Can Sleep Apnea Machines Treat COVID-19 Patients?

The expanding pandemic of COVID-19 disease cases in the USA could overwhelm the nation’s hospitals, which would force doctors into making respirator allocation decisions given their limited availability.

As demand grows, hospitals could sterilize and reuse ventilator tubing rather than discarding it after every patient.

And if supplies continue to run short, they could use transport ventilators or even positive airway pressure machines, similar to the devices sleep apnea patients use at home.

Furthermore, if demand continues to grow, hospitals could use sleep apnea machines, suggests George Washington University Law professor John Banzhaf, an MIT-trained engineer, and inventor.

Banzhaf suggested in an email newsletter distributed on March 15, 2020, the possibility of using existing CPAP (Continuous Positive Airway Pressure) machines, used to combat sleep apnea, as devices to help persons with respiratory problems due to coronavirus infection.

This potential use-case could fit especially in less serious cases which do not require the full power and sophistication of expensive hospital-type ventilator machines, says Banzhaf.

CPAP is a type of positive airway pressure, where the airflow is introduced into the airways to maintain a continuous pressure to constantly stent the airways open, in people who are breathing spontaneously. Positive end-expiratory pressure (PEEP) is the pressure in the alveoli above atmospheric pressure at the end of expiration.

CPAP is a way of delivering PEEP but also maintains the set pressure throughout the respiratory cycle, during both inspiration and expiration, said this NIH article published in May 2019.

Professor Banzhaf suggests these advantages of using CPAP machines:

• the number of existing CPAP machines greatly exceeds the number of hospital ventilation machines,
• they are simpler and less expensive to acquire,
• manufacturing capability can be increased far more quickly,
• CPAP machines, especially those with full-face masks, can provide a very significant increase in the amount of air (and therefore oxygen) a user can consume, and many can easily be adjusted to provide even higher air pressures than would ordinarily be required to overcome mild sleep apnea.
• those most at risk of respiratory problems from the coronavirus virus are the elderly and/or have other medical problems - are also the population most like to already have and use CPAP machines already,
• family members are therefore familiar with and comfortable with using them,
• existing CPCP users could be asked to bring their units to the hospital where they might be used,
• many CPAP units are used largely to limit snoring, and in some cases, users might be able to do without them in an emergency without risk of serious health problems such as cardiovascular events.

Professor Banzhaf, despite a lifetime of professional work and successes in the public health field, says he cannot fully evaluate the feasibility of using CPAP machines to overcome the potential shortfall of hospital ventilators in the USA.

Therefore, Banzhaf hopes that those who are more knowledgeable will consider investigating and evaluating the idea.

The American Academy of Sleep Medicine (AASM) Public Safety Committee’s website said on March 17, 2020, ‘It is unclear if sleep apnea causes you to have a higher risk of getting the coronavirus.’

And, if you are diagnosed with the SARS-COV-2 coronavirus, it is possible that using a CPAP could increase the risk of spreading the virus to others around you.

However, it is important to talk to your medical provider before stopping any medical treatments.

Previously, on February 27, 2020, the U.S. Food and Drug Administration (FDA) issued a Safety Communication to inform patients and healthcare providers that devices claiming to clean, disinfect or sanitize CPAP devices or accessories using ozone gas or ultraviolet (UV) light are not legally marketed for this use by the FDA, in the USA, and as such, their safety and effectiveness for use with CPAP devices and accessories is unknown.

The FDA says to ‘follow the CPAP manufacturer’s instructions and recommended cleaning and replacement guidelines for your CPAP machine and accessories. Most often, CPAP manufacturers recommend regular cleaning of CPAP device accessories with mild soap and water.

As of March 15, 2020, the FDA and CDC have NOT endorsed this CPAP use-case.

COVID-19 outbreak news published by Coronavirus Today.