.
It’s natural for there to be some moisture, especially if your CPAP mask has a heated humidifier – but too much moisture can be a breeding ground for mold, bacteria and viruses. With this in mind, it’s important to keep your equipment as dry as possible when it’s not in use – and to allow it to dry thoroughly if you wash it with soap and water. The SoClean uses the same sanitizing process found in water purification, produce handling and hospital sanitizing to destroy 99.9% of CPAP mold, bacteria and viruses – no water or messy chemicals required. In fact, many of our happy customers who once experienced the issues listed above have reported a notable improvement since they began using the SoClean.
The SoClean uses the same sanitizing process found in water purification, produce handling and hospital sanitizing to destroy 99.9% of CPAP mold, bacteria and viruses – no water or messy chemicals required. In fact, many of our happy customers who once experienced the issues listed above have reported a notable improvement since they began using the SoClean.
1 Sanner BM, Fluerenbrock N, Kleiber-imbeck A, Mueller JB, Zidek W. Effect of continuous positive airway pressure therapy on infectious complications in patients with obstructive sleep apnea syndrome. Respiration. 2001;68(5):483-7.
2 Ortolano GA, Schaffer J, Mcalister MB, et al. Filters reduce the risk of bacterial transmission from contaminated heated humidifiers used with CPAP for obstructive sleep apnea. J Clin Sleep Med. 2007;3(7):700-5.
3 Harrison W, Pence N, Kovacich S. Anterior segment complications secondary to continuous positive airway pressure machine treatment in patients with obstructive sleep apnea. Optometry. 2007;78(7):352-5