CPAP And Sinus Infections

November 12, 2010

One of the more common complaints from CPAP users is that they are prone to sinus infections. Typically, they deal with it using saline irrigation, decongestants, and sometimes even go to their doctor for antibiotics. As a result, people suspect contamination or infection from their equipment, especially the mask, tubing or even the machine itself. Other suspects include molds, allergies or even sensitivity to their masks.

I had an experience today with a patient that makes me rethink how CPAP may aggravate nasal or sinus infections. This patient was unable to use CPAP after 4-5 days because his nose and sinuses would burn. He interpreted this as an infection. His numbers and other compliance parameters were perfect. While performing nasal endoscopy (placing a thin flexible camera in his nose) he commented that the sensation was identical to the feeling that he experienced when he used CPAP.

That got me thinking about how most cases of sinus headaches and pain have been shown to be a variation of a migraine. This is a neurologic reaction to any sort of irritation or stimulation. If you were to undergo a CAT scan during an episode, you’ll see that in most cases, it’ll be completely normal. Unfortunately, too many people end up being given oral antibiotics.

What can you do about this if you’re susceptible to these problems? Unfortunately, it’s a catch-22. In theory, the best way of handling this is to treat the underlying obstructive sleep apnea, but in this case, the treatment itself can cause nasal inflammation that can worsen sleep apnea. Many people benefit significantly by using CPAP, but there will always be a few people who absolutely can’t tolerate CPAP, no matter how hard they try to use it (different machines, settings, masks, medications, or other gadgets.)

Do you get recurrent sinus “infections” when you use your CPAP?

79 Responses to “CPAP And Sinus Infections”

  1. malvin on November 13th, 2010 4:03 am

    Yes I do especially during winter and cold months which usually follow by the common cold or flu and some infections treated by antibiotic. One of the best way is to have sinus cleaning with salt water to the nostril. Mouth wash diluted with water submerge the cpap humidifier containers would help for better infection and bacterias and mold control. A real refresh method figure out after a night of good cpap treatment!

  2. RAY THOMPSON on December 10th, 2010 5:07 pm


  3. Ed Jackson on December 21st, 2010 8:54 am

    I have exactly the same problem as Ray–just during Nov-March timeframe here in VA. Gonna see if I can get a better humidifier plus flush my sinus passages more ofen.

  4. Thom McFarlane on April 11th, 2011 11:53 am

    In the North-West I have the some prob as Ed Jackson, except when I use approved salt water solutions I get a terrific head ache?
    Can anyone help?

  5. Virginia on December 31st, 2011 12:19 pm

    I continue to get sinus infections off and on with my cpap. I clean it regularly and still continue to get infections. I have a coworker who is sick now and suffering with a sinus infection due to her cpap machine and she is an LPN. My husband uses a full mask cpap and seldom does he get a sinus infection. Just wondering, is there something we can put in the water to eliminate bacteria. We had an aquarium years ago, we added a supplement to the water to eliminate bacteria and to make the water clearer. Is there something we can add to the water in our cpaps to eliminate this bacteria? Just a thought. I don’t use my cpap due to getting sinus infections and I wake up tired and I am miserable, but would I rather be miserable from lack of sleep vs a sinus infection. Therefore I suffer from lack of sleep, take my 5 hour energy drink and off I go. I am very allergic to antibiotics (cillians, myacins, cipro) all the major name antibiotics. I have to result to the health food store for grapefruit seed extract and collidal silver for my antibiotics. I have been working 10 – 12 hours days and I wake up every day tired because I am afraid of using my cpap in fear of getting another sinus infection that takes a week to get rid of. Frustrated and miserable.

  6. BillHoo on February 1st, 2012 3:50 pm

    Last year I got a severe sinus infection after using CPAP during the cold November. It took me over a year to get back on it (now January) and after one use, I got another sinus infection and sore throat the lasts from morning to mid-afternoon. What’s bad this time is that WITHOUT the CPAP my sinuses and throat get dry each night and it takes nearly the full day to feel normal again. Been a week now and I’m almost to a point where I can sleep without waking to pain in the morning. the only residual effect is the infection has spread to my eustation tubes and it hurts for me to chew food. At first I thought I had TMJ, but I now realize it’s in my ear!

  7. Michael on February 24th, 2012 6:05 pm

    I have been using CPAP for 12 years. My first sinus infection began two weeks ago. I had switched from a mask that covers my entire nose to a nasal pillow. The nasal pillow seems to blow the air with more force than my old mask. Any correlation?

  8. Sharon on March 4th, 2012 2:31 pm

    I have been using a CPAP for about two years. During this time I have continually had sinus issues with several serious sinus infections. This last one is the final straw. Call me crazy….but something else I am thinking might be linked to the CPAP is the fact that I do not sneeze. In the past month I have probably sneezed twice even when using pepper or other things to try to make me sneeze. I believe this is what causes the build up of fluid in my sinuses and ears. Anyway, I wish someone would come up with a better way to treat sleep apnea.

  9. Steven Swope on March 13th, 2012 9:49 am

    I too have used a CPAP for the past 12-15 years. Switching from full face mask to nasal cannula didn’t help. Dry HIPPA filters only irritates sinus membranes and the reaction is an abundance of mucus. Within the past two years I have encountered numerous sinus infections and LEFT ear infections…to the point I had the ENT put a tube in that ear, signed up for allergy shots, did the nasal irrigation thing, and even had a wisdom tooth extracted due to the pain from the sinus “weeping” into the tip end root system of the good tooth, resulting in a toothache type pain. I am considering trying the TAP III dental device to eliminate the chronic sinus/ear infections I encounter even after proper faithful cleaning of all equiptment.

  10. Cathy Bemis on June 20th, 2012 5:45 am

    I had used CPAP for 6 years. I did get occasional sinus infections. The last 2 years have had a number of sinus infections. I used distilled water in the humidifier, and clean the humidifier, tuving and mask daily. I do get frequent allergies in the spring and the fall. I use a steroid nasal spray daily. I quit my CPAP, and sleep on a wedge pillow. I did hot have problems of daytime sleepiness. My husband said only snored occasonally. I began working night shift a little over a year ago, and my sleep is all messed up! 6 months ago complained to Doctor about being tired. She insists I have another sleep study and USE the CPAP. I don’t want to go through PAINFUL sinus infedions again from CPAP ! Thanks Cathy

  11. Sam on June 22nd, 2012 6:30 am

    I’ve been using cpap for 1.5 years. Loved it at first, but started having the same symptoms as most of the posts here. My wife insisted that there has to be a connection to the cpap. I’ve NEVER had allergy problems or any kind of sensitivity to springtime pollen, etc. I just figured that as I’m getting older, maybe allergies were an additional health problem to deal with. My family doctor insisted it was allergies. A number of different allergy meds didn’t help. During one visit, he wanted to write me 4 different RX’s, and give me a steroid shot. I told him no way. My cpap doctor told me that I need to replace the tubing and the humidifier every 6 months, something I wasn’t told on the front end, was only told that the mask would last about 6 months. Upon reading all of this I realize my beloved wife is correct, it has to be from bacteria within the components. I do need to do a better job of cleaning the components, but not convinced it will solve my problem.

  12. Christina on July 30th, 2012 12:07 pm

    I just started using a CPAP live in florida so i haven’t used any water and have already had sinus problems and then i have this little nose so the mask is literly sitting on my sinsuses and moves up around my eyes but, im finding i just can’t sleep with out it and wake up feeling horrible with sinus issues. I was thinking of using water and my questions is what about putting something menthol or pepermint oil in it to help keep the sinusis clear?

  13. Jen on October 18th, 2012 10:59 am

    I have a sinus infection right now — first one in 2 years, only 48 days after beginning CPAP therapy. PLEASE answer these, if you have any information:
    1) I’m told to wash the water basin with ONLY vinegar and DISTILLED water, never a mention of dishwashing liquid. Hoses are to be washed with REGULAR water, dishwashing liquid, and white vinegar.
    Question: Should I be rinsing it with distilled water when done washing/rinsing?
    2) Malvin said in his post, “…mouthwash diluted with water submerge the cpap humidifier containers would help for better infection and bacterias and mold control.” I’m not sure I follow. Is he saying that, when I’m washing the basin, I should use mouthwash? That would definitely be easy for me, but I just want to know it’s safe — and that I understand HOW he’s doing that – before I try it.

  14. Kevin Russell on November 4th, 2012 7:57 am

    What is the point of having people leave responses to this article if the Dr. never responds to all of the questions? Hello Dr Park?? Are you still out there??

    Perhaps these doctors don’t know as much about this as we seem to think they know and therefore have little accurate information to give?

    It is up to us people. When we find a answer to a problem please follow up on your post and state what works for you so others can try it.

    I don’t have the answer but I find putting shirt over my head at night during the cold months helps keep my face and sinus warmer and I wake feeling a bit better. Cutting out all sleep meds also helps, cutting out all prescription medication also ended my daily headaches.

  15. Steven Park on November 6th, 2012 8:33 pm

    Mr. Russell,

    Sorry, but I can’t respond to hundreds of comments and emails that I receive every month personally, especially for medically related questions. This is why I have my monthly teleseminars where you can ask me in a live group setting.

  16. Bee on December 11th, 2012 4:35 am

    It was 0300hrs when I awoke this morning due to a sinus headache. I suppose that I ought to feel blessed since I received 6 hours of sleep, but I would much rather have 5 and not wake up with a headache.

    I soak the tubing, mask and water reservoir in hot water and vinegar at least once a month and more often in the winter. I make sure to only use distilled water in the unit. I also turn on the humidifier in the winter as I love to sleep in a very cold house and the humidifier use to make a difference, but not any more.

    Catch-22 indeed, I can’t sleep without it, but can’t deal with the continual sinus headaches/infections and live a normal life either. But on that note, I have wondered if one drop of eucalyptus oil would help with keeping the sinus passages clear.

  17. leonard vplk on January 25th, 2013 1:25 pm

    I started cpap in May 2012-my sinus infection started in late June of that year and has lasted on & off until the present time. I use a full face mask covering both nose and mouth, but rarely can breath thru my nose for more than a few minutes. I clean masks and machine daily and only use distilled water in it. How do I rid myself of this constant sinus infection? My PCP has prescribed various antibiotics and I have tried every over-the-counter nasal decongestant available. The only relief i can get is by using Afrin every 4-5 hrs, but my Dr. says that isn’t a good idea. Somebody please recommend another therapy!!!

  18. Bernadette on February 7th, 2013 2:34 pm

    I have severe sleep apnea diagnosed in 2011. I have been using the cpap (nasal pillows). For the past 2 months I have been having really bad headaches across the top of my head, my face, and even my teeth hurt at times. I don’t have any congestion. Since I get some relief from steam, I realize this is my sinuses. I wash my hoses with vinegar and water. I rinse the water chamber with hot water and a little oxy clean.

    Do you have any suggestions to help me eliminate this pain. I do not want to take decongestants because of my blood pressure. I am 75 yrs. young and in excellent health except for this problem.

    The humidity level on my maching is set at 3.5. Thank you.

  19. katie on February 24th, 2013 5:55 pm

    I just started using cpap mask two weeks ago and i hate it first i broke out in sores all over my face where my mask lays and i have had 2 sinus infections already in bed with second one know this one is worse than the first one i have called doctor no responce called respiratory therapist and he says call for a new mask. Last night my bf said he noticed a strange odor coming from machine anyone else ever experienced
    Any odors? This is so not what i was expected…

  20. John on February 26th, 2013 11:47 am

    I have been using CPAP for 2 years now. I was half face mask first year and am now using nostril only. Cold weather has caused problems for me also. I put the hose under the blanket or my pillow to help keep it warm and this helps.
    My sinus problems almost totally went away when I got aggresive about cleaning my mask and hose. I work for a company that distributes cleaning products to hospitals and have been using their Steiro lotion hand sanitizer every couple of days in the morning to sanitize the hose & nasal heads. I use a Q tip with the steirolotion on it to get between the two layers inside the nose piece I also pump the foam into the hose and then let it run (not on me just open to air) until dry and then leave it out to be completely dry before using again at night. The sanitizer has no alcohol or fragrance, so less chance of damaging the mask and hose and no smell speaks for itself.

  21. Janice on March 6th, 2013 12:32 am

    I started on my cpap with a nasal pillow and within a couple of days of using it developed sinus infection. This happens every time I try to use the pillow. I have had to use the full face mask and don’t have the same problems with it. Seems the pillow blows too hard. It is okay when I ramp it, but them when it goes back to full force can’t take it.
    The face mask makes my face sore every morning and I have had to make a shield for it so the mask itself doesn’t touch my face as it is very irritating. Would really like some way to use the pillow .

  22. Terri on July 23rd, 2013 10:13 pm

    I have been using cpap with nasal pillow and have not suffered from any sinus infections due to cpap usage. I also don’t think I have been cleaning all my equipment appropriately. I just add distilled water to the humidifier each day to whatever is left over to bring level, wash my nose pillow every morning with baby shampoo and let air dry and hang the tubing up to dry. I think it’s time to wash the tube!

    I found this post because I have some sinus congestion (passed to me from contact with my daughter and my granddaughter) and was wondering how to use the cpap while having a sinus infection.

  23. Lynne on October 19th, 2013 1:07 am

    I’ve been using a CPAP for about 13 years now. I have the nasal pillows and found that I get a stuffy nose every night. Since April of this year I started putting a small piece of 100% Menthol Crystals in the humidifier and it has helped tremendously in keeping my nasal passages fairly clear most of the night. I have found that a piece about the size of a round coffee stirrer 1/4th inch long works fine. Had to experiment to find the right size for me. I tried a couple of drops of Grapefruit Seed Extract in the humidifier last night for the first time and found I didn’t wake up with a stuffy nose. I’m hoping the GSE will last throught the night. Time will tell….

  24. Matt on November 8th, 2013 6:53 pm

    I’ve been on CPAP for 4 months. My machine has the humidifier and can operate at various pressures. The first two months were wonderful. I could breathe all night and didn’t wake multiple times. Then about two months ago, the flu came through our area and I came down with a nasty secondary bacterial sinusitis. The CPAP seem to be making the sinus infection hang-on much longer than ever before. I’ve done the antibiotics, nasal steroid, and cough enhancer meds, but this thing would not go away. A silver nano-colloid spray has helped (, but most of the morning congestion still hangs on until late afternoon. It is definitely being caused or aggrivated by the CPAP.
    After reading all of these posts, I’m beginning to question if there might be a fundamental flaw in the science behind CPAP. The cilia hair in the nasal cavities are supposed to be able to move freely in order to remove foreign particles like dust, pollen and bacteria. Could the strong air pressure from the CPAP be somehow interfering with the cilia’s proper function thus allowing the build-up of mucus and congestion, regardless of how clean the machine is?
    The manufacturers of these machines have a responsibility to do the medical research to find out what is causing this infectious side-effect of CPAP.

  25. Geoff Fitzgibbons on November 29th, 2013 10:58 am

    Dr park is it possible that the inside of my Cpap machine has a mold or bacteria inside it causing me to have severe sinus infections. I change the filters the humidifier reservoir and tubing/mask regularly ….I can’t get inside the machine however where the a ir passes thru. What else can I try.

  26. joe on December 12th, 2013 7:48 am

    I too have been experiencing problems with my cpap unit .. I started to get a bloody nose in the shower the morning after using my cpap unit . I also had the burning in my nostrils plus crustyness and inflamation

  27. Dawn3813 on December 14th, 2013 12:24 pm

    I have been on cpap with oxygen for about 2 1/2 yrs. The first year was pretty good and I felt better with respect to my fatigue. However, the past 1 1/2 yrs have been different. I use a petite nasal mask (My pressure is 12 which I worked up to from 8, and I always use the dehumidifier with distilled water. I set the humidifier at 5.) This was better than the other mask I had. Also, initially I tried the nasal pillows (which I thought would be the better choice) and experienced severe sinus pain and headaches every morning.

    At any rate, I can relate to many of the posts. I have severe post nasal drip, mouth dryness, nasal dryness, nosebleeds, sinus pain, eye pain, loose teeth, mouth sores, balance issues, ear pain (went to ENT and was told my ears are fine). My left eye always feels puffy and the vision seems to be getting worse, my top front teeth are very loose, and I have severe nasal inflammation (ENT diagnosed as allergies, but that diagnosis came over 1 yr after starting cpap. Rx-Flonase). Now, I believe I have a sinus infection. I am at the point of calling my Dr. and asking for alternative treatments. I am only 53 yo and I feel like I am going to loose all my teeth! I think Matt’s comments from Nov 8th make a lot of sense with respect to the cilia and the force. I have woken up numerous times gagging on gunk… a lot of gunk! Many times there is blood. There has to be a better way of treating this.

  28. Darlene Gaskell-Chandler on January 3rd, 2014 8:10 am

    I have been using the CPAP machine for 10 years and for the past 5 years have had a chronic sinus infection. I wash all the machine parts, tubing, etc., frequently. I have tried with the moisture setting and without and many different masks. I have had numerous antibiotics but nothing helps. I have ear infections too. My GP is sending me to an ENT but I am positive it is the CPAP machine that is causing it. However, I have bad sleep apnea and cannot sleep without it. Catch 22 situation. :-(

  29. KathyMcduffie on January 3rd, 2014 12:56 pm

    Every time I use my C-PAP I get a sinus infection. I have one right now. Woke up this morning with a migraine and sinus so sensitive they are bleeding. No way can I have this thing blowing up my nose like a leaf blowe. Think I will use the grapefruit seed extract and see how that helps.

  30. Steven Park on January 3rd, 2014 1:06 pm

    I do realize this is a common problem for CPAP users, but it’s likely that what you’re experiencing is not so much an infection as it is a migraine of your sinuses. In fact, most sinus headaches and “infections” have been shown to be migraines, which can feel like infections. Having a very sensitive nervous system in your nose can make it react to pressure changes, which is a common migraine feature. Unfortunately, as Darlene mentioned, it can be a catch-22, since you need CPAP to treat your sleep apnea, but it can also cause problems.

  31. kris rice on January 27th, 2014 9:49 pm

    I got a sinus infection everytime I used the humidifier with the CPAP. I was told by the technicians that because of the the moisture from the humidifier that a lot of people were prone to sinus infections, which I am anyway. But without the humidifier you get cold air in the winter and hot air in the summer. So I can’t use CPAP even though I have severe apnea. I am a slender woman, fit and am atypical. It was very frustrating as I was meticulous in sterilizing the equipment every day. But after a few days of the moist air I would get a severe sinus infection.

  32. Marg Bourcier on February 19th, 2014 2:03 pm

    I just came from my Dr.’s office for another round of antibiotics. I get a sinus infection twice a year (Feb and September) since using my cpap mask. I use a full mask, love the device but can’t seem to shake the infections. I wash the entire unit (mask, tube, water container and filter) in vinegar and warm water weekly. I let it air dry. I put new water in every night and pour out the old every morning. I use Saline spray every day. I also take allergy meds year round. I need the mask to get good sleep but three weeks or more twice a year of non-function is affecting my work. I have no symptoms other than tired and fever. Once on antibiotics all heck breaks loose and I get congested, coughing, sore throat. I’ve never had these before using the cpap. Please come up with a better system. Please!

  33. Larry on February 20th, 2014 7:32 am

    I have only been using the CPAP machine with full face mask for about four months . My sleep study said I have moderate sleep apnea ( 28 ). I have had the pressure adjusted twice, I clean the mask and water reservoir daily, I clean the hose weekly with a special five foot long baby bottle brush I found online designed especially for this purpose. My CPAP has three adjustable features : temperature ( with heated tube ), humidity level and pressure ramp up time. Right now, I have sinusitis as determined by my GP doctor and this is the third time I have had a sinus infection in the last eight weeks. Not sure if it matters, but after doing some reading and research, last night I propped up several pillows to keep me head about 18 inches higher than my waist. I am not a back sleeper but I am willing to try anything after being knocked down three times with these infections. The CPAP machine has helped me but not sure how much more of this I can take. I appreciate all the posts.

  34. Micky on March 10th, 2014 11:44 am

    I used to have sinus infections with my CPAP usage about once every three months. About five months ago, in addition to emptying out the water from my humidifier reservoir every morning, I started using a spray bottle of hydrogen peroxide on the humidifier reservoir to sterilize it. CVS sells peroxide in refillable spray bottles, but you can also just buy an empty spray bottle and fill it yourself. After spraying the reservoir, I shake off the excess peroxide and let it air dry during the day. By nighttime, it’s dry and ready to be reused.

    I also bought a hose cover for my CPAP hose. It greatly reduces the amount of condensation (“rainout”) that I get in my mask and hose when I sleep in a cold room. Plug “cpap hose cover” into any web search engine and some options will pop up. (The zippered ones cost a little more, but they’re a lot easier to get on and off the hose.)

    Since I started implementing these two extra measures in my CPAP care and use routine, I haven’t had a sinus infection, and they don’t cost a lot of time or money.

  35. Gwen on March 11th, 2014 5:17 pm

    I have had my APAP for about 4 years. About that time I developed allergies, which are mainly animal danders and dust. I have found homes for all of my animals and now my allergies are minimal. However, I get allergy “symptoms” daily. The allergist thinks my nasal problems are from the APAP. I dont get infections but I feel like I am catching a cold multiple times a day. I also wash my masks after one use, my water tank after 3 uses, but I put in fresh distilled water every night (no “topping-off”). I hang my hose daily so that I start with a totally dry hose each night. What to do? I -and my husband-hate feeling like I am continually having cold symptoms. I would really love a better plan ……

  36. pam on March 19th, 2014 9:35 pm

    I would just caution you to be careful how much grapefruit seed extract drops (no more than 4) you put in your chamber. It can cause your throat and sinuses to burn and throat turn red I discovered. When I cut back on these drops my throat got better. It is an excellent product to use to kill the bacteria and I use that in my cleaning solution.

  37. Jane on March 25th, 2014 7:06 pm

    I was diagnosed with severe sleep apnea 8 years ago, and initially prescribed the CPAP for 3 years, but later switched to an APAP machine 5 years ago. Since the beginning of this diagnosis of “Sleep Apnea,” I have encountered nothing but problems trying to get a full night of uninterrupted sleep. Currently for the past two years, I started to suffer from sinus problems while lying down., (Matt and Geoff posted re possible bacteria in the CPAP mechanism. Interesting theorty. As others have done, I consulted an ENT specialist several times, and he recommended: cortisone sprays, allergy sprays and hypertonic saline solution, even some nasal surgery to chip away at some cartilage in my nose, but on subsequent visits, again recommended the cortisone spray, which I have again told him I cannot tolerate, as various kinds were tried and gave my throat problems with dryness and my tongue seeming to attach to the roof of my mouth, a scary feeling, and a rise in blood pressure at night. I find that the cortisone spray only aggravates dry mouth problems, gives me very bad dreams and causes restlessness at night. Also tried allergy sprays not helping much. Interestingly, I do not experience these sinus/nasal problems during the daytime, only on lying down and waking up. Hypertonic nasal spray the use of veryh warm water on my nose for a few minutes with a wet washcloth seems to clear the sinus blockage if only for an hour or so. I am finding myself in the same “catch-22″ as other posters I have read. I have also tried various face masks, including” full face”, and the nasal pillows masks, but was unable to tolerate them. Now, I am back to the nasal mask which is the most comfortable but allows the lower jaw to open the mouth at times so recommended to use some strap or to tie around the headgear to keep the mouth closed when I turn onto my back. What a lot of trouble! The solutions to sleep apnea are far from ideal for me and the benefits have so far managed to escape me. The nights I can sleep a full 6-8 hours on APAP have happened occasionally but unfortunately, are not the norm for me and at times would rather sleep without the CPAP, and I have tended to do so quite regularly. Steven Park’s comments and book are very enlightening and things I have never considered or mentioned with the ENT I consulted.

  38. Steven Park on March 25th, 2014 8:48 pm


    That’s an interesting theory. It’s possible that pressure itself can cause the cilia not to function properly. That’s something that must be studied experimentally. Another possibility is that if you catch a cold or have an allergy attack, then with increased nasal congestion, your CPAP pressure needs are raised. Since your CPAP pressure remains the same, this causes a rise in the number of apneas, which can directly and indirectly aggravate nasal congestion. We know that nasal surgery can lower CPAP pressures, and it’s not too far fetched to guess that increased nasal congestion may cause your current CPAP pressure to be not as effective.

  39. Steven Park on March 25th, 2014 8:55 pm


    Thanks for commenting. I understand your frustration as well as all the other peoples’ comments. CPAP can definitely be a love-hate relationship. What I find is that the various treatment options for nasal congestion offered by ENTs produce various results. For many sleep apnea sufferers, congestion persists despite optimal therapy. There are also situations where although CPAP does help eliminate apneas and hypopneas, it can cause more irritation and arousals, leading to more fragmented sleep. Some people also don’t do well with prescription nasal medications, like you. If you keep at it and try different things, it’s likely you’ll find something that works for you. Good luck.

  40. Sarah Bernardi on March 29th, 2014 11:00 am

    I have the same sinus problems in the morning after using the breathing machine at night, I relaced the heated tubing, and the mask and I still have problems. I think someone needs to take a look at the insides of these machines and see if that’s the problem. This is a real pain, and I’m sick of waking up and blowing my nose out every morning to find blood and mucus.

  41. KM on April 24th, 2014 1:13 am

    I have a C PAP was used lees then 1 month the smell of mold was coming from it if you held it close, it was taken apart and black mold was found inside the machine in areas that could not be cleaned with out taking it apart and replacing the blower, I think that the devices need to be more regulated or built better, or in away that will allow the user to clean the part that require air to pass through them into you body, but ever mind about the health concerns that it may be causing with who knows how many people, the cure is worse then the bite beware until they build these machines better or in away that will allow the user to clean it to contain mold growth I would not use one

  42. Sunita Menon on July 6th, 2014 8:23 am

    I have been a sleep apnea patient for 3 years and had 2 sinus surgeries prior to this to get rid of my ethmoid polyps. After my 2nd sinus surgery my ENT Surgeon Dr Milind Kirtane had suggested I do JALNETI ( It’s saline water irrigation of the sinus ) everyday, which I have been doing religiously.
    I am using CPAP for the past 3 years, the humidifier is used in the winter months of December, January and again in summer months of April and May when the AC is ON all night. Once I didn’t realise and used the CPAP without the humidifier, I woke up at 3 am with the similar symptoms like many others mentioned here. Next morning I went to my GP and she prescribed some antibiotics for the burning sensation and dryness of the nose to heal. As I mentioned earlier I did the ‘Jalneti’ after I returned from the doc, believe me I felt much better immediately, that day I did it twice and continued this practice till my nose healed. Jalneti is usually taught at the Yoga center, it’s worth a try if it can help out.

  43. Shane on July 15th, 2014 3:28 pm

    I’ve been using CPAP for about 7 years. This last year I came down with a sinus infection that got so bad I thought I would have to go to the hospital. Several rounds of oral anti-biotics that didn’t work unitl finally my ENT doctor decided to prescribe nasal anti-biotic solution that turned things around. I was sick from 09/13 – 02/14. And now I am starting to get sick again!

    Here’s what I think could be the problem with CPAP. Your nasal passages and sinus cavities were not meant to have a constant flow of direct air (pressured air) blowing through them for long periods of time. I think this air flow / pressure is causing nasal inflammation.. In other words, the nasal passage is suffering a kind of wind burn effect. If your sinuses get dried out or inflamed, they cannot function properly so as to expel the allergens, dirt, etc (by natural mucus flow) so those irritants build up and cause infections. This might explain why people (like myself) never had allergies prior to using the CPAP machine, now are told we have sinusitis because we have allergies. Actually, it’s just a build up of allergens because ‘air-caused’ inflammation is impeding proper mucus flow. It’s not that mold is in the mask or machine. It’s the air and air pressure that is causing an imbalance in your sinus cavities and nasal passages. Proper humidity levels help, but will not fully mitigate the wind burn effect.

    I think doctors may be hesitant to blame the CPAP machine in any way, because of fear that people will stop using it. This is understandable because the consequences of not using the machine can be far more detrimental than a sinus infection.

    BUT REMEMBER – Blowing air through your nasal passages is just not natural. It may help apnea but it’s going to have a negative effect…eventually. And if your eustachian tubes are blocked with fluids (like mine), it’s most likely because the imbalance of pressure (going in) has pushed fluids into the tubes instead of a natural drain (going out) opposite direction.

    That’s my theory anyway. Think about it and let me know what you think…

  44. Steven Park on July 17th, 2014 10:40 pm


    Thanks for your insight. I agree with you that blowing air into your nose is not natural, and I see many patients with similar experiences like yours. However, the vast majority of people do relatively well with CPAP. Unfortunately, there is a significant proportion that don’t react well, like you. Many people with obstructive sleep apnea have hypersensitive nasal and sinus nervous systems that over-react and creates inflammation, leading to not only sinus migraines but also bacterial infections. Unfortunately, you can’t know if CPAP will work with you until you try it. There are a number of troubleshooting steps that can be taken (like some of the suggestions in other reader comments), but at at certain point, you need to give up on CPAP and consider other options.

  45. Bernie on July 24th, 2014 4:28 pm

    What a great forum. I am at my wits end to know what to do with my sinus. Like everyone here I really believe there is a direct link with CPAP and the endless merry go round of sinus infections. It is a constant circle of anti- biotics and steroids which works for about a week and then everything starts to deteriorate. I use saline flush twice a day and clean my cpap regularly. I use bottled water in the machine. I dont smoke eat well and am resonable healthy at 52. I have just purchased a travelling APAP machine for holidays and will try this at home to see if this makes any difference. I have tried different doctors but they really don’t know what to do and are quite unwilling to accept my theory of the CPAP playing a major part in all of this. I never had a sinus infection until I started using the CPAP.

  46. Leonard Volk on July 25th, 2014 10:09 am

    New subject—I was just wondering if anyone knows of any additive that you can use in your c-pap H2O container that will aid in keeping your nasal passages open (like vaporizer fluids), but won’t be hrmful to your repiratory system after you have used them for 6-8 hrs, nitely.

  47. Shaun Wang on July 31st, 2014 3:33 pm

    Hi all,

    I am having similar problems with CPAP, which I have used for around 2 years. Every month or so I seem to get a sinus infection. I’ve gotten fairly good at stopping CPAP and aggressively treating until it goes away, so it usually only affects me for 5 – 7 days. However, it’s still a problem since it occurs every 4 weeks. Dr. Park, do you think these infections have something to do with bacteria/viruses/irritants on the humidifier or somewhere along the humidification system? I’ve heard various theories, some yes, some no, but it seems if more rigorous disinfection or adding a disinfectant to the humidifier water (GSE whether its the GSE or the preservative) seems to help people, it suggests that regular cleaning cannot get rid of the accumulation of microbes, and the pressurized air may provide an effective way for them to reach our sinuses? I’ve noticed my lungs are seem more inflammed with CPAP and have recently started asthma medication, which I did not need before. Thanks all!

  48. Elizabeth on July 31st, 2014 9:32 pm

    I have been using the CPAP for about four months. No sinus issues before now. Having surgery soon.

  49. Geoff Fitzgibbons on August 4th, 2014 5:29 pm

    I was getting severe sinus infections routinely until I began doing the following regiment….since then I have had ZERO sinus infections…
    When it’s cold out I fill the chamber with distiller water and my cpap machine has the ability to set it on 1 thru 5 to heat the water….li keep mine on two….I add water every day and only I day week I will use cap full of listerine mouthwash and water to clean the water chamber or reservoir and the hose….no more then once a week…. When the outside temp begins to warm up….generally may thru sept….I stop using the water at night and only blow the air…. During this time I do not flush the chamber or the hose with water listerine or anything else….as I believe various airborne molds develop…..knock on wood I have been sinus infection free for 2 yrs

  50. Jack on November 26th, 2014 9:34 pm

    I clean my hose and humidifier once a week for hose ,I my hose put it in the freezer for about 1 to 2 hours I heard this will kill all germs and bactiera that would hang out in the hose when all residue water is frozen all germs and bactiera is killed so I was told. If anyone knows anything different please inform me . Is their anyone that known how I can also keep my sinuses moist .

  51. Steve on December 5th, 2014 4:17 pm

    Like most I have been frustrated with Sleep Apnea and having to use the CPAP device. I was diagnosed in 2008 and since then have had re-occurring bouts of what has been diagnosed as Sinusitis.
    Late last year (Oct) I contracted a rather serious bout of Bronchitis. I was prescribed the usual anti-biotics and inhaler and after about 6 weeks started to show some signs of recovery. Then in April it came back and the same sort of regiment was applied again, another 6-8weeks. Early July again…this time I got into a local clinic as my GP was booked, same routine anti-biotics and inhaler. I had just recovered from that episode when it hit again this time sending me to the ER as now my breathing was severely compromised, chest xray’s led the Dr. to diagnose Bronchitis once again and once again the aforementioned regiment however each time the Anti-biotics seemed to change and Predisone was added.

    I suspected something with my machine must be causing this and despite a thorough cleaning on regular basis I decided it was time for an upgrade. The technician examined my old machine closely and was able to get inside and I was horrified to hear him tell me it was infected with Mold!
    After doing some research on my own I have insisted on an ENT as I was tested previously and confirmed to have an allergy to Mold, I suspect I have mold that has taken up residence in my Nasal Cavity if not Lungs as each night the constant air pressure sends these spores into my lungs causing the Bronchial like conditions.
    What else could it be? Many of the symptoms a lot of people describe sound so familiar, sinus headaches-infections, facial pressure, hot and cold flashes even though I am Male, nasal discharge, dry and “very” wet cough, extreme fatigue at times and the list goes on.

    I am a non-smoker in relatively good condition and active, 53 years of age but have become very ill over the past few years all stemming from my diagnosis of Sleep apnea and the use of this machine.

    Someone will make a fortune when they invent a machine that is Mold and Infection free and smart enough to force only enough air to prevent an apnea episode throughout the night.

  52. Jess on December 11th, 2014 10:46 am

    Dr. Park,

    In response to your comment to Matt on March 25th, 2014:

    This is interesting. Would you go as far as to say that nasal congestion caused by CPAP equipment that is not clean can negate a good CPAP prescription?


    Jess, Better Rest Solutions

  53. Jess on December 11th, 2014 10:49 am

    Dr. Park,

    You say that having a very sensitive nervous system in one’s nose can make it react to pressure changes, which is a common migraine feature, but is it possible that not keeping one’s CPAP clean could also factor into these unfortunate problems?

    Also, I would love the opportunity to ask you questions during one of your teleseminars. Can you give me some more information on this? I’m curious when your next teleseminar is and how the Q&A portion works. Is there a chat box or some other way of asking questions?


    Jess, Better Rest Solutions

  54. Jess on December 11th, 2014 10:49 am

    Dr. Park,

    You say that having a very sensitive nervous system in one’s nose can make it react to pressure changes, which is a common migraine feature, but is it possible that not keeping one’s CPAP clean could also factor into these unfortunate problems?

    Also, I would love the opportunity to ask you questions during one of your teleseminars. Can you give me some more information on this? I’m curious when your next teleseminar is and how the Q&A portion works. Is there a chat box or some other way of asking questions?


    Jess, Better Rest Solutions

  55. Jimmy Branch on December 19th, 2014 10:34 pm

    I’ve been on BiPap for two months. Pressure at 22/13, full face mask because I’ve
    never been able to breath through my nose. Severe apnea, waking up 87 times an hour. Allergy MD gave me fluticasone for nasal passages but once I started using a drop of GSE in my humidifier I’ve ceased using the script and have never breathed better. I told the allergy specialist my lung capacity was already improved. He didn’t believe me and said that was probably due to better heart performance (which has gotten better). He then tested my lung capacity and it was up 10 points from 60% to 70%. Grapefruit Seed Extract not only keeps bacteria levels down in my equipment but it has lowered my mucus levels in my lungs and nasal passages. Google the many benefits of this natural product.

  56. David on January 23rd, 2015 10:32 am

    I’ve had two sinus surgeries, tonsils out and can clean the damn CPAP daily, but ALWAYS within 1-5 days of use, my nose runs, feels like a nail is being driven through my nose into my sinuses, eyes uncontrollably water and am completely miserable. I hate this machine and apnea with a passion!! Is dying the cure??

  57. Steven Park on January 26th, 2015 6:36 am


    Sorry to hear about your CPAP troubles. It looks like you need to to look at alternatives besides CPAP.

  58. Jerry on February 7th, 2015 12:20 pm

    I wash it out every 3 to 4 days but I think it is causing me to have sinus colds, chest gets tight after a evening of sleep and I get nasal drippage.
    I have stopped using it and went to doc for some antibiotics that cleared me up after a week I started using machine again and in 4 to 5 days I am getting sick again. tight chested ,coughing is constant.
    Have had it for a year now and thinking this is the cause to my sinus problem.
    Anyone else have problems like this?
    let me know.

  59. Julie on February 23rd, 2015 10:15 am

    I find it helps my sinuses. I sufer from frontal sinus infections and don’t get them as often with sleep machine.

  60. David on February 23rd, 2015 12:13 pm

    Has anyone had or heard of the benefits of Crainialsacral Therepy (CST) for apnea?

  61. Vanessa on February 24th, 2015 8:50 pm

    Oh wow, I thought I was the only one, I have so much to say, I don’t know where to begin. I will never touch a CPAP machine again, I was up to my third night on trial for my severe headaches and migraines. So on this third night I was unsettled with mask etc, which seems to be normal. I went about 6 hrs in total, I don’t know what pressure setting was on as it was fixed, but I woke up severly sick and I was due to travel that day, I had to cancel everything. My symptoms were severe dizziness, I couldn’t lay down without the room spinning, I needed to vommit, I couldn’t vomit but I chucked up white foamy stuff. My ear was muffled and felt blocked. I had on and off chills through the day, mild sore neck pain. All symptoms lasted that day. I thought had gone but today I woke up with mild dizziness again. The worst part is the main doctor and scientist at the sleep unit are saying it def wasn’t from “their” machine but I know it made me sick. I’m in the middle of handling this delicately at the hospital and made formal complaints about the doctor and the sleep unit. Esp with the lack of compassion with what I went through. My 3 and 5 yr little girls were also scared of what was going on. I believe there is not enough research and there needs to be more of an investigation when dealing with oxygen and oxygen pressure. I’m reading more and more stories about hearing issues or hearing loss and other major problems related to CPAP machines esp using long term. My treatment and the response from the doctor and staff was just awful and traumatic. I hope people speak out more of the negatives and doctors listen to their patients when they say, “this is making me sick”
    Been through it.

  62. JoAnn on February 27th, 2015 12:45 pm

    I feel for people that need the cpap it’s great. I personally think this machine is killing my husband and the doctor just don’t get it. We drive for Schneider National. He was elected to take the sleep study 5 months ago. They said his score was low, and if he didn’t also have high blood pressure he wouldn’t have to use the machine. He always slept 6 to 8 hours before cpap. Now he hardly sleeps, got an infection that now requires surgery, and his front teeth are loose and needs dental work. But, if he doesn’t use the machine he gets put on a DOT safety hold and can’t work. As anyone else had problems like this?

  63. Domingo on March 4th, 2015 3:08 pm

    I’ve been on CPAP for quite some time. I believe my machine is forcing mucus into my ear canal somehow. At one time I had over $1,000.00 worth of masks and couldn’t get used to any one of them. Now, I use Nasal pillows. My machine was set real high, so I found out how to turn it down. Sometimes my nasal passages get what feels like “Wind burn” so I would take it off, but then I couldn’t sleep. One night I took a “Q” tip, and put a tiny bit of Vaseline on it and rubbed the inside of my nose. It worked!. I’m not suggesting to put a big glob of Vaseline in your nasal cavity, just enough to coat your sinus. works for me.
    Also, one of the times that I went in for a sleep study, the nurse kept waking me up to tighten my mask. She had it so tight I couldn’t stand the pain. I told her about it and she said the mask was leaking. Till this day I have dreams of her getting in bed with me and trying to tighten my mask. Not good! (I’m a retired truck driver, but having worked local for the last few years of my carrier, I never got caught by the DOT)

  64. Meg on March 4th, 2015 7:29 pm

    I successfully use Nutribiotics grapefruit seed extract concentrate in my cpap reservoir it not only knocks out the sinus infections but I believe it processes through the lungs and kills candid and other things. Silver Sol or colloidal silver works but so far I stick with a couple drops gse to a tank of water

  65. Sharon Baron on March 13th, 2015 7:27 am

    I had to stop using the CPAP due to awful infections in my nostrils using nose pillows. I would have a hard crust and cracks in my inner nose along with tenderness when touching the nose tip.In my left nostril I have lost the cartilage in the nose tip. I started using the mouth devices which helped,but my lower teeth started to loosen. I have great looking teeth so that option was trashed. One good thing is that I did not get those nostril infections for about 6 months when using the mouth piece, but the cartilage remains missing. I decided to try another type of nose cover and damn if that infection did not return immediately! This time in the right nostril. I found that the triple antibiotic grease applied in the nose helps greatly, but I don’t want to overuse use even this over the counter topical antibiotic. My blood pressure has become hypertensive and am now on lisinopril which I’m not too happy about. When I read about other problems many people are experiencing I just can’t figure out how we can resolve this awful diagnosis. Forced air does not appear to be the answer, but just another entry way for more problems with some being serious.

  66. Ronald Burke on March 25th, 2015 2:06 pm

    Today 3/25/15
    I just came back from the CPAP distributer and got a complete new machine and all accessories that are included. I have used a CPAP machine for 12 years and thought I would check on the internet to see if any other people have problems as I do.
    I was told you dont have to use the humidifer part in the winter so mold could not be a problem.. So I am not using any water in my machine for about 2 months.
    I have a constant sinus problem od nose drainage all day and especially in the morning when getting up. I must use 10 or 15 tissues with my 2 cups of coffee. It is a pain through the day but I put up with it. I thought it was an alergie but after taking Zertex for 3 months it didnt stop the drainage…. BUT..

    I was watching a program on 20/20 or something like it. I really cant remember exatly…The show was talking about a Lady, her Husband and Son.

    The lady was on a plane coming home from a work flight and she was sneezing and sneezing and the gentleman sitting next to her was listening to her problem concerning Her son developing an allergy problem or something like it. It got so bad he had to be put in the hospital and under care until they could dioginize the problem. Her husband was an intelligent person but lately has been having some of the forgetting problems and has been dioginazed with altsimer problem.

    He had some sort of forgetting and some of the systems of his child..They lived in a 3 Million home with 50 acres and not afraid of going to the doctors to check the problems.
    To make a long story short, The man on the plane told the lady to check the mold problem in the house and being a clean freak she could not believe this could be the problem.
    The Husband has altzhymer and boy is still having pproblems…

    The mold issue had been the problem and they have moved out since. I believe I have some sort of forgetting problem associated with the mold problem and the mold problem is considered poison. When I picked up my CPAP equipment today, I actulally forgot the correct year, I am getting worried…Ron

  67. Jimmy Branch on March 26th, 2015 10:15 pm

    Two drops of grapefruit seed extract in my humidifier has
    helped my sinuses. It’s a natural antimicrobial. I’ve heard
    some just use it to keep bacteria down in their equipment.

  68. Susan on March 28th, 2015 2:38 pm

    Humidity plays very important role, it can make a huge difference to the sinus. One of my friend told me that CPAP increase the possibilities of sinus infection. Great article by the way.

  69. Jen on May 11th, 2015 10:18 am

    I am about to start autoCPAP, but I am puzzled as to why the technician has given me a nose mask when I have MRI-diagnosed chronic sinusitus and can rarely breathe through my nose, even in the day.

    I asked 4 times and was just told that ‘most people’ do best with nose masks.

  70. Robin on June 25th, 2015 1:14 pm

    I swear every time I use my c-pap I get a cold. Not sure why. But its seems to happen every time. Anyone have any reasons why this happens.

  71. Fred on June 29th, 2015 10:54 am

    My doctor says, cpap does not cause infection. I know that’s wrong. I haven’t had a sinus or lung issue since 2007. I started using the cpap 3-13-2015 and I have had a horrible lung infection and sinus infection. I also have copd. and cronic kidney disease, and coronary artery blockage. I am so short winded, I thought this cpap would help. Now I cant lay down and sleep on back or side. I cant sleep in recliner. I am lucky to get 3 hours sleep a night. I wasn’t washing nose pillows and water reservoir daily. There is a ton of info on youtube with videos showing how to clean, how to wear, and address other questions. Don’t rely on your family doctor to guide you down the road to good health. I log every visit to every doctor on MS Excel. Date, time, Rx, treatment, etc. that way I can go back and answer any of my 5 doctors when they ask, ” when did this begin”? when did you have that surgery. etc..

  72. Anthony on August 16th, 2015 8:30 am

    I was diagnosed with sleep apnea in 2002. I have to say that the CPAP has significantly improved my life and allows me to get the sleep each night. However, it s seems I have cured one problem to create another. It was around 2005, three years after using the CPAP I started to waked up with a bleeding nose each morning. My right nostrile is so sensitive, just bumping it lightly sets it off. I use a naisal gel each night which helps with the bleeding but still at times it makes not difference. Sinus has now become a problem and 2-3 times a week I would wake with headache, pain behind my eyes and very sore naisal passages. The only thing that helps me ease the pain is cold and flu tablets but who wants to take these all, your life. I’m now taking the advise of others have have posted here and thoroughly cleaning my hose and water tank regularly plus using a good sinus rinse system. I have to say that after 3 months I’m seeing some releif.

  73. Sally Pickering on August 28th, 2015 1:56 pm

    Wow, So much great information. I relate to all of it!

    The pressure is definitely moving mucus and all sorts of stuff backwards in my nasal passages. I can say I feel it going out my throat instead of blowing it out my nose in the morning. I use to have buggers that I would clean out of my nose in the shower all of my life. They are now gone, but I feel mucus I have to clear out of my throat coming from upper sinus cavities. This change was gradual and not a problem at first. Now, I feel like this back up no longer come out of my throat but has settled in my ear canals and is steadily getting worse. My ears itch a bit and are painful sometimes. Allergy medications help alleviate acute pain. However, I have gotten to the point where I have had a persistent cough for a month that lead to an antibiotic treatment for pneumonia. I have been 100% compliant for 9 months. Only stopped to heal for the last 7 days.

    I am rethinking some of my cleaning habits. I will now let the water pan dry out during the day. I am definitely getting some of that grapefruit seed extract. Everybody likes that one. Replacing the hose every six months. Getting more of those ridiculously expensive machine filters. Something, I learned from my son and his sleep tech girlfriend, to use 2 teaspoons of Kosher salt in the water to help eliminate bacteria growth. That is if the grapefruit extract does not work. I agree the machine needs to be cleaned on the inside. I am going to look up how to do this and if I can do this online.

    I also agree the medical community is being very evasive about admitting that the cpap pressure therapy could be causing respiratory problems. The first step to solving a problem is admitting it. I love the sleep I get but not at the risk of my lungs. If I can do a better job of cleaning or maybe have to change out some parts more often, I will do so. Fix the bacteria issue, or give my body rests from it. That is what I am concluding so far.

  74. Kathy on December 1st, 2015 9:10 am

    Many of the symptoms mentioned sound very much like the symptoms my daughter had for nearly a year when we suddenly learned that her home was exposed to toxic black mold. Aches and pains, sinus issues and infections. She learned of the mold after her dog nearly died from exposure within two weeks of a rain storm. Southern California during the Summer by the way, and that is the last place you would expect to have mold grow. So she moved from the home back to my home. Did not use her CPAP for three months. Recently, she decided to use the machine again and during the night, her dog nearly stopped breathing. We removed him from the room and he got better. Removed the CPAP and the dog could sleep in the room fine. In reality, the dog saved my daughter more than once. CPAP issue: I personally made a call to the medical company that the sold the CPAP machine. I was told how to clean the machine and made a point to thoroughly clean the machine as instructed. They said the machine itself (inner parts), would not be affected. WRONG! Do not ignore your symptoms. My daughter had necessary wrist surgery, six ER visits and an endoscopy procedure during the year she was unknowingly exposed. From the moment she moved the medical visits ceased. Check the machine and if needed, have it tested by an expert. Black mold has always caused medical issues however, there are a lot of toxins in the air these days. Oh, lastly, I wanted to point out that my daughter also began to have memory and cognitive problems. I was only exposed one day a week while visiting, I too began to have memory and cognitive issues. Don’t underestimate black mold.

  75. Scott McDonald on December 20th, 2015 1:21 pm

    I too have been having sinus problems and infections…coughing up a white frothy Flem…I too wondered if machine itself was contaminated…it was! I just took apart and the blower wheel and the intake and out take was black….I figured I had nothing to was either that or get a new machine….we will see tomorrow if this helped which I suspect it will.

  76. Kim Pro on January 9th, 2016 11:07 am

    I like travel around the world. My problem is how to bring CPAP machine. I only sleep when use cpap machine.

  77. Steven Park on January 9th, 2016 2:05 pm


    CPAP machines come in very small sizes, and can be used in different countries and even on planes. There are battery packs as well as solar panels to recharge the batteries. Campers usually have no trouble at all.

  78. Kim Pro on January 11th, 2016 10:26 am

    Thanks so much

  79. marty kruppenbacher on January 16th, 2016 9:36 pm

    I have used cpap for 10 years. cleaned tube and nose pillow every couple of months . Poured and sprayed rubbing alcohol on and in hose and nose pillow maybe once a week or less.. I hang hose with head harness and nose pillow on a hook everyday.Always used city tap water with chlorine and would sometime just top it off. Foam filters were replaced every couple of years. Meant to do more often but I stay busy.If I didn’t reorder I would just wash old ones. Always had my yearly upper respiratory(feb–march) problem along with a consistent mucus related deep cough.
    I recently received a new machine. Had it two years already and replaced foam filter once. I recently stopped using water and put a quarter inch of sea salt in bottom of reservoir. Perhaps the salt will prevent bacteria and/or mold from running rampant. Where I live there are membership clubs that you attend and sit in a room lined floor to ceiling with dead sea salt and breathe. I’s humid where I live so I really don’t need water.Once a week I let it run as I spray rubbing alcohol near air intake filter .
    I let it run to let mist of alcohol run through the machine and out the hose.
    I’m probably breaking all the rules but I’ll see how I do.
    I really should order a new head harness and nostril thing as tape is holding it together.

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