Our Sleep Apnea Blog | I Hate CPAP

Obstructive sleep apnea affects around 20 million Americans and can lead to hypertension, heart attack, stroke, depression, muscle pain, fibromyalgia, morning headaches, and excessive daytime sleepiness.

Tuesday, July 15, 2008

Meticulous Cleaning Essential for CPAP

One common complaint among CPAP users is that they get sinus and ear infections. They are more likely to suffer bronchitis than the general population. The constant mucous surplus created by your body in an attempt to fight against infection can be almost as disruptive as the sleep apnea that CPAP is designed to cure. These infections are the result of exposure to the micro-organisms that breed on the mask and hose of the CPAP machine. With daily use, the CPAP machine can host a dangerous menagerie of bacteria, fungi, and viruses that feed on the skin, mucous, and oils from your body that accumulate on the mask.

Then, once these populations have been breeding all day, the CPAP machine becomes a delivery system that pushes them inside your body. The positive airway pressure makes sure these micro-organisms are forced throughout your otolaryngal cavity. The inside of your ears, your throat, even your lungs are all seeded with a breeding population, making it highly likely that the populations will take hold. This is made even more likely as a result of the drying of your mucous membranes that can be a side effect of CPAP treatment.

To avoid the dangers of the CPAP machine, it is essential that you maintain an impeccable cleaning routine for the mask and hose. It is often advisable that you have several sets of hoses and masks so that you can rotate them and soak them in an antibiotic solution between uses.

Another option is the use of oral appliance therapy, which not only fosters less in the way of bacterial and other micro-organismal populations, but is easier to clean, and, even if it becomes populated, does not give these infectious disease organisms a free ride into your lungs. Most people prescribed CPAP therapy can actually get as good or better results from oral appliance therapy, without this health-threatening side effect.

To learn more about how oral appliance therapy can be healthier than CPAP, contact Dr. Ira Shapira at the Snoring and Sleep Apnea Treatment Center today.

posted by Dr. Candelaria at 12:41 PM

2Comments:

Joe said...: Dr. Shapira:

While I respect your decision to market your products, I find it disturbing that you publish false and misleading information in order to scare people away from competing therapy.

CPAP equiment is not maintenance intensive. I have been on CPAP for the better part of 6 months and have yet to have an issue with colds, infections, etc.

CPAP equiment is easy to maintain. All it requires, according to the manufacturers specific instructions, is a daily wash in warm soapy water. That's all. In fact, the manufacturers directions specifically state NOT to use antiseptic products on the equiment as this may damage it.

My mask is a ResMed Liberty Full Face mask, and here are the cleaning instructions: http://www.resmed.com/en-us/assets/documents/product/mirage/cleaning-mirage-masks-usa-eng.pdf

Moreover, if a proper heated humidifier is used in conjunction with the CPAP therapy, excessive drying of the mucous membrandes does not occur.

I have never been advised, by my Ear Nose and Throat doctor, or by the Doctor who administered my sleep study, nor by my Durable Medical Equipment supplier, that measures above and beyond those recomended by the manufacturer are necessary.; July 16, 2008 8:43 AM
Dr Ira L. Shapira said...: Joe,

It is essential to keep the masks very clean and while you may not have had
any problems with sinus infections or bronchitis many patients do. While my
web site is called "I HATE CPAP!" I do not hate CPAP. I think it is great
treatment for some patients. The problem is that less than half of patients
prescribed CPAP use it and most average only 4-5 hours not the recommended 7
1/2-8 hours a night. Having said that about a third of patients like it
from the start and never have problems. Most of those patients never even
come to my site.

I have a dermatologist who regularly refers patients with skin problems from
their CPAP. And chronic sinus problems are a frequent complaint of
patients. The admonition to meticulously clean CPAP is to prevent that type
of problem. I know there are advantages to humidifiers to keep tissues
moist but that also increases the chance of developing bio-films on the
equipment. If one was to err it is better to do so on the side of extra
cleaning rather than less cleaning. If a mask needs replacement sooner that
is a minor concern. I will also tell you that most patients I see do not
clean their masks and hoses on a daily basis, that may be why you do not
have problems. Also, some patients are more prone to problems than others.

Dave Hargett is the founder of AWAKE groups and the American Sleep Apnea
Association and a long time colleague and friend. When I began telling him
about oral appliances he was a hard sell. He was a patient who loved his
CPAP from the day he received it and never goes without. From his view
point he felt everyone should feel the same but over the years has altered
his position because he understands many patients never accommodate
themselves to CPAP for a variety of reasons.

The National Sleep Foundation has declared that oral appliances to treat
sleep disordered breathing whose time has come. CPAP is almost 100%
effective if you ignore compliance, but any treatment not used does not
work.

I will also tell you that oral appliances are not perfect and that
meticulous cleaning of the teeth and oral appliance are important for
success. There are many issues with appliances that must be addressed on a
case by case basis and the experience of the doctor in dealing with problems
can be the difference between success and failure.; July 18, 2008 12:39 PM

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Our Sleep Apnea Blog | I Hate CPAP

Tuesday, July 15, 2008

Meticulous Cleaning Essential for CPAP

2Comments: