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Continuous Positive Airway Pressure: Is it a route for infection in those with Obstructive Sleep Apnoea?
Liam Mercieca1, Richard Pullicino1, Kyra Camilleri1
1Department of Medicine, Mater Dei Hospital, Msida, Malta.
Introduction:
Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnoea (OSA), with limited data about the prevalence of respiratory infections and microbial colonization in these patients.
Objectives:
The aim of this study was to determine if CPAP use is associated with respiratory infections and to identify the organisms that colonize or infect these patients.
Method:
A retrospective, case-controlled study in patients diagnosed with OSA was carried out. 137 patients were recruited and interviewed using a questionnaire. A nasal swab was taken from each patient. Patients using CPAP machines had swabs taken from masks and humidifiers.
Results:
66 (48.2%) patients received CPAP treatment with 60.6% of them having a heated humidifier. 78.8% were male, with the majority using a full face mask (63.6%). No significant difference was seen in the prevalence of rhinosinusitis, lower respiratory tract infections and hospital admissions for pneumonia between CPAP and non-CPAP treated patients. The presence of a humidifier did not influence the prevalence of infections. Commensal flora was predominantly cultured from nasal swabs from both patient groups. Coagulase Negative Staphylococci and Diphtheroids were the main organisms cultured from masks and humidifiers respectively.
Conclusions:
This study shows that the use of CPAP, choice of mask and humidifier have no significant impact on the prevalence of infections and micro-organisms isolated. This is very reassuring to the physician prescribing CPAP therapy and users.
Insights
Continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA) does not increase respiratory infections. CPAP use, mask type, and humidifiers showed no significant impact on microbial colonization or infection rates in patients.
Area of Science:
- Sleep Medicine
- Infectious Diseases
- Microbiology
Background:
- Continuous positive airway pressure (CPAP) is the primary treatment for obstructive sleep apnoea (OSA).
- Limited data exists on respiratory infection prevalence and microbial colonization in OSA patients using CPAP.
Purpose of the Study:
- To investigate the association between CPAP use and respiratory infections.
- To identify organisms colonizing or infecting patients undergoing CPAP therapy.
Main Methods:
- A retrospective, case-controlled study involving 137 OSA patients.
- Data collected via questionnaires, nasal swabs, and CPAP mask/humidifier swabs.
- Comparison between CPAP and non-CPAP treated groups.
Main Results:
- No significant difference in rhinosinusitis, lower respiratory tract infections, or pneumonia hospitalizations between groups.
- Humidifier use did not affect infection prevalence.
- Commensal flora predominated; Coagulase Negative Staphylococci and Diphtheroids were most common on CPAP equipment.
Conclusions:
- CPAP therapy, mask selection, and humidifier use do not significantly impact infection rates or microbial isolation.
- Findings are reassuring for healthcare providers prescribing CPAP and for patients using the therapy.
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