CPAP use & increased chance of pneumonia

[wm_hess]

I was reading through the news when I found an article stating that people who use CPAP machines are 20% more likely to have pneumonia than other people. See the following articles.

http://www.medicaldaily.com/sleep-apnea ... ria-270464
and
http://globalnews.ca/news/1184843/peopl ... nia-study/

One of the recommendations are to make sure to keep your equipment nice and clean.

-Bill

[zoocrewphoto]

I suspect it has to do with people who have narrow airways and/or lung issues have a higher chance of illness.Not a cause and effect, but simply that the same group of people who have sleep apnea might have a higher rate of illness. Most people who use cpap seem to have the positive effect of not getting sick as often.

[chunkyfrog]

Agreed, and they are more likely to survive than those who need, but don't use cpap.

[JDS74]

I carefully read the referenced article.
In it the study describes comparing matched groups with the difference being sleep apnea or not.
Then they followed them for a period of time and noted a significant increase in risk of pneumonia in the apnea group that tracked the severity of the apnea. The more severe the apnea, the higher the risk.

The conclusion was that sleep apnea is a significant and separate risk factor for pneumonia and other infectious lung disorders.

This fits in with my personal experience. Pneumonia frequently in the late winter with one episode leading to hospitalization. That time, I had lung scarring and now have mild COPD as a result.

[Julie]

Yes, but were you on Cpap at the time (+ for how long)?

[JDS74]

For those who wish to read the original research, here is a link to the published article rather than the summary.


http://www.cmaj.ca/content/early/2014/0 ... 7.full.pdf

[Lukie]

They did not say how many of the people studied were obese or had gastric reflux. Many people who have gastric reflux take protein pump inhibitors that reduce the amount of acid in the stomach. Reducing the amount of acid in the stomach allows bacteria to grow and the person will still reflux but the material that is refluxed is full of bacteria thus making PPI users more prone to community acquired pneumonia.
Many of the co-morbid diseases of sleep apnea may make the person more prone to pneumonia. Heart disease, stroke, dementia, obesity, reflux etc etc make a person more prone.* I don't know how they can make the statement that the actual CPAP machine is responsible for increased pneumonia.

[JDS74]

They did not say that the machine was the cause.
They did say that sleep apnea and treated sleep apnea are independent risk factors for pneumonia.
The study groups were matched for comorbid conditions and that matching should remove the effects of other conditions on the study results.

The message I got from the study is to be very careful with equipment hygiene and to carefully watch for anything that could progress to pneumonia.

What they didn't say was the absolute increase in risk just the relative increase in risk.

[ubnoxus]

I was plagued with pneumonia at least once a year, sometimes twice a year prior to XPAP therapy. This was a trend for about 12 years. I have been on XPAP therapy about 7 years and had one episode of pneumonia about 2 weeks after I started therapy, and none since. So I'd say therapy has had a positive effect on my battles with pneumonia.

[chunkyfrog]

In reading the first article, I noted the article is based on data from
"Taiwan National Health Insurance Research Database"
Am I the only one uncomfortable with this?

[archangle]

BTW, pneumonia vaccines are safe and cheap. I got one for $35 at my local Walgreens. (I think.) Not 100% effective but improves the odds.

[SleepySleepNeeder]

I was plagued with pneumonia and bronchitis for years before starting CPAP therapy, but I got the pneumonia vaccine (and stopped smoking as well) several years before I started CPAP. However, I have had neither problem since starting the vaccine and CPAP therapy.

HOWEVER, I have been plagued with respiratory issues (due to bacteria in the equipment) and lack of restful sleep even with CPAP, I just couldn't keep the equipment sanitized. I suspect it was related to my use of a proton pump inhibitor (Omeprazole/Prilosec) and the lowered levers of acidity in my digestive system and probably my entire body. No matter how often I cleaned I always ended up with bacteria and breathing problems. I also sleep in a recliner so I don't have acid reflux episodes at night anymore. Anyhow, I recently found the SoClean CPAP sanitizer system that keeps all parts exposed to moisture (tank, hose, mask) sanitized using ozone in a closed environment. And it finally resolved the issue for me.

However, I did have to modify my equipment, because the SoClean adapter restricted the airflow in the hose and dropped the pressure at the mask. So, with their assistance, I acquired the parts to run the SoClean ozone tubing directly into my humidifier tank with a quick disconnect and it was very easy to install myself. The SoClean was $300 (and well worth it for the problems it solved for me) and the parts to modify it cost $22 (including S&H). If you search for SoClean in this forum, you will find the original question I posted asking if the SoClean adapter restricts airflow (it does), and at the bottom of that thread's first page (I think) you should find my instructions on acquiring the parts and how to install them.