Positive Airway Pressure Device Care and Cleaning Practices in the Pediatric Home

Regular care and cleaning of positive airway pressure (PAP) devices are important for maintaining equipment in the home. Illness and hospitalization have occurred from inadequate cleaning and use of tap water in the humidifier. In recent years, ozone and ultraviolent-light disinfection devices have been advertised for cleaning home PAP equipment. Our clinic provides instructions; however, cleaning practices performed in the home are unknown.

A survey of home cleaning practices for PAP equipment was conducted in a pediatric sleep clinic during 2019-2020. Survey domains were method, cleaning and replacement frequency for each component, type of water used, instruction preferences, and demographics. The primary aim was to identify home PAP cleaning practices and compare with provided instructions. The secondary aim was to determine if respiratory-related symptoms (eg, congestion, runny nose, sneezing, coughing) occurred or increased with PAP use or inadequate cleaning.

The survey was completed by 96 respondents. Most reported weekly cleaning of mask (36, 38%), tubing (41, 43%), and humidifier (31, 33%) with soap and water as the primary method for each. The majority used distilled water in the humidifier (74, 77%) and reported respiratory symptoms did not occur with PAP use (64, 67%). Very few indicated a device was used to clean equipment. No associations were found between length of time for PAP use and cleaning practices. There was a moderately low correlation between age and cleaning. Increased age was associated with decreased cleaning frequency (r = 0.20, P = .048).

Care and cleaning practices of home PAP equipment varied from instructions provided in clinic. Most reported at least weekly cleaning of items for which daily cleaning is recommended. Few reported using a device for cleaning or having respiratory symptoms from PAP treatment.