Are CPAP Machines Dangerous?
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Can a CPAP Machine Kill You?
Currently, all FDA-approved CPAP machines have not been proven to cause serious life-threatening consequences as long as they are used correctly. Although there have been some recalls of CPAP machines before, experts believe that these cases of death are extremely rare, and the health benefits of treating sleep apnea (such as preventing heart disease and stroke) far outweigh the small risks that the machine itself may bring.
In actual use, the probability of death directly caused by CPAP machines is very low. Most people may encounter some minor problems in the early stages of treatment, such as dry nose, skin indentation or mild headaches, but these conditions can usually be quickly relieved as long as timely adjustments are made (such as refilling the humidifier with water, changing to a suitable mask), and basically no need to go to the hospital for treatment. It is important not to stop using the machine without authorization because of concerns about side effects. Stopping treatment will make the apnea problem more dangerous.
Have There Been Any Deaths Associated With CPAP Machines?
On August 15, 2023, Dutch medical giant Philips was caught in an unprecedented ventilator product recall storm. The company recalled approximately 5.5 million CPAP, BiPAP and mechanical ventilators worldwide because a sound-absorbing foam material used in these devices has the potential to degrade and release harmful and possibly carcinogenic substances.
The sound-absorbing foam material used in these respiratory devices is polyester polyurethane (PE-PUR), which will degrade into harmful particles under certain conditions, which may be ingested or inhaled by the user and may cause headaches, irritation, nausea, vomiting, etc., and may even be potentially carcinogenic. If the equipment is not cleaned properly or placed in a hot and humid environment, the foam inside may break and release harmful gases.
Philips said it has not received any reports of deaths due to these problems. But according to the U.S. FDA, since April 2021, the agency has received 105,000 reports of problems, including 385 reports of deaths related to foam degradation issues. While this number sounds large, it is only about 0.007% of the 5.5 million positive airway pressure devices that were recalled during the Philips recall. Aside from the recall, there have been no official reports of deaths or serious injuries related to CPAP machines.
After the recall, people understandably became concerned about the safety of using non-Philips CPAP machines. As a result, the FDA began investigating all approved PAP manufacturers in response to these growing concerns.
After completing its investigation, the FDA stated that there is no evidence that PE-PUR foam is used in any other CPAP machines or by any other manufacturer. Ultimately, as long as our CPAP machines are not included in the recall, we can safely continue to use them.
CPAP Machines Side Effects
The therapeutic effect of CPAP is well-known. High-quality evidence shows that for most adults, CPAP can reduce the frequency of apnea and hypopnea during sleep, reduce daytime sleepiness, reduce the risk of motor vehicle accidents, and improve systemic blood pressure, male erectile dysfunction, gastroesophageal reflux symptoms, blood sugar control and quality of life in diabetic patients. However, the biggest problem with this treatment is the problem of patient “compliance”, that is, many patients cannot insist on using CPAP.
The most common side effect is related to air leakage. Other side effects include rash, bloating and discomfort in breathing. Some factors affect the occurrence of side effects, such as the fit of the mask to the cheek and the air pressure level of the machine. Changes in medication and weight may also have an impact.
Common side effects of sleep apnea therapy include:
Swallowing air:
If you swallow too much air during sleep apnea therapy, you may experience stomach discomfort, bloating, burping, excessive farting, etc. Some people call this condition aerophagia. Aerophagia is caused by the accumulation of air in the gastrointestinal tract. About 16% of patients using continuous positive airway pressure experience aerophagia.
In recent years, with the increase in the number of patients using automatic positive airway pressure, the occurrence of aerophagia has decreased significantly. Aerophagia may be caused by excessive pressure in the ventilator. Excess air does not enter the respiratory tract, but enters the stomach through the esophagus. Reducing the pressure level can help prevent aerophagia. It should be noted that any changes to the machine settings, including changes in pressure, must be made under the guidance of a doctor or professional to avoid danger.
Skin damage:
Masks containing latex can cause allergic dermatitis in some people, which manifests as redness and itching of the cheeks or nose. In extreme cases, skin damage such as rashes, ulcers, and pressure sores may occur. Using mask pads or barrier creams, loosening the mask straps, or using a new mask that fits better may help.
Congestion, dry nose and mouth, dry eyes:
When using a CPAP machine, you may experience a stuffy and runny nose. You may also experience dryness in your nose due to air flowing into your nose. Dryness in the nose and mouth is usually caused by air leaking from the mask. Air leaks can occur if the mask does not fit your cheeks properly, especially when you change positions while sleeping, or when the air pressure is too high. Dryness in the nose or mouth may cause nosebleeds, cracked mouth or tongue, and even damage to gums and teeth.
Mask leaks allow pressurized air to flow from the top of the mask to the eyes, causing dry eyes. Since mask leaks are the main cause of nasal congestion, dry nose and mouth, and dry eyes, preventing leaks is the fundamental way to eliminate these side effects. Nasal saline sprays, using a humidifier, and heated tubing can also help relieve nasal dryness.
Discomfort when exhaling:
After wearing a CPAP sleep ventilator, it is generally easy to inhale. When using the CPAP machine for the first time, you may find that it is difficult to exhale. Most people do not need to treat this situation, and it can improve on its own after a period of treatment. In some cases, the machine is set to a pressure ramp, that is, starting from a lower pressure and slowly increasing to the required pressure. For some patients, the pressure of the ventilator needs to be reduced. In rare cases, it may be necessary to switch to a bi-level PAP machine for treatment.
Infection:
People who use CPAP machines are at risk for upper respiratory or sinus infections, which should be prevented. Bacteria and viruses from the mouth, throat, and lungs, as well as allergens such as mold and dust, can enter the mask or hose of the machine when you breathe during sleep. If the machine is not cleaned properly, bacteria and allergens can accumulate inside the device and may cause infection. Keeping your CPAP machine clean is the main way to prevent infection.
Meningitis:
Meningitis is an inflammation of the spinal cord and meninges caused by bacterial infection. Although it is a rare complication, its potential fatality cannot be ignored. In cases related to the use of CPAP equipment, the disease almost always develops from untreated sinus infections. It is particularly important to be vigilant when patients have a combination of symptoms such as severe headache with neck stiffness, high fever (body temperature over 39°C), photophobia and visual impairment, persistent vomiting, changes in consciousness (such as abnormal drowsiness or confusion), and sudden visual abnormalities, indicating that acute meningitis may have developed. In such cases, emergency treatment procedures must be initiated immediately to prevent irreversible neurological damage.
Claustrophobia:
Claustrophobia is the fear of enclosed spaces. Some people feel trapped and confined when using a CPAP sleep ventilator. The solution to claustrophobia varies from person to person. Some people just need to spend some time getting used to the mask. Usually, the fear symptoms disappear automatically over time. In order to increase tolerance and adaptation to the mask and CPAP pressure, you can wear the mask for a short time during quiet activities such as reading. Doing so can make the mask more comfortable when using it at night and reduce the occurrence of claustrophobia. For others, you need to change the mask.
There are three commonly used masks. One is to cover both the nose and mouth, called a full-face mask; another is to cover only the nose, called a nasal mask; the third is called a nasal pillow, which is to insert the ventilation tube directly into the nostrils, covering neither the nose nor the mouth. In comparison, a full-face mask is most likely to cause claustrophobia, followed by a nasal mask, and a nasal pillow is least likely to cause it.
Is Your CPAP Making You Sick?
As long as you clean your CPAP machine, mask, and tubing regularly, you can basically avoid getting sick from using the device. However, it’s better to be prepared for some signs that something may be wrong. We’ve compiled some CPAP common problems and solutions tips, but here are some new symptoms to pay special attention to:
New headaches
Persistent nasal congestion
Frequent sinus infections
Persistent cough
Recurring respiratory infections
Increased shortness of breath
New oral health problems
Recurring dizziness
Skin irritation around the mask cushion
Chronic dry mouth, nose, and/or eyes
If these situations occur, it may be that the machine is not cleaned properly, the mask is not suitable, or there is a problem with the pressure setting. At this time, it is best to check the equipment immediately, clean and disinfect it, or ask a doctor or respiratory therapist to help adjust it.
Some factors may increase the risk of side effects. In these cases, the machine may need to be adjusted. Relevant factors include:
Weight change: Weight gain or obesity is one of the main risks for developing sleep apnea. If you gain weight, you may need to change the pressure of your CPAP machine. Weight loss can make it easier to swallow air, have a leaky mask, or have trouble breathing. Reducing the pressure of your CPAP machine can help.
Allergies: If you have environmental allergies, you can take medication or spray your nose to improve nasal airflow. This may reduce the pressure requirements.
Surgery: Surgery, including tonsillectomy, septoplasty, and surgery on the soft palate or tongue, may alter the requirement for ventilator therapy.
Drugs and medications: Drinking alcohol before bedtime relaxes your muscles and worsens symptoms of obstructive sleep apnea. Smoking can also worsen snoring and sleep apnea. Quitting smoking and drinking may reduce the pressure needed for a sleep apnea machine. Muscle relaxants and benzodiazepines can make sleep apnea symptoms worse. Stopping these drugs may reduce the pressure needed for the machine.
Preventing CPAP Machine Side Effects Tips
The side effects of sleep apnea therapy can make people less comfortable using the machine and affect the effectiveness of treatment. Some patients even quit treatment because of side effects. Although the thought of getting sick from using a CPAP machine sounds scary, it is usually easy to avoid. The following suggestions may help reduce or prevent side effects and improve the quality of treatment:
Buy your CPAP from a legitimate authorized dealer:
Make sure the device you buy is FDA certified. Purchasing a CPAP machine from an authorized seller ensures that it is FDA approved and in good condition. Never buy a CPAP machine without a prescription!
Know your CPAP:
Take the time to learn how your CPAP machine works, how to maintain your equipment, and how to clean CPAP.
Routine cleaning of the machine and accessories:
Follow the equipment manufacturer’s instructions to regularly clean the CPAP machine and related accessories. Masks and hoses should be cleaned daily due to the retention of bacteria, mold, and dust. Cleaning not only prevents infection, but also reduces the possibility of air leaks.
Choosing the right mask:
CPAP masks come in a variety of styles and sizes. It is important to choose a mask that is comfortable and seals well. Full-face masks are more likely to leak, and nasal pillow masks are the least tolerant of high levels of air pressure. Sometimes you may need to try a few different styles and sizes of masks before you decide on the right fit.
Timely adjustment of CPAP machine pressure:
In the first few weeks of using the CPAP machine, the machine’s pressure level needs to be adjusted to reduce the risk of side effects. If the user’s lifestyle or body changes, including weight fluctuations, or the use of sedatives or alcohol, the machine’s pressure needs to be adjusted promptly.
Professional medical advice:
If you have concerns about the safety of any medical treatment, it is best to seek professional medical advice. Your doctor or sleep specialist will have the latest information on the health risks of CPAP and can provide personalized advice.
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