Pneumonia and CPAP

Hi Everyone,

I had an incident this week where I woke up in the middle of the night with my lungs crackling with mucous and I was coughing into my mask. I fell back asleep, and woke up three hours later to find that I was coughing up blood, and I had an almost 102 temperature. My pressures are set to 5-20, and I varied my humidity between 0-1 on my Respironics System One APAP. I had my humidity setting low because I do not tolerate warm air blowing at my face on or off CPAP.

Recently I switched from cleaning the mask with alcohol swabs; the humidifier and tubing with vinegar and distilled water to cleaning everything with tap water and a mild non-antiseptic soap. With both types of washing, I would dry the inside of the mask and humidifier with paper towels if they did not dry completely throughout the day.

I am currently in the hospital receiving multiple antibiotics, and was told that my chest x-ray looks like I have pneumonia, or atypical pneumonia, such as Legionnaires. I have never had pneumonia in my life. I now wonder if the lack of humidity dried out my lungs, and cleaning with tap water (from a major metro area) created a perfect storm. Anyone have thoughts about this? I am looking for input because part of this sounds crazy to me, and the other part sounds realistic. I asked my doctors and all they could say was, "perhaps."

Also, I have never, ever had pneumonia. I rarely am sick from the flu. I do have a chronic runny nose that I believe is from either my allergies (I have a few), or sinusitis.

I think it's very unlikely that your lungs 'dried out' because of Cpap and/or cleaning methods. In fact I'm much more inclined to think you simply caught pneumonia somewhere (new strains are strong these days) or possibly you had your humidifier set higher, if anything, to what you needed... 'wet' air is far more of a problem than dry air when it comes to bacteria.

It's EXTREMELY unlikely (like impossible) that your pneumonia is in any way linked to your CPAP use.
Lots of people get respiratory infections and pneumonia. I had pneumonia (also coughing up blood) in April of 2011 and the hospital staff reported that in the previous few months there had been many cases of that type of thing. Several other forum members have reported having pneumonia over the last few years. We're exposed to many other people and stuff in our environments more than when we're connected to our machines. It happens.

Hope you get well soon. It's no fun.


Den

.

Thanks Julie and Wulfman,

I hate having to spend the last few days in the hospital. If I wanted a break from work, I would have chosen somewhere much more fun!


PB&J

First, let me remind everyone that pneumonia vaccines are cheap and last many years. Pneumonia can be caused by many different kinds of germs, so the vaccine doesn't protect 100%, but it probably helps.

I doubt the pneumonia was directly caused by the CPAP equipment. The germ didn't evolve there, it had to come from elsewhere and go into the CPAP machine and then into your lungs. If it found somewhere to multiply inside the CPAP equipment, it's possible that it "grew in numbers" there, but that doesn't really seem that likely.

I think it is possible that CPAP could dry you out or moisturize your nasal passages and leave you more susceptible to pneumonia, but it's equally possible it leaves you less susceptible to pneumonia.

As for tap water, you're drinking it. Every time you take a shower, you're breathing aerosolized droplets of it into your lungs. Unless you're brewing germ stew in the humidifier tank, it shouldn't be worse coming out of the CPAP.

Now that you've got it, even if there is "germ X" living in your CPAP, you've already got it in your body and all over everything. Having a few more of that germ probably won't affect your body for a while.

However, just for the heck of it, clean everything really well at least once now.

New tubing is pretty cheap if it's not heated. Buy several new tubes. If you don't already have it, I recommend having at least one set of spare parts, including water tank, hose, and mask. Your DME is usually eager to sell you replacements every x months as the insurance will pay. It's often almost as cheap to buy online. Accumulate enough sets to have a few spares. Wash one set and set it aside to dry for a week or so while you use the other set. Replace your filters in the machine.

Control III disinfectant from our host, cpap.com, is reasonably cheap. You don't need to use it every night, but you could give everything a good soak now wouldn't be a bad idea. Read the directions. It's sort of nasty until you dilute it, but it's only one ounce of concentrate per gallon and then it's fairly gentle once diluted.

There are links to the ResMed sanitization procedures in my signature line links.

If you have a spare set of parts, you can try hot water to kill off germs on one set of parts after a thorough cleaning. What I have done when I got used equipment was to take a big pot of water, bring it to a boil, turn off the heat, drop CPAP parts into it and then cover it and let it cool. Don't do this with headgear or hoses. Don't do it with anything with fabric or foam.

I have done this successfully with PRS1 series 50 water tanks, S9 dishwashable tanks, Swift FX masks, ComfortGel Blue, Oracle, and a few other masks. I did damage one of the newer model S9 "standard" tanks, although the older versions were OK. A standard hose got sort of "crinkly" when I did this.

I've read reports of people who damaged the "short hose" that's part of some masks by boiling with the heat on.

Don't try it on anything that you can't stand to lose, especially if you notice a design change.

For my regular weekly cleaning, I give everything but the headgear and hose a cycle through the dishwasher with the hottest, longest cycle my machine will do. Nothing but CPAP equipment in the dishwasher during the wash cycle.

Note that ResMed says not to clean in the dishwasher. I've done it that way for years with no problem.

Note that even boiling water won't actually kill all strains of germs and sterilize things, but it will kill off most strains of germs. Control III also won't kill off all strains of germs.

Thanks Archangel,

What is so interesting about what being diagnosed with atypical pneumonia for me is that I rarely have respiratory issues such as the flu, and never had pneumonia before. I did receive confirmation from my doctors at Univ of Penn, that bacteria can come from anywhere, and that I especially need to disinfect my equipment before reusing them after this infection. I am finally home and today I am going to use the sanitize function on my dishwasher, and will be purchasing the disinfectant specifically for my equipment. I will also be disinfecting our air conditioning system and any fans (as much as possible) as you never know.

I hate the water here. I had to laugh about the tap water. I am not originally from where I live and severely HATE the water here, I don't cook or drink with it, and as much as possible I hold my breath during showering (LOL). I'd give anything for the clean mountain water I had where I used to live!

I am faithful on my pneumonia flu and MMR vaccines, so whatever happened had to be somewhat of a fluke. If it happens again, I am seriously looking into my procedures for cleaning the machine, and the humidity levels I use (finding one that may not be comfortable for my breathing, but healthy for lungs, etc.

I have an appt with a ENT to check out my nose, and my lung doctor was attending throughout my hospitalization so, thinking I am in a good place going forward. However, any tips, tricks, hints are appreciated.

Sincerely Thankful,
PB&J

archangel wrote:First, let me remind everyone that pneumonia vaccines are cheap and last many years. Pneumonia can be caused by many different kinds of germs, so the vaccine doesn't protect 100%, but it probably helps.

I doubt the pneumonia was directly caused by the CPAP equipment. The germ didn't evolve there, it had to come from elsewhere and go into the CPAP machine and then into your lungs. If it found somewhere to multiply inside the CPAP equipment, it's possible that it "grew in numbers" there, but that doesn't really seem that likely.

I think it is possible that CPAP could dry you out or moisturize your nasal passages and leave you more susceptible to pneumonia, but it's equally possible it leaves you less susceptible to pneumonia.

As for tap water, you're drinking it. Every time you take a shower, you're breathing aerosolized droplets of it into your lungs. Unless you're brewing germ stew in the humidifier tank, it shouldn't be worse coming out of the CPAP.

Now that you've got it, even if there is "germ X" living in your CPAP, you've already got it in your body and all over everything. Having a few more of that germ probably won't affect your body for a while.

However, just for the heck of it, clean everything really well at least once now.

New tubing is pretty cheap if it's not heated. Buy several new tubes. If you don't already have it, I recommend having at least one set of spare parts, including water tank, hose, and mask. Your DME is usually eager to sell you replacements every x months as the insurance will pay. It's often almost as cheap to buy online. Accumulate enough sets to have a few spares. Wash one set and set it aside to dry for a week or so while you use the other set. Replace your filters in the machine.

Control III disinfectant from our host, cpap.com, is reasonably cheap. You don't need to use it every night, but you could give everything a good soak now wouldn't be a bad idea. Read the directions. It's sort of nasty until you dilute it, but it's only one ounce of concentrate per gallon and then it's fairly gentle once diluted.

There are links to the ResMed sanitization procedures in my signature line links.

If you have a spare set of parts, you can try hot water to kill off germs on one set of parts after a thorough cleaning. What I have done when I got used equipment was to take a big pot of water, bring it to a boil, turn off the heat, drop CPAP parts into it and then cover it and let it cool. Don't do this with headgear or hoses. Don't do it with anything with fabric or foam.

I have done this successfully with PRS1 series 50 water tanks, S9 dishwashable tanks, Swift FX masks, ComfortGel Blue, Oracle, and a few other masks. I did damage one of the newer model S9 "standard" tanks, although the older versions were OK. A standard hose got sort of "crinkly" when I did this.

I've read reports of people who damaged the "short hose" that's part of some masks by boiling with the heat on.

Don't try it on anything that you can't stand to lose, especially if you notice a design change.

For my regular weekly cleaning, I give everything but the headgear and hose a cycle through the dishwasher with the hottest, longest cycle my machine will do. Nothing but CPAP equipment in the dishwasher during the wash cycle.

Note that ResMed says not to clean in the dishwasher. I've done it that way for years with no problem.

Note that even boiling water won't actually kill all strains of germs and sterilize things, but it will kill off most strains of germs. Control III also won't kill off all strains of germs.

PB&J wrote:Thanks Archangel,

What is so interesting about what being diagnosed with atypical pneumonia for me is that I rarely have respiratory issues such as the flu, and never had pneumonia before. I did receive confirmation from my doctors at Univ of Penn, that bacteria can come from anywhere, and that I especially need to disinfect my equipment before reusing them after this infection. I am finally home and today I am going to use the sanitize function on my dishwasher, and will be purchasing the disinfectant specifically for my equipment. I will also be disinfecting our air conditioning system and any fans (as much as possible) as you never know.

I'm skeptical about reinfecting yourself from your own equipment in general, but clean the bejesus out of it anyway.

If the equipment has been in the hospital, definitely clean it thoroughly. Double especially the hose. I'd probably get a spare hose, even if I had to pay out of pocket, and clean the hose, Control III it, boil it despite the risk of damage, then sit it aside to dry and not use it for a few weeks. If it wasn't a heated hose, I'd just toss it. Unheated hoses are pretty cheap.