Effects of using in-line bacterial filters with continuous positive airway pressure devices in patients with sleep disordered breathing

Area of Science:

• Respiratory Medicine
• Sleep Medicine
• Medical Device Technology

Background:

• Philips Respironics recommended in-line bacterial filters for continuous positive airway pressure (CPAP) devices in June 2021 due to a recall.
• The clinical impact of using these in-line filters with CPAP devices remained unexamined.

Purpose of the Study:

• To evaluate the effects of in-line bacterial filters on CPAP therapy in patients with sleep-disordered breathing (SDB).
• To assess patient perceptions of CPAP pressure when using in-line filters.
• To determine if in-line filters influence SDB control as measured by the apnea-hypopnea index.

Main Methods:

• Retrospective evaluation of 160 patients with SDB who voluntarily used in-line bacterial filters.
• Patient perceptions of CPAP pressure were collected through verbal interviews.
• Apnea-hypopnea index (AHI) data from CPAP devices before and after filter use were analyzed.

Main Results:

• A significant portion of patients reported perceived changes in CPAP pressure: 8.1% felt it was very weak, 26.2% somewhat weak, 64.4% unchanged, and 1.3% somewhat strong.
• Among those perceiving very weak pressure, 38.5% discontinued filter use.
• No significant change in the apnea-hypopnea index was observed after using in-line filters (n=129, p=0.85).

Conclusions:

• In-line bacterial filters may alter subjective patient perception of CPAP pressure.
• These filters do not appear to impact the objective control of sleep-disordered breathing as indicated by the apnea-hypopnea index.
• The use of in-line filters in CPAP therapy for SDB requires further investigation regarding patient adherence and objective efficacy.