Is it Necessary to Sterilize Your CPAP?

I have been fielding a lot of questions lately about the new gadget on the market that sterilizes your CPAP machine. Patients want to know 1) if the CPAP sterilizing machine works, 2) if CPAP sterilizing machines prevent infection, and 3) if health insurance plans pay for the machine. CPAP sterilizing machines do work. The most popular version on the market generates ozone which circulates through the CPAP unit. Because so many of my patients have questions about CPAP sterilization machines, I decided to write this informative Advanced Respiratory and Sleep Medicine blog article.

Diluted vinegar, once a week.

Ozone is bactericidal. White vinegar is also bactericidal. I will never forget when I was a medical student rotating through the vascular surgery service at the VA. Every morning we would change dressings on veterans with chronically infected leg wounds. The wounds would be weeping pus even after several weeks of oral or IV antibiotics. The medical students were responsible for changing out wound dressings that were soaked in a diluted vinegar solution. In a couple of days, the wounds would be clean. If vinegar can take care of those wounds with hospital bacteria, it can certainly keep a home CPAP clean. This is why we instruct our patients to wash personal CPAP with a dilute vinegar solution once a week.

I have been practicing sleep medicine for many years. I have never known a person to get an infection from their CPAP machine, and I have seen some nasty CPAP machines. There have been multiple occasions I have discovered roaches in CPAP machines brought to the clinic (yes - some alive). I have seen countless machines with mold growing inside of the water chamber. Filthy masks are a daily occurrence. I have not diagnosed one infection from CPAP. I decided to do a literature search and did not find any medical research documenting evidence of infection being spread by a personal CPAP machine.

People do not catch diseases from themselves.

In fact, the only paper I found on the topic suggests personal CPAP machines do not cause infection. It is important to note the difference between a personal CPAP machine and a CPAP machine in a hospital that is used by multiple people. Personal CPAP machines are used by one person only. People do not catch diseases from themselves; they catch infectious diseases from other people or things. If your immune system becomes compromised, you can undoubtedly get an infection from the bacteria that are always on your body, but that is different than transmitting an infection.

Hospital CPAP machines are used over and over again by multiple people and have been shown to harbor infection. Anything that is in a hospital can harbor infection and should be sterilized between uses.

Is it worth the cost?

I can promise you that insurance companies do not pay for CPAP sterilizing machines. The units cost about $300. Do I recommend everyone get a CPAP sterilizing machine? I do not. Do I recommend keeping your CPAP clean? I do. Patients do find the CPAP sterilizing machines more convenient.

If the convenience is worth the price tag, by all means, get one. If you are getting one because you think you need to sterilize your CPAP machine nightly, then think again. Then you also need to sterilize your pillowcase because the same germs that end up on your CPAP are also on your pillowcase. Regardless of how you clean your CPAP machine, just remember to do it on a regular basis. This can help prevent mold and bacteria, and ensure that your CPAP machine works properly.