Man asleep using CPAP machine for sleep apnea
Sleep Medicine

Sleep Doctor Offers Tips for Safe CPAP Use Amid COVID Pandemic

By on 06/22/2020

A sleep medicine doctor at Einstein Medical Center Philadelphia has urged patients who use CPAP machines at night to alleviate sleep apnea to continue doing so unless they’re infected with COVID-19 or believe they’ve been exposed – but to clean them on a daily basis.

Bhavna Sharma, MD

Pulmonologist Bhavna Sharma, MD, says some patients in her sleep clinic have expressed concerns about the safety of the continuous positive airway pressure machines, fearful of potentially spreading the virus to family members if they’re infected.

Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts throughout the night. Loud snoring and daytime drowsiness after a full night’s sleep are indications of potential sleep apnea.

An estimated 22 million Americans, by some accounts, have sleep apnea and nearly one-third of them use CPAP machines.

Dr. Sharma stresses that patients who don’t have symptoms of COVID-19  and haven’t been exposed to someone with the virus should continue to use their machines because the consequences of untreated sleep apnea can be severe.

Research shows that patients with sleep apnea are at higher risk of high blood pressure, diabetes, heart disease, stroke and other complications. “The risk may be higher than not using it,” she says.

She urges patients, however, to clean the machines more consistently, especially the filters. “We recommend cleaning the mask every day with hot water and dish detergent,” she says.

Filters should be washed or, if disposable, replaced often and “make sure everything is dry before reuse.” Dr. Sharma says the tubing should be cleaned out with hot water and detergent a couple of times a week.

Patients should refer to manufacturers’ guidelines for more details about cleaning. According to the American Academy of Sleep Medicine (AASM), the following provides a good framework for use of CPAP during COVID 19 pandemic.

CPAP Machine Care

If you have symptoms of COVID-19, you should isolate yourself in a separate bedroom and use a separate bathroom, if available. In this “recovery room,” you can continue to use CPAP while you sleep alone. Be sure to follow these steps for routine CPAP care:

  • Wash your hands thoroughly with soap and water before and after handling the CPAP device, mask, tubing and filters.
  • Clean your CPAP equipment according to manufacturer’s instructions.
  • Change filters and accessories as directed in your CPAP user guide.
  • Avoid letting anyone smoke in your home, especially around the CPAP machine.
  • Keep pets away from your CPAP machine.
  • Use distilled water in your humidifier to keep the tub clean.

Dr. Sharma stresses, however, that people who have been diagnosed with COVID-19 and those who have been exposed to the virus should stop using the machine temporarily, especially if they are unable to isolate in a separate bedroom.

If You’re Infected

Patients with symptoms such as fever, cough and shortness of breath should be tested for COVID-19 and stop using the CPAP machine until they’re sure they’re not infected.

In the meantime, Dr. Sharma suggests using alternatives such as mouth guards that are available over the counter. “An oral device is not as effective, but it’s better than using nothing at all,” she says.

COVID-19 is believed to be spread by droplets or aerosolized particles of exhaled breath from an infected person. A valve on the CPAP machines forces breath out at high pressure, “spreading the droplets with much higher force into the environment,” Dr. Sharma says.

Others could get the virus by breathing in the droplets or touching an infected surface and then touching their own mouth, nose or eyes.

Be sure that you routinely clean “high-touch” surfaces in your recovery room and bathroom.  This includes phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets and bedside tables.

A person who has recovered from COVID-19 should wait about three weeks to make sure the nasal passages are free of the virus before reusing the machine, unless they are able to isolate themselves in a “recovery” room. Dr. Sharma says. In the interim, they should avoid driving or operating heavy machinery. If the symptoms of sleep apnea become severe, please reach out to your doctor for guidance.

The device itself should be safe after that amount of time “because the virus dies within three days on a non-living surface, according to recent data,” she says.

Dr. Sharma says she believes public education on this topic is necessary because the patients she sees in Einstein’s sleep clinic – 80% of whom use CPAP machines – are confused about whether to continue their use during the pandemic.



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