As the limited supply of ventilators across the country concerns hospitals and governors, some emergency plans developed by states have included using positive airway pressure machines, like those used to treat sleep apnea.
While that may help save lives by helping with the shortage of ventilators, there is a drawback.
Officials and scientists have known for years that when used with a face mask, such alternative devices can possibly increase the spread of infectious disease by aerosolizing the virus, whether used in the hospital or at home.
That may have been the unfortunate case in a nursing home in Washington state where first responders called to the Life Care Center of Kirkland initially used positive airway pressure machines, often known as CPAPs, to treat residents before it was known the patients were infected with COVID-19. Responders were even using special filters to reduce the amount of virus released.
Now doctors are informing patients who use the devices at home to take precautions to prevent spreading the COVID virus to others.
Ventilators are used to push air in and out of the lungs through tubes inserted in a patient’s airways. The machines can be fine-tuned to provide the needed volume of air, the rate of breathing, and the amount of oxygen and air pressure optimal for each patient.
Hospital and home positive pressure airway machines are much simpler. Continuous positive airway pressure machines, known as CPAPs, provide a continuous flow of air at a constant pressure. More advanced bilevel versions, called BiPAPs, which can be used at home or in health care facilities, push the air in, but then lower the pressure to allow the air to be exhaled.
Certain BiPAPS can function like a ventilator, depending on how the device is connected to the patient. If a BiPAP is fitted with a breathing tube, it would be a safer closed system than with a face-mask that would leak air and the virus into the room.
“If your hope is that maybe this might be a temporizing measure that might hold them from hours to a couple of days, you’ll try to use the mask,” Finigan said. “There are some situations where somebody is breathing OK, but is just having trouble getting enough oxygen. Theoretically, a CPAP might be enough to get them enough oxygen. But, again, doing it with a mask is more likely to generate an aerosol and create an infectious problem.”
So, what about home use of the CPAP?
Dr. Christopher Winter, a sleep medicine specialist in Charlottesville, Va., said people who rely on CPAP machines at home for sleep apnea can continue to use them as long as they have no symptoms of COVID-19. But they should speak to their physicians if they develop upper respiratory symptoms, to help determine whether they should continue.
Anyone who uses a CPAP machine at home may want to consider sleeping in a separate room to avoid infecting others, even if the person using the machine doesn’t have any symptoms.
This was found at NPR and you can find more information on CPAP tips here at the American Academy of Sleep Medicine.
