Coronavirus FAQs: CPAP Recommendations, Cautions, and Alternatives

Our lives have changed in many ways since March when the Coronavirus (Covid-19) pandemic came to the United States.  Now we are bombarded with instructions and recommendations to keep us safe and minimize the health impact to our country.  I trust we are all doing our part with social distancing, washing our hands to reduce transmission, and even using masks in many circumstances.  Many of us need to take additional precautions for ourselves and those around us, including people with sleep apnea using a CPAP.

If you are using CPAP and wondering what the guidelines are during the Covid-19 outbreak, this will address your questions.  These answers are based on information published by the CDC and recommendations Rajkumar (Raj) Dasgupta, MD, FACP, FCCP, FAASM, the assistant professor of clinical medicine at Keck School of Medicine at the University of Southern California.

 If I have symptoms of the coronavirus, should I continue using my CPAP?

Studies have shown that people with a lack of quality sleep are more likely to get sick after being exposed to a virus and can slow your recover if you do get sick. Since, your CPAP improves your quality of sleep, it could be helpful in fighting the virus.

However, if you have symptoms of the coronavirus, the CDC says should isolate yourself in a separate bedroom and use a separate bathroom, if available. In this “recovery room,” you can continue to use CPAP while you sleep alone.

If I have symptoms of the coronavirus, will using CPAP spread the virus to others?

Current evidence suggests that the virus that causes COVID-19 spreads between people who are in close contact and is transmitted through respiratory droplets produced when an infected person coughs, sneezes, or talks.  There is some concern that using CPAP could spread the virus through the exhalation port, which allows carbon dioxide to escape from your mask. This port also may release smaller virus-containing particles as an “aerosol,” which can remain suspended in the air for a few hours.  It’s possible that your bedpartner could inhale these virus particles. Therefore, it is important to sleep alone by isolating yourself in a separate bedroom. You can continue to use CPAP while sleeping in this recovery room.

Should I use CPAP if I have symptoms of the coronavirus but can’t self-isolate?

If you have symptoms of the coronavirus but are unable to isolate yourself in a separate bedroom, then you should contact your medical provider.  Ask your medical provider if there are short-term interventions or alternative treatments for sleep apnea that could help you while you recover from the coronavirus.

An alternative treatment would be the custom-made Mandibular Advancement Device that a qualified Sleep Dentist could fabricate, also called oral appliance therapy.  These devices do not spread the coronavirus by aerosolization.  The new devices are not as porous as the older plastic devices, so they have less bioburden or risk of the virus surviving.  One of Sleep Impressions’ dentists can discuss options and fit you with an appliance.

If I have symptoms of the coronavirus, should I do anything different to clean my CPAP?

Be sure to follow these steps for routine CPAP care:

  • Wash your hands thoroughly with soap and water before and after handling the CPAP device, mask, tubing and filters.
  • Clean your CPAP equipment according to manufacturer’s instructions.
  • Change filters and accessories as directed in your CPAP user guide.
  • Avoid letting anyone smoke in your home, especially around the CPAP machine.
  • Keep pets away from your CPAP machine.
  • Use distilled water in your humidifier to keep the tub clean.

Be sure that you routinely clean “high-touch” surfaces in your recovery room and bathroom. This includes bedside tables, counters, tabletops, bathroom fixtures, doorknobs keyboards, tablets, phones, and remote controls.

After you are free from coronavirus, replace your CPAP filters and disposable accessories.

If I have the coronavirus, will my CPAP be helpful? Or could CPAP cause the coronavirus to get worse?

There is evidence that CPAP improves sleep quality and sleep quality boosts your immune system.  Therefore, your CPAP could be helpful in fighting the virus.  There is no evidence that using CPAP will cause the coronavirus to get worse.

Is it safe to use CPAP if I don’t have symptoms of the coronavirus?

Having sleep apnea puts you at higher risk of severe symptoms if you contract the virus.   Using your CPAP is safe and could improve your ability to fight off the virus is you are exposed.  However, it is possible to spread coronavirus to others before you have symptoms, so you may want to sleep and use CPAP in a separate bedroom during this public health emergency.  If you know you have come in contact with someone that has the virus, then you should strongly consider sleeping in a separate room.

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