Can CPAP Cause a Sinus Infection?

CPAP Sinus Infection Symptoms

Sinus infections often arise after you’ve had a cold or something has weakened your immune system. Smoking, seasonal allergies, and specific facial structures can also lead to increased risk of sinus infections. 

While many symptoms are similar to a regular cold, there are some that set sinus infections apart from the everyday cough.

• Stuffy nose that doesn’t get better
• Runny nose
• Headache
• Facial pressure or pain
• Sore throat
• Cough 
• Post-nasal drip
• Bad breath

CPAP Sinus Infection Treatment

Most sinus infections clear up on their own, but not always. If you notice sinus infection symptoms that aren’t getting better with time, you should reach out to your healthcare provider. 

A physician may tell you to keep an eye on your symptoms and see if they decrease with time before prescribing treatment. In the event that your symptoms don’t improve, a doctor might prescribe antibiotics. However, healthy immune systems can usually fight a sinus infection without antibiotics. Unnecessary antibiotics can increase resistance and side effects.

Though you might just have to wait a sinus infection out, there are steps you can take to help ease symptoms. 

• Using a CPAP humidifier can help ease inflamed sinuses.
• Temporarily switching from a nasal mask to a full-face mask may give your sinuses a break.
• Decongestants and nasal sprays can help break up mucus.
• Relieve sinus pressure with a warm compress on your forehead.
• Breathe in steam from the shower or a bowl of hot water.
• Ask your doctor about taking an over-the-counter cold medicine.

How to Prevent Sinus Infections While Using CPAP

If you develop a sinus infection, it’s unlikely that your CPAP machine is the main culprit, though it could be a contributing factor. An infection could be the aftermath of a cold, smoking, or a weakened immune system following an illness. However, there are some steps to reduce CPAP-related risk. 

Clean Your CPAP Equipment Regularly

Most CPAP manufacturers offer specific guidelines highlighting how often you should clean your CPAP machine and accessories. Ideally, your CPAP equipment should get a daily wash, or consistently cleaned once a week at a minimum. 

Mild dish soap, water, and five minutes each day can help prevent bacteria and germs from growing inside your mask, cushion, tubing, and humidifier. Make sure to use only fragrance-free dish soap, or vinegar if the manufacturer recommends it. Residue from scented cleaners irritates airways.

Avoid using CPAP cleaning machines and products, you don’t need them to get your equipment clean, and the Food and Drug Administration (FDA) warns against using them. Ultraviolet (UV) cleaners can break down the components of your CPAP equipment, rendering them dysfunctional and possibly harmful to your breathing passages. Ozone cleaners can leave unsafe amounts of ozone gas behind, which can lead to breathing problems and headaches. 

“Manual cleaning remains the safest option,” says sleep medicine physician Lulu Guo, MD.

Use Distilled Water

You should only use distilled water in your CPAP humidifier tank. There are often minerals in tap, spring, and purified water, and while these minerals can enhance drinking water, they can lead to buildup in your humidifier tank. Mineral scaling reduces humidifier performance.

Distilled water is made by boiling water, then capturing the vapor and condensing it back into liquid. The process removes bacteria, germs, and minerals. Because it’s so pure, distilled water is ideal for CPAP humidifiers. While your tap water may be completely safe to drink, it may have fluoride, chloride, or minerals that can cause scaling in your CPAP machine. 

Replace Old Parts Regularly

CPAP machines and accessories should be replaced on a regular basis. Most manufacturers offer a suggested replacement schedule that will keep your machine functioning and bacteria-free. Worn parts can increase air leak and harbor bacteria.

Most insurance companies, including Medicare, cover replacement parts on a schedule similar to the following:

• Nasal masks and cushions: twice a month 
• Full-face masks: monthly
• Mask frame: every 3 months
• Headgear: every 6 months
• Hoses and tubing: every 3 months
• Humidifier chamber: every 6 months

Don’t Share a CPAP Machine

Sharing a CPAP machine isn’t a good idea for multiple reasons. Your pressure settings are specific to your needs and prescribed only for you. Getting effective CPAP therapy also requires that you use your machine nightly, which is tough to do if you’re sharing with someone else. 

Sharing a CPAP machine also means you’re sharing germs. Bacteria can build up inside your mask, tubing, headgear, and humidifier. If your partner is developing a cold, sharing your CPAP machine with them is a good way to get on the fast track to developing a cold yourself. 

When to See a Doctor

In people with healthy immune systems, sinus infections usually heal with time. If you have a cough, a sinus infection that won’t go away, or chronic sinus infections, you should schedule a visit with your physician. Your CPAP machine could be helping to create an environment that allows sinus infections to take hold, especially if you use it without a humidifier. 

If you’re developing sinus infections and have taken care to clean your machine, replace the parts regularly, and use it as directed, you should contact a doctor. 

Frequently Asked Questions

Should I use CPAP with a sinus infection?

If you think you have a sinus infection, you should speak to your doctor to get the best advice for your individual needs. That said, it’s usually best to stick with your CPAP therapy, even when sick. Stopping therapy, even briefly, can worsen sleep and lead to harmful side effects. 

Try increasing your humidity settings to help add moisture to your breathing passages and consider sleeping with your head slightly elevated to allow your nasal passages to clear. If you usually use a nasal mask or cushion, it may be worth swapping to a full-face mask while you have the sinus infection, as breathing through your mouth could be easier if your nose is congested. 

Can CPAP make allergies worse?

In one study, researchers found that allergy symptoms may be worse for people who use CPAP machines, perhaps because CPAP therapy can dry out nasal passages. The researchers suggest that users could prevent allergy issues by using clean CPAP air filters and replacing them regularly.

Allergies and OSA are linked. People with allergic rhinitis, or hay fever, could be at increased risk for developing OSA because of how restricted their breathing can be while sleeping. CPAP therapy helps keep breathing passages open and functioning, so it’s important to stick with CPAP therapy even if you have allergies. Treating the allergies first can increase CPAP adherence.

Can CPAP cause sinus pressure without infection?

There are a few reasons why you could feel sinus pressure even if you don’t have an infection. CPAP machines have a wide range of pressure settings, and BiPAP machines have even more. If you’re using a pressure setting that’s too high for what you need, it can cause discomfort. 

To compensate for a CPAP mask leak, sometimes people turn their pressure settings too high or use too much tension to attach masks to their faces. Headgear or mask frames that don’t fit correctly or are too tight could also be culprits. A lack of humidity can also cause stuffiness or uncomfortable pressure and dryness inside your nasal passages. An integrated humidifier can help.