Help this sleep reseacher answer a CPAP patient's question

[UMsleepresearcher]

Hi Everyone,

I am a sleep researcher from the University of Michigan (U-M). U-M recently started a new research campaign (called "WellSpringboard") that allows patients and the public to decide what research questions should be studied. Fortunately, one of their priority areas is SLEEP! Patients' questions are assigned to a researcher in their area of interest and then the researcher designs a project to answer the question. However, they only have 30 days in total to crowd-fund the project.

As my research focuses on sleep apnea, I was asked to help answer a patient's question about whether prolonged CPAP use could increase the risk of upper respiratory infections, as this is a concern of hers. I was shocked to see that very little work has been done in this area, so I designed a project to answer this important question, and now we only have a few more days to reach our goal to fund the project!

I was just introduced to the CPAPtalk forum today, and think it would be a wonderful way to help us meet our funding goal, and also to spread the word through social media to make other people with sleep apnea aware of the project. WE NEED PATIENTS LIKE YOU who understand the impact of obstructive sleep apnea to help us advance the field, and make a difference in the health of the millions of Americans who have this condition.

Any support you can provide would be tremendously appreciated. Please visit the University of Michigan WellSpringboard website (and click on "matched ideas") to view videos about our project, and find out how you can donate.

Thanks in advance, and Best Regards,
Tiffany Braley, MD, MS
Assistant Professor of Neurology
University of Michigan Health System

[Wulfman...]

Hi Everyone,

I am a sleep researcher from the University of Michigan (U-M). U-M recently started a new research campaign (called "WellSpringboard") that allows patients and the public to decide what research questions should be studied. Fortunately, one of their priority areas is SLEEP! Patients' questions are assigned to a researcher in their area of interest and then the researcher designs a project to answer the question. However, they only have 30 days in total to crowd-fund the project.

As my research focuses on sleep apnea, I was asked to help answer a patient's question about whether prolonged CPAP use could increase the risk of upper respiratory infections, as this is a concern of hers. I was shocked to see that very little work has been done in this area, so I designed a project to answer this important question, and now we only have a few more days to reach our goal to fund the project!

I was just introduced to the CPAPtalk forum today, and think it would be a wonderful way to help us meet our funding goal, and also to spread the word through social media to make other people with sleep apnea aware of the project. WE NEED PATIENTS LIKE YOU who understand the impact of obstructive sleep apnea to help us advance the field, and make a difference in the health of the millions of Americans who have this condition.

Any support you can provide would be tremendously appreciated. Please visit the University of Michigan WellSpringboard website (and click on "matched ideas") to view videos about our project, and find out how you can donate.

Thanks in advance, and Best Regards,
Tiffany Braley, MD, MS
Assistant Professor of Neurology
University of Michigan Health System

No reason studying things that aren't logical or hardly ever happen.
It's pretty simple.
If a user keeps their air intake filters clean or changed on a somewhat regular basis and use distilled water in their humidifier tanks, there is practically no chance of getting respiratory infections from their equipment. This subject has come up many, many times over the years. If the user is breathing filtered air, how is it possible to get respiratory infections? The "germs" which may infect a person would presumably already be in their environment.......their bodies, their dwellings, where they're breathing unfiltered air the other hours they're not using their machines, or, from their work or shopping environments.

If you don't check back to read the responses to this post, it's unlikely that people will visit your site.


Den

.

[UMsleepresearcher]

Hi Den,

I agree that increased infection risk is highly unlikely (we hypothesize in the proposal that the prevalence of infection will NOT increase in CPAP users and may, in some chronic disease populations, actually DECREASE since poor sleep is also associated with impaired immunity, and CPAP will improve sleep quality).

That said, many patients still have lingering concerns about this issue and a well-designed study to support or refute the concerns are lacking. This concern may serve as a barrier to CPAP non-compliance, which affects about 50% of OSA patients. Interestingly, fueling concerns, a recent study from Taiwan claims that the CPAP use is associated with an increased risk of pneumonia (Canadian Medical Association Journal, 2014). This study had significant limitations in my opinion and I think another study that addresses these limitations is needed. We hope that our study which will objectively characterize the relationship between CPAP and upper respiratory infection risk will facilitate the most appropriate CPAP use and hygiene practices in patients with OSA, and serve to optimize treatment. If no association between CPAP and URI risk exists, findings from this study will also help to allay patient concerns surrounding repeated used of CPAP equipment.

Thanks,
Tiffany

[BlackSpinner]

No.
Most of us have seen LESS incidence of infections through the use of cpap therapy. And even if we get one cpap use reduces the severity dramatically. There is nothing like breathing filtered humidified clean air to help you breath better.
Some people have sensitive sinus passages and the air flow will cause inflammation - adjusting the humidity levels often helps - however is is the bacteria trapped in those blocked areas that are far more likely to cause the infection.



ETA: People will use anything to prevent them from using cpap therapy. We are well aware of the "River of De Nile". Most patients fail due to the lack of support or the total ignorance of the people supplying them with their equipment.

[jnk...]

. . . crowd-fund the project. . . . to fund the project . . . Any support you can provide . . . find out how you can donate. . . .

Personally, I would recommend getting permission from cpap.com before using this site to solicit donations.

. . . While using CPAPtalk.com, you will not: . . . •distribute or post, email or otherwise transmit any unsolicited or unauthorized advertising, promotional materials . . . --user-agreement.php

Oh, and the answer to your research question is that, yes, initiating CPAP may TEMPORARILY slightly increase the likelihood of URIs because it takes a while for the body to acclimate to the pressure and the humidity lost from the venting from the mask, which can temporarily result in drying of the nose, mouth, or throat, which in turn can allow a virus easier access. Some manufacturers mention this in their user guides for their equipment. Proper humidification and eventual adaptation to the therapy alleviates this slightly increased risk rather quickly, though, from what I understand.

I wish you the best with your research.

[Wulfman...]

Hi Den,

I agree that increased infection risk is highly unlikely (we hypothesize in the proposal that the prevalence of infection will NOT increase in CPAP users and may, in some chronic disease populations, actually DECREASE since poor sleep is also associated with impaired immunity, and CPAP will improve sleep quality).

That said, many patients still have lingering concerns about this issue and a well-designed study to support or refute the concerns are lacking. This concern may serve as a barrier to CPAP non-compliance, which affects about 50% of OSA patients. Interestingly, fueling concerns, a recent study from Taiwan claims that the CPAP use is associated with an increased risk of pneumonia (Canadian Medical Association Journal, 2014). This study had significant limitations in my opinion and I think another study that addresses these limitations is needed. We hope that our study which will objectively characterize the relationship between CPAP and upper respiratory infection risk will facilitate the most appropriate CPAP use and hygiene practices in patients with OSA, and serve to optimize treatment. If no association between CPAP and URI risk exists, findings from this study will also help to allay patient concerns surrounding repeated used of CPAP equipment.

Thanks,
Tiffany

Well, good luck.
It's been awhile since I reread that Taiwan study, but if I recall, the type of water (if they even used any) wasn't specified.
And, there are just too many "unknowns" about some of these studies and how they're conducted.
On top of that, how could it be determined that the respiratory infection actually came from the CPAP equipment?
Nobody lives in a "sterile" environment and infections can come from many things.
In my opinion, many "studies" are controlled to produce the outcomes that the researchers/writers want them to be.
I.E........"global warming" and "climate change".

From the following link, select "Humidity" and then "Can germs pass from the humidifier to me?"

https://www.fphcare.com/sleep-apnea/edu ... port/faqs/

From that "graphic", it's not logical for the germs or viruses to be able to be carried from the heated humidifiers to the user.


Den

.

[UMsleepresearcher]

Thank you jnk, excellent points. I appreciate the input from you and others who have experience with this.

Tiffany

[Wulfman...]

I'm another one of those (as BlackSpinner stated) who has had lots fewer colds, flu or other respiratory ailments.
And, with regard to the ones I have had, I'm sure I have caught those from other sources.

For those who have never had one, I would strongly recommend they get a pneumonia shot as a preventative measure.


Den

.

[Janknitz]

Not only do I have fewer upper respiratory infections since starting CPAP six years ago (before CPAP as many as 6 to 10 per year, after CPAP 1 every few years, but I also changed other health factors such as diet), but on the rare instances when I do have any upper respiratory issues or lung issues (asthmatic bronchitis) the CPAP is very soothing and helpful.

I don't need a study to tell me that personally, although occasionally we see newbies here who blame every little thing on their CPAP, including foot pain!

[jnk...]

I'm another one of those (as BlackSpinner stated) who has had lots fewer colds, flu or other respiratory ailments. . . .

+1

And improved allergy symptoms due to air filtration and adjustable humidity.

Personally, I think the drying effect of PAP having a small impact on the likelihood of getting a cold only really applies to those with milder forms of OSA. Snoring and gasping have their own more serious inflammatory and drying effects, after all--and proper PAP therapy can fix all that.

[jnk...]

. . . including foot pain!

"WARNING: Please wear proper protective footwear when carrying your PAP machine to prevent toe-stubbing in the dark and the risk of dropping equipment on the upper foot area."

Let's fund a study!!!!!

Just kidding. I applaud all efforts to calm scared newbies about PAP risks. I just won't donate to the researchers. (That's what universities are for.) But hey, just me.

[UMsleepresearcher]

Totally agree with Den, Blackspinner, and jnk.

I believe impaired immune function (and inflammation, autoimmunity) from sleep deprivation/OSA is the bigger threat, and that in the long run CPAP can alleviate these problems, a least to some extent. The intricate relationship between sleep and the immune system is just now starting to get proper recognition, and I hope others will take notice.

thanks again for the advice,
Tiffany

[bwexler]

I am just to slow and inarticulate.
The group above has stolen all my thunder.
I had planned to chime in on the foot pain. But then I have never dropped my CPAP on my feet.

I have to agree with just about everything that has been said.

[UMsleepresearcher]

You never know about the foot pain...I've seen stranger projects get funded

all kidding aside though, after reviewing a some of the other topics, I'm impressed with this forum (wasn't aware it existed until today). Informative and lively discussions, and a great resource for patients.

Tiffany

[HoseCrusher]

Tiffany, Den and I go back and forth about this and with proper care I view it as a non issue. However there can be a big difference between what is presented in theory and what actually happens.

Here is a link to a study done with older machines. Keep in mind that back then the equipment manufacturers told the same story that water isn't aerosolized by their machines.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556912/

Bottom line is don't add bacteria to the humidifier water...