When a person who uses Continuous Positive Airway Pressure (CPAP) therapy contracts a respiratory illness like COVID-19, concerns arise about the safety of continuing use. CPAP machines deliver pressurized air through a mask to prevent airway collapse during sleep, managing conditions like Obstructive Sleep Apnea. Using the device while actively infected requires careful consideration of household safety and the patient’s respiratory health, necessitating specific protocols and medical consultation.
The Primary Concern: Aerosol Spread and Household Safety
Using a CPAP machine during an active viral infection creates a risk of aerosolizing viral particles into the surrounding environment. The positive pressure from the device forcefully disperses respiratory droplets containing the virus, turning them into fine, airborne particles. This aerosolization is a major concern because these smaller particles can remain suspended in the air longer and spread farther than typical cough or sneeze droplets.
The primary point of viral escape is the exhalation port on the mask, designed to vent carbon dioxide, or through mask leaks caused by an imperfect seal. This increases the radius of transmission within a shared living space, potentially exposing housemates to the virus. If you are confirmed or suspected to have the infection, isolating yourself is the most effective safety measure for others.
Isolation should involve sleeping in a separate, dedicated room with the door closed, and using a separate bathroom if possible. To maximize household safety, increase ventilation in the isolation room. This can be done by opening a window or using a high-efficiency particulate air (HEPA) filter unit. If isolation is impossible, or if you share a bedroom, consult your physician about temporarily stopping CPAP use to reduce the risk to others.
Personal Health Considerations: When to Stop Using CPAP
In most cases, it is safe to continue CPAP use while recovering from a mild COVID-19 infection, as maintaining sleep apnea treatment supports overall health. However, the CPAP device treats sleep-disordered breathing, not acute respiratory distress or pneumonia caused by a viral infection. Therefore, monitoring your personal medical status is essential when you are ill.
The CPAP machine may not be sufficient, or could even mask a worsening condition, if your respiratory symptoms become severe. Contact your primary care physician or sleep specialist immediately upon a positive diagnosis to discuss your individual risk profile. Medical consultation is necessary if you experience symptoms like worsening shortness of breath, chest pain, or confusion.
A drop in oxygen saturation (SpO2) indicates your body is struggling to maintain adequate oxygen levels. If your SpO2 reading falls below 92–94%, or if you feel you cannot breathe adequately, seek immediate medical attention. Continuing CPAP therapy during an acute respiratory illness must be done under the guidance of a healthcare provider who can weigh the benefits against the risks of your acute illness.
Essential Hygiene and Operational Adjustments
For those cleared to continue using the device, strict hygiene and operational adjustments are necessary to mitigate viral spread and maintain equipment function. Moisture from exhaled breath and the humidifier allows microorganisms, including the virus, to persist on surfaces. Therefore, the frequency of cleaning all CPAP components must increase significantly while you are infectious.
Clean the mask, tubing, and humidifier water chamber daily using warm, soapy water, then allow them to air dry completely. The infected individual should ideally perform the cleaning to limit the exposure of other household members. Wash your hands thoroughly with soap and water before and after handling the CPAP equipment.
To reduce the amount of viral material expelled into the room, speak with your provider about incorporating a viral or bacterial filter. These filters, placed between the mask and the tubing or at the air output, trap microscopic particles, potentially reducing the viral load of the expelled air. Ensure that the machine’s standard disposable air filter is also replaced more frequently than usual.