Continuous Positive Airway Pressure (CPAP) therapy is the standard treatment for obstructive sleep apnea, delivering a steady stream of pressurized air to keep airways open during sleep. Users rely on this device nightly to maintain breathing and overall health. However, the common cold frequently introduces a challenge to this routine. When nasal passages are inflamed and blocked, the pressurized air can feel uncomfortable. This guidance addresses how to manage CPAP use effectively and safely when dealing with the congestion of a mild respiratory illness.
Using CPAP While Congested
Continuing CPAP therapy during a cold is generally recommended, although it requires patience and a few adjustments. Congestion involves inflammation and swelling of the nasal lining, which narrows the breathing passages and restricts airflow. When the CPAP machine attempts to push air through these constricted areas, the pressure can feel overwhelming and uncomfortable, like trying to breathe through a pinched straw.
The inflammation and excess mucus often compel the user to breathe through their mouth, especially when the nasal passages are severely blocked. For individuals using a nasal mask or nasal pillows, this mouth breathing leads to significant air leaks, compromising the pressure seal and reducing the effectiveness of the therapy. Untreated leaks mean the prescribed pressure is not fully reaching the airway, causing sleep apnea symptoms to return and fragmenting sleep at a time when the body needs rest for recovery.
Optimizing Machine Settings and Accessories
One of the most effective strategies for maintaining comfort is the proper use of heated humidification. Increasing the humidifier setting can soothe the inflamed nasal passages and throat by preventing the drying effect of the continuous airflow. The warm, moist air also helps to thin the thick mucus associated with a cold, making it easier to clear the airways and breathe against the pressure.
For users who also employ heated tubing, this accessory prevents a phenomenon called “rainout,” where the warm, moist air condenses into water droplets inside the hose as it cools. Maintaining a consistent temperature from the machine to the mask ensures the maximum benefit of humidification is delivered without the irritating splash of condensation. If the congestion forces consistent mouth breathing, temporarily switching from a nasal mask to a full-face mask is a highly effective remedy.
A full-face mask covers both the nose and the mouth, allowing the user to breathe through whichever is clearest without losing the therapeutic pressure. This temporary switch accommodates the body’s natural response to nasal blockage and prevents debilitating mask leaks.
Furthermore, many machines include pressure relief technology, such as Expiratory Pressure Relief (EPR) or C-Flex, which lowers the pressure slightly on exhalation. Engaging or maximizing this feature can make breathing out against the continuous pressure less effortful when the airways are already restricted by congestion.
In addition to machine adjustments, pre-treatment aids can improve comfort and compliance. Using a saline nasal spray or performing a saline rinse approximately 30 minutes before bedtime helps to clear the nasal passages and reduce internal swelling. This non-medicated approach can open the airways just enough to tolerate the initial air pressure and make falling asleep significantly easier.
Essential Cleaning and Maintenance Protocols
When an illness is present, the CPAP equipment requires stricter hygiene protocols to prevent the reintroduction of germs or the growth of pathogens. The warm, moist environment created by the humidifier is an ideal breeding ground for bacteria and mold, making daily cleaning paramount.
The mask cushion and frame should be cleaned daily using mild, unscented soap and warm water. The water chamber is a particular focus, as it is the component most susceptible to contamination. It must be emptied, rinsed, and allowed to air dry completely each morning, using only distilled water when refilling. The tubing should also be washed regularly during the illness, soaking it in warm, soapy water and ensuring it is fully dry before the next use. This diligent maintenance minimizes the risk of a secondary infection.
Recognizing When to Temporarily Stop Treatment
While continuing CPAP is generally best for managing sleep apnea, certain severe symptoms may necessitate a temporary pause or a medical consultation. If the illness involves severe nausea or active vomiting, the pressurized air from the machine could exacerbate the discomfort or increase the risk of aspiration. In such cases, pausing the therapy until the acute symptoms subside is a safety-minded approach.
Similarly, if the CPAP pressure causes severe, radiating pain in the ears or sinuses, it may indicate a developing ear or sinus infection. A high fever, shortness of breath, or symptoms that rapidly worsen beyond a common cold should prompt an immediate call to a healthcare provider. Any pause in therapy should be as brief as possible, as discontinuing CPAP allows the full severity of sleep apnea to immediately return.