Is there any reason to be concerned with infection from CPAP

[suzieqiluvu2]

Went to my Pulmonary Dr. today. I told him I had got a ClimateLine hose and was sleeping much better than before, due to rain out quite often and very very dry tongue and mouth. While there, was also diagnosed with a sinus infection. He told me I needed to be careful, but didn't elaborate.
I've not had an infection since I started using the CPAP approximately 1 1/2 years ago. Was he trying to say that due to the climateline I am subject to have infections?

[bdp522]

I doubt that the hose caused a sinus infection. Dry mouth is a sign of mouth breathing, check your data to check for leaks. Keep the mask clean(clean everyday during the infection) and you should be good to go.

Brenda

[deltadave]

Went to my Pulmonary Dr. today. I told him I had got a ClimateLine hose and was sleeping much better than before, due to rain out quite often and very very dry tongue and mouth. While there, was also diagnosed with a sinus infection. He told me I needed to be careful, but didn't elaborate.
I've not had an infection since I started using the CPAP approximately 1 1/2 years ago. Was he trying to say that due to the climateline I am subject to have infections?

Absolutely:

Effect of continuous positive airway pressure therapy on infectious complications in patients with obstructive sleep apnea syndrome.

Sanner BM, Fluerenbrock N, Kleiber-Imbeck A, Mueller JB, Zidek W.

Department of Medicine I, Ruhr University Bochum, Marienhospital Herne, Germany. Bernd.Sanner@ruhr-uni-bochum.de

Abstract
BACKGROUND: Nasal continuous positive airway pressure (CPAP) is a well-established, widely used and effective treatment of obstructive sleep apnea syndrome (OSAS). Unfortunately, side effects are frequent during CPAP treatment.

OBJECTIVES: Little is known about the effects of CPAP on infectious complications in patients with OSAS.

METHODS: We retrospectively analyzed the kinds and rate of infections of the upper airway in 246 consecutive patients (mean age, 59.7 years) with polysomnographically verified OSAS using CPAP with or without a heated humidifier and compared them with OSAS patients who received non-CPAP therapy.

RESULTS: Of the 246 patients, 40 received conservative therapy and 206 CPAP treatment, 36 of them with a heated humidifier. The mean follow-up period of the study group was 165.4 +/- 92.1 weeks and did not differ between the three groups. Infectious diseases were frequent in all three groups, but patients using CPAP without humidifier suffered from upper airway infections significantly more frequently than controls (42.9 vs. 25%; p < 0.05), and more patients on CPAP therapy with humidifier than controls (22.2 vs. 2.5%; p < 0.01) reported an increased rate of upper airway infections since initiation of CPAP therapy or diagnosis of OSAS. Especially patients using a hot water bath humidifier who cleaned their devices inadequately had significantly more upper airway infections since diagnosis (57.1 vs. 20%; p < 0.05) or during the past 6 months (52.4 vs. 13.3%; p < 0.05) than patients who regularly cleaned CPAP machines, humidifiers and ventilatory circuits.

CONCLUSIONS: Our results suggest that patients using CPAP therapy either with or without heated humidity seem to be at an increased risk of upper airway infections compared to conservatively treated patients.

http://www.ncbi.nlm.nih.gov/pubmed/11694810

[BlackSpinner]

Absolutely:

Effect of continuous positive airway pressure therapy on infectious complications in patients with obstructive sleep apnea syndrome.

......
CONCLUSIONS: Our results suggest that patients using CPAP therapy either with or without heated humidity seem to be at an increased risk of upper airway infections compared to conservatively treated patients.

http://www.ncbi.nlm.nih.gov/pubmed/11694810

However strangely enough most people here report the opposite. My asthma, colds, flus and sinus infections have gone down considerably. In fact I haven't had one sinus infection since I started. Those colds I did have were less bad and the one flu induced pneumonia was way more tolerable and over much quicker then the ones I had before cpap.

[xenablue]

Not that allergies are an infection, but when I have my mask on there are absolutely no problems - as soon as my mask comes off - instant sinus and nasal blockage and watering eyes.

Cheers,
xena

[Perrybucsdad]

I think the area of caution (at least explained to me by a nurse) is that masks and hoses are great breading ground for bugs, so just make sure to regularly wash them.

I came down with a sinus infection last week and part of me wonders if my lax cleaning habits with regards to my mask and hose may be the cause. No idea really, but just keep the stuff clean and you should be good.

[n0hardmask]

......
CONCLUSIONS: Our results suggest that patients using CPAP therapy either with or without heated humidity seem to be at an increased risk of upper airway infections compared to conservatively treated patients.

And what, pray tell does conservatively treated mean, I wonder?!

[TalonNYC]

OK, I have to /rant here a little.

This brief is flawed, and I have my doubts about the study in general.

The study doesn't say what non-CPAP therapies were used. The standard therapy for OSA that isn't xPAP is either surgery to reduce the tissues of the throat or a tracheostomy. Granted, reduction surgery doesn't have a risk of ongoing infection, but it does have only a moderate rate of success. Trach-tubes are notorious for all kinds of OTHER infections.

They could mean dental appliances, but that's only suitable for mild to moderate OSA, and so isn't a help for those of us with severe apnea.

So the choice becomes between treating occasional sinus infections (which I got anyway, waaaay before I started CPAP) or treating:

Heart disease
Diabetes
Chronic fatigue symptoms
about 100 other medical issues caused by continuously disrupted sleep.

I'd rather not treat anything, but if I have to choose between something that can be very effectively treated (occasional sinus infection) vs. things that are permanently damaged by OSA, I'll take the CPAP machine.

Finally, the study is severely lopsided. The non-CPAP group was a fraction of the CPAP group, and there was no control group of non-treated patients to see if infection was simply endemic amongst people with OSA in general.

/rant off.

[BlackSpinner]

OK, I have to /rant here a little.

This brief is flawed, and I have my doubts about the study in general.

The study doesn't say what non-CPAP therapies were used. The standard therapy for OSA that isn't xPAP is either surgery to reduce the tissues of the throat or a tracheostomy. Granted, reduction surgery doesn't have a risk of ongoing infection, but it does have only a moderate rate of success. Trach-tubes are notorious for all kinds of OTHER infections.

They could mean dental appliances, but that's only suitable for mild to moderate OSA, and so isn't a help for those of us with severe apnea.

So the choice becomes between treating occasional sinus infections (which I got anyway, waaaay before I started CPAP) or treating:

Heart disease
Diabetes
Chronic fatigue symptoms
about 100 other medical issues caused by continuously disrupted sleep.

I'd rather not treat anything, but if I have to choose between something that can be very effectively treated (occasional sinus infection) vs. things that are permanently damaged by OSA, I'll take the CPAP machine.

Finally, the study is severely lopsided. The non-CPAP group was a fraction of the CPAP group, and there was no control group of non-treated patients to see if infection was simply endemic amongst people with OSA in general.

/rant off.

There was also no comparison historically of before cpap and after. It could be that the people with the cpap had many more resp. issues before they started cpap.

[Elle]

I know anecdotal reports are meaningless but I used to have sinus infections often and have not had one since starting cpap tx 5 years ago.

I clean my mask cushion often but have only washed hoses once in 5 years.....hope I don't get shunned for that.

[chunkyfrog]

As long as you keep your equipment reasonably clean, there should be no problems.
The only exception might be for someone with compromised immunity--like a transplantee.

[deltadave]

Absolutely:

Effect of continuous positive airway pressure therapy on infectious complications in patients with obstructive sleep apnea syndrome.

......
CONCLUSIONS: Our results suggest that patients using CPAP therapy either with or without heated humidity seem to be at an increased risk of upper airway infections compared to conservatively treated patients.

http://www.ncbi.nlm.nih.gov/pubmed/11694810

However strangely enough most people here report the opposite. My asthma, colds, flus and sinus infections have gone down considerably. In fact I haven't had one sinus infection since I started. Those colds I did have were less bad and the one flu induced pneumonia was way more tolerable and over much quicker then the ones I had before cpap.

This was absolutely in no way meant to discourage the use of humidity in xPAP therapy. Clearly, after leak correction, additional humidity may be the most important factor in improving therapy compliance.

This should, however, serve as an important reminder to practice good infection prevention techniques with their equipment.

[nichola]

Absolutely:

Effect of continuous positive airway pressure therapy on infectious complications in patients with obstructive sleep apnea syndrome.

......
CONCLUSIONS: Our results suggest that patients using CPAP therapy either with or without heated humidity seem to be at an increased risk of upper airway infections compared to conservatively treated patients.

http://www.ncbi.nlm.nih.gov/pubmed/11694810

However strangely enough most people here report the opposite. My asthma, colds, flus and sinus infections have gone down considerably. In fact I haven't had one sinus infection since I started. Those colds I did have were less bad and the one flu induced pneumonia was way more tolerable and over much quicker then the ones I had before cpap.

ACtually it makes perfect sence.

If you think about it most OSA paitents have run down immune systems before CPAP as a result of lack of sleep and in particular REM sleep which repairs the body.


Thus our bodies experienced more and prolonged sickness before CPAP

What we are experiencing now is how it should be normally... getting sick rarely and getting better at the right speeds

[Izabela]

@suzieqiluvu2,

Doctors see so many people that don't take care of their equipment properly, which is probably why the doctor said you needed to be careful. He doesn't know how well you might clean your equipment, but I'm sure he (or she) has spoken with people who go weeks or even longer without giving their masks and hoses a good wash out with soap and warm water. Yes, studies have been done on the subject of whether you can get sick from a dirty mask or not, etc. Not to trivialize these studies, but even without reading a study, logic would seem to dictate that there's a good chance you can get sick from dirty equipment.

Still, some folks manage to get away with minimal cleaning and still say they haven't been sick in years. There are so many factors that influence whether a person gets sick or not and CPAP cleaning is only one of them.

It sounds like your doctor was just telling you to be cautious, not necessarily saying you are subject to more infections because of the Climateline. Just like others have said, I would say keep your equipment clean and you'll be OK.

[avi123]

Another discussion on this subject:


http://www.sleepguide.com/forum/topics/ ... -infection

Check also:

http://doctorstevenpark.com/cpap-and-sinus-infections