A continuous positive airway pressure (CPAP) machine delivers pressurized air through a mask to keep the user’s airway open, effectively treating obstructive sleep apnea (OSA). A sinus infection, or sinusitis, involves inflammation and swelling of the tissues lining the sinuses, causing nasal congestion, mucus buildup, and facial pressure. The dilemma for CPAP users is whether to continue therapy when nasal passages are blocked, as using the machine can become uncomfortable. While this article provides general guidance, it is important to consult a healthcare provider for personalized advice regarding continued use during illness.
Using CPAP During Acute Congestion
In most instances, healthcare providers recommend that patients continue using their CPAP machine even when dealing with a sinus infection or cold. Stopping therapy, even for a few nights, can cause the symptoms of untreated sleep apnea to return, such as excessive daytime fatigue and an increase in breathing events. Pausing CPAP use can worsen the body’s ability to rest and recover, as sleep quality is already compromised by illness.
Congestion makes the use of a nasal mask or nasal pillows challenging because the pressurized air cannot easily pass through the blocked passages. This can lead to the user instinctively breathing through their mouth, which results in air escaping and the loss of therapeutic pressure, known as a mouth leak. The air pressure itself can also feel irritating when forced against inflamed sinus tissues, sometimes causing a temporary feeling of increased pressure in the ears or sinuses. Adjustments may be necessary to maintain comfort and the effectiveness of the therapy during mild or moderate congestion.
Adjusting Machine Settings for Comfort
Specific machine settings can be modified to make CPAP therapy more tolerable when the user is congested. Increasing the humidity setting on the machine’s integrated humidifier is one of the most effective steps, as the added moisture helps to soothe irritated nasal linings and thin the thick mucus. Using a heated tube in conjunction with increased humidity helps prevent “rainout,” which is condensation that forms inside the tubing, ensuring the air delivered remains warm and moist.
For those using a nasal mask, complete nasal blockage may require a temporary switch to a full-face mask, which covers both the nose and mouth. This allows the user to maintain therapy pressure even if they must breathe entirely through the mouth due to severe congestion. While prescribed pressure settings should not be changed without a doctor’s consultation, a user can often increase the ramp time setting. This allows the machine to start at a lower, more comfortable pressure before gradually increasing to the prescribed level, easing the initial discomfort.
Cleaning Protocols to Prevent Reinfection
A rigorous cleaning schedule is necessary when using a CPAP machine during an infection to prevent the equipment from harboring bacteria or viruses and causing reinfection. The moist environment of the mask, tubing, and water chamber is an ideal breeding ground for microbes.
The following cleaning steps should be followed:
- The water chamber should be emptied and rinsed daily, using distilled water when filling it to prevent mineral buildup and reduce the risk of microbial growth.
- The mask, tubing, and headgear should be washed daily with warm water and a mild, non-abrasive soap to remove mucus, skin oils, and germs.
- All components must be allowed to air-dry completely before the next use, preventing residual moisture from encouraging new bacterial or fungal growth.
- Filters, especially the disposable ultra-fine ones, may need to be replaced more frequently than usual to ensure the air entering the machine remains clean.
Thorough disinfection of all components is also recommended once the sinus infection has fully resolved.
Signs That Warrant Stopping CPAP Use
While continued use is generally recommended, certain signs and symptoms indicate that CPAP therapy should be temporarily paused and medical attention sought. These symptoms suggest a potentially more serious illness that requires prompt professional assessment.
Red flags include:
- A high fever.
- Signs that the infection is spreading, such as severe ear pain, a stiff neck, or a severe, persistent headache.
An inability to maintain the mask seal due to excessive nasal drainage, persistent coughing, or severe vomiting makes effective CPAP use impossible and can even pose a choking risk. If the nasal blockage is so profound that the user cannot breathe at all through the nose, even with a full-face mask and adjustments, the therapy may need to be temporarily discontinued. In these severe cases, a healthcare provider should be contacted immediately for guidance on managing the illness and when it is safe to resume therapy.