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Can a CPAP Mask Cause Sinus Infections?

A CPAP (continuous positive airway pressure) device is recognized as being the gold standard for treatment for obstructive sleep apnea (OSA). 

This condition causes pauses in breathing during sleep, and affects millions of people across the world. However, despite the obvious benefits of these machines, there remain a few questions about possible problems. 

One of the most commonly asked questions: does the mask carry a risk of causing sinus or other respiratory infections?

Machine and Mask

A continuous airway pressure mask machine works by delivering a steady flow of air that keeps your airways open during sleep. A tube and a mask connect the device with the mouth, allowing the pressurized air to do its job.

Because the mask is worn for a sustained period of time, there will always be some build-up of saliva and exhaled germs present. Any bacteria present in the mask (or the tubing) always has the potential to be harmful  which is why keeping all parts of the equipment clean is so vital.

When the machine is brand-new, it is sterile and completely free of any bacteria and germs. Once put into use, however, the situation is completely different. 

Germs can, will and do enter the device through any tiny gaps  and the mask is particularly susceptible to contamination as any exhalation from the nose and mouth will contain some bacteria. 

Fortunately, the human body is relatively immune to its own bacterial output – but this still poses a small amount of risk. 

On the other hand, water-borne bacteria, like bacterium legionella pneumophila which causes Legionnaire's Disease, can develop in the machine's humidifier reservoir – and can contaminate the entire CPAP device.

Possible Infections

Improperly cleaned or badly maintained CPAP machines can lead to a number of infections but these can largely be avoided if proper care is taken. Legionnaire's Disease is extremely rare but some common minor complaints include:

  • Eye irritation or dry eyes
  • Fungal or yeast infections
  • Skin irritation
  • Nasal congestion
  • Sinus infection

Some users have also reported an increase in acne  but this is more likely due to oil and grease build-up around the mask.

Serious Conditions

Water-borne illnesses are the biggest risks attached to CPAP machines but these are extremely rare and unlikely to occur if the equipment is properly cleaned and maintained. 

Most machines contain a humidifier in which water is stored and this is a potential breeding ground for fungus, bacteria, yeast and mold. If the water is not changed regularly  and the tank thoroughly cleaned  these harmful substances will quickly multiply and spread through the tubing and into the mask.

Any CPAP device would need to be in a very unhygienic state for this situation to arise  but it can happen if you fail to follow even the most basic cleaning routine. 

While Legionnaire's Disease is one possible outcome, other conditions are also possible including:

  • Bronchitis
  • Pneumonia
  • Pneumonitis (inflamed lungs)

All these conditions can usually be attributed to the water in the humidifier reservoir that has been left to stand and become contaminated. 

Emptying and cleaning the reservoir should be done at least once a week to avoid any risk. Also, it is always best to use distilled water when refilling the tank. Similarly, stagnant water in the tubing can also lead to problems – so all parts of the machine should be allowed to dry completely before use.

Avoiding Infections

As is generally true, “prevention is better than cure” and this is the case in avoiding possible infections when using a CPAP device. Following some simple steps regarding the use and care of a machine is easy to do -- and will almost eliminate the chances of suffering any adverse effects.

  • Clean the device as per the instructions
  • Use hot water and dish-washing soap
  • Clean mask and tubing daily, or at least once a week
  • Allow the mask and tubing to dry completely after cleaning
  • Only use distilled water in the humidifier reservoir
  • Never share the device or mask with others
  • Do not use second-hand equipment, particularly tubing and masks
  • Replace component parts (mask, filters) as recommended by the manufacturer

Proper care and cleaning of masks and mask cushions, as they are in contact with the nose and mouth, plays an important role in reducing or avoiding the possibility of an infection. The interior and sides of the mask are a magnet for bacteria and should always be kept as clean as possible. 

If possible, they should be thoroughly cleaned on a daily basis using a mild detergent or dish-washing soap and hot water and dried completely afterwards. 

Cleaning every couple of days is acceptable but once a week is essential.

Generally speaking, mask filters need to be replaced every two to four weeks while the mask can last for up to three months. 

However, these are only guidelines and different makes and models will have different lifespans. Always follow the manufacturer's guidelines regarding maintenance, cleaning and replacement times to get the best from the machine.






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