CPAP and COVID-19

Sleep Apnea and COVID-19

Research has found that people with obstructive sleep apnea have an increased risk of contracting COVID-19 Trusted Source National Center for Biotechnology Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source . People with OSA may be more likely to be hospitalized Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source if they get COVID-19. Some research also suggests that, once hospitalized, people with OSA are more likely to be admitted to an intensive care unit (ICU) Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source .

Fortunately, using CPAP therapy as directed by a doctor is associated with lower rates of COVID-19 in people with OSA. Adherence to CPAP therapy generally requires using the device for at least four hours per night Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source no less than five nights per week, though even those who only use their CPAP device for a few hours per night may have a lower risk of infection than those who do not use CPAP therapy at all.

CPAP as a Treatment for COVID-19

CPAP therapy has emerged as a treatment option Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source for improving oxygen levels in some people with COVID-19 regardless of whether they have obstructive sleep apnea.

COVID-19 can affect lung function. Many people who are admitted to the hospital with the disease have low levels of oxygen in their blood, a condition called respiratory failure. When this occurs, doctors have several options for trying to improve blood oxygen levels.

Using a mechanical ventilator Trusted Source Merck Manual|MSD Manuals View Source involves intubating a person by inserting a plastic tube into their windpipe and having a machine move air into and out of their lungs. This is an invasive treatment, and the risks of complications means that it is not the best option for everyone who needs supplemental oxygen. In addition, mechanical ventilation requires specific equipment, which was a concern at the beginning of the pandemic when ICU beds were limited. As a result, doctors have explored the use of CPAP therapy and other non-invasive treatments to address low oxygen levels caused by COVID-19.

After early reports of success, doctors began using CPAP therapy as an initial treatment for respiratory failure in some people with COVID-19. One small study found that CPAP was successful at raising oxygen levels among people who were hospitalized with COVID-19. Additional studies have found similar benefits to CPAP as a non-invasive treatment for respiratory failure. For some patients, initial use of CPAP therapy may prevent the need Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source for intubation.

However, further investigation is needed to fully understand the benefits and downsides of CPAP therapy as a treatment for complications of COVID-19. Some research found that CPAP provided no added benefit Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source in people who were not eligible for intubation. Additionally, treatments like oxygen therapy Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , which delivers oxygen through a face mask or small tubes placed in the nostrils, may offer similar benefits to CPAP therapy. It is difficult to draw conclusions from existing research Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source about how CPAP use compares to oxygen therapy and other non-invasive treatments.

Not everyone with COVID-19 is a good candidate for CPAP therapy. Some studies found CPAP therapy to have lower effectiveness in older adults and people with more significant respiratory failure. Around half of people may ultimately require intubation despite CPAP therapy. For these people, delaying intubation may actually worsen their lung injury and increase the risk of death from COVID-19. Additionally, some people have issues continuing CPAP therapy because of feelings of claustrophobia, anxiety, or discomfort when wearing a CPAP mask.

Given the rapidly developing knowledge about COVID-19 and its treatment, researchers are still seeking out ways to make CPAP therapy more effective and identify people who are most likely to benefit from using it. For example, one study found that lying face down Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source while awake when using a CPAP reduced the effort required to breathe and improved oxygen levels among people with respiratory problems from COVID-19.

CPAP Machines vs. Ventilators

A CPAP machine is a non-invasive way of providing breathing support to people with lung problems. A CPAP works by sending a constant stream of pressurized air through a mask and into the airway, which helps deliver oxygen contained in air to the lungs.

In contrast, a ventilator is a device that mechanically controls breathing for a person who otherwise cannot obtain enough oxygen. Ventilation requires placing a tube in the windpipe Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , also known as the trachea. This tube is connected to a machine that regulates breathing, which in many cases is a life-saving treatment. However, ventilators can increase the risk of lung injury, infection, and other unwanted side effects.

Non-invasive ways of providing breathing support like CPAP therapy may be used as a first-line treatment for people with certain lung conditions who either do not require or cannot tolerate invasive mechanical ventilation. Research supports the idea that certain people with COVID-19 may benefit by starting with non-invasive therapy instead of mechanical ventilation.

Is It Safe to Continue Using a CPAP if You Have Symptoms or Test Positive for COVID-19?

In most cases, it is safe for people with sleep apnea to keep using their CPAP device even if they have COVID-19. That said, if you have symptoms or have tested positive for COVID-19, you should talk with your health care provider about whether to continue using your CPAP machine for OSA.

Using a CPAP as directed by a doctor can enable steadier breathing and improve sleep quality Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source in people with OSA. Getting good sleep can help the immune system function properly. In addition, suddenly stopping CPAP therapy for a period of weeks may raise blood pressure and heart rate.

Whether or not to continue using a CPAP is a decision you can make with your doctor based on the severity of your OSA and other factors related to your overall health.