Although much controversy surrounds the claims that the use of a CPAP machine causes infection, scientific evidence does not support that theory. People suffering from obstructive sleep apnea may find relief by using a continuous positive airway pressure device, or CPAP. Understanding how this device functions, what effect it has on the human body and how to properly maintain and care for the equipment ensures the safety and health of the patient.
What Is Apnea?
During sleep, some people experience moments when they quit breathing. This can last for several seconds and go unnoticed. This is called apnea. A few moments of apnea do not require intervention. However multiple episodes of apnea each night can create a plethora of problems for the patient. When apnea occurs, the brain is starved of oxygen, and proper, restful sleep is interrupted as the brain sends a message to "wake up" and "take a breath." Although most people do not wake entirely, they are deprived of deep sleep and do not achieve the renewal the body requires to function properly. For some, these moments occur as often as 400 times each night. Without ever reaching REM sleep, the patient is never rested and the body can begin to lose the ability to fight disease. These patients also are at risk for injury due to accidents simply because of exhaustion.
Why Use a CPAP Machine?
It is unclear why some people experience apnea while others sleep peacefully. What is known is that for different reasons, the trachea (windpipe) of apnea sufferers seems to collapse, or become obstructed during sleep. A CPAP machine creates a specific amount of positive air pressure. By connecting tubing to the base machine and using a full face mask, or a mask for the nose (nasal pillows), the positive airflow passes into the trachea and keeps it from collapsing. This positive airway pressure can reduce or eliminate snoring and, if used correctly, can prevent sleep disturbances due to apnea. Many patients report feeling remarkably better after using the CPAP machine for a short time.
Do CPAP Machines Cause Infection?
Most CPAP machines deliver room air. This can cause the airway to become dry and uncomfortable. Doctors may order a humidifier to be used with a CPAP machine if a patient experiences dryness. Poor maintenance of the machine and the humidifier leads to bacterial growth. Although this does not cause an infection, it can result in the introduction of bacteria to the patient's respiratory system. Keeping the machine and its components clean decreases the opportunity for bacterial growth. The only infection clearly associated with CPAP use is meningitis. A recent study done by Tomasz J. Kuzniar, Benjamin Gruber and Gokhan M. Mutlu, concluded that meningitis occurred in patients using CPAP only following a skull trauma. This type of infection was never reported in the absence of a base skull trauma.
How Do You Clean a Base Unit?
The base of a CPAP machine should never be immersed in fluid. This will damage the unit and render it unusable. Simply using a damp cloth to wipe the machine two to three times each month is sufficient. Before wiping down the unit, take note of the settings. If the settings are unintentionally changed, they can be easily corrected. Non-disposable filters should be cleaned weekly and replaced according to the manufacturer's guidelines. Use a mild soap and distilled water to clean, allowing the filter to air dry completely before it is reinserted into the unit. Most home health care businesses sell disposable and non-disposable filters for CPAP machines.
How Do You Clean the Other Equipment?
The strap assembly used to hold the mask or nasal pillows to a patient's head is known as headgear. Most headgear can be washed by hand with mild soap and distilled water. Headgear should never be washed in a washing machine. After the headgear has been rinsed thoroughly, it should air dry. Headgear can be washed as needed, but should be washed at least once each week. Masks and nasal pillows should be washed with mild soap, rinsed and air dried daily. Oils in skin and minerals in tap water cause these items to break down. Using a cleanser free of moisturizers, dyes and other additives can lengthen the life of the equipment. Wash the tubing twice each month with mild soap and allow it to air dry. Distilled water should be used in the humidifier and replaced daily before use. The chamber should be cleaned each day by soaking it for 30 minutes in a vinegar and distilled water solution (equal parts) and allowing to air dry.
- CPAP Station
- CHEST Journal, Cerebrospinal Fluid Leak and Meningitis Associated With Nasal Continuous Positive Airway Pressure Therapy, Tomasz J Kuzniar MD, PhD, Benjamin Gruber, MD, PhD, Gokhan M. Mutlu, MD, FCC, September 2005
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