CPAP And Sinus Infections

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?

Please note: I reserve the right to delete comments that are offensive or off-topic.

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164 thoughts on “CPAP And Sinus Infections

  1. That’s exactly what I did…I have a so clean machine…and a new cpap machine…I feel better already…I hope this is the answer and all my infecton will go away. thank you for your comment…you would think the insurance would help to pay for one, instead of paying all the doctor bills because of all the infections you get with a cpap.

  2. I also buy disposable small spherical in line micro filters that help filter out the dust (I live in the southwest). I change the filter about every 2-3 weeks, they are clear so you can see when the filter is getting dirty. It’s very easy to do and fits between the hose and the SoClean adapter on the machine. It will filter spores too if you have allergies. It’s about $30 for 10 filters and I buy them at a CPAP store on line. And of course I wash my foam intake filter on the back of the machine. I’m glad the SoClean is working for you!

  3. Yes, after using cpap for 19 years and being very compliant, I have over the last few years noted many more sinus and allergy issues that are stubborn and loathe to go away. Migraine\sinus headaches are very numerous, and I am unable to use my machine or sleep flat due to profuse mucus and drainage. I believe, no matter how clean I keep my cpap which is new, it is making me sick, and keeping me sick. My guess is, cpap, allergies and sinus are all making each other worse together. I have to quit cpap to stop and shorten my infections. Still a problem with OSA, will probably need a dental apnea oral appliance.

  4. Try a SoClean system. Since I started using one my sinus infections have all but disappeared. I do get dried out from time to time even with using my humidifier. I was about to dump my CPAP until I tried a SoClean. It really does work. It was worth every penny I paid for it. I even got a travel version that I leave in my travel trailer.

  5. I have pressure and mild dizziness in my head that behaves exactly like a sinus infection: head and face pain that moves around, constant tinnitus, unsteadiness etc. but very little drainage. This has been going on for over 6 months nonstop and hit with 4 ABs that have accomplished nothing and an MRI that has suggested nothing to treat. I believe the APAP machine has been aggravating the problem by forcing air into my nose. I only had mild apnea anyway. I am switching to breath right strips and nasal sprays and sleeping with temazepam and other aids to see if I can make a dent in it.

  6. I just read this entire website and I was sure it was me that wrote every single comment. I thought I must have had a camera on me. I have never had sinus problems in my life. I have had my CPAP for 4 years. Starting December 2017 I got what I though was the flu or cold. It is now May, 2018 and I have had three doses of antibiotics. They work well for about 5 days and then all my symptoms return. Headache, sore cheeks, sore dry eyes, clogged head. I went to an ENT and they put a camera down my throat. Nothing deadly was found thank goodness. I just have REALLY REALLY DRY nose and air passage. I clean my CPAP periodically but not going to lie. I don’t sanitize it. After reading all the comments, I am going to take a break from the CPAP and see what transpires.

  7. I started using Airsense 10 with humidifier cpap in May of 2015 (With nasal pillows). Starting in June of 2015 I started getting allergy/sinus type symptoms. I have had about 5 episodes of this and am currently experiencing another episode. I bought a so clean machine About one year ago and that doesn’t seem to help. It’s gotten so bad that now my sleeping has gotten terrible and the bags under my eyes look horrible. I’ve tried reducing humidity on cpap in summer and that hasn’t helped either. Going to GP again tomorrow and will also make apt with ENT specialist. Thinking about switching to dental appliance which my husband uses and likes. All this money spent and I felt better with sleep apnea…ugh!

  8. My suggestion is get a HEPA filter from your supplier, one like one used on the outflow of a ventilator. HEPA will filter down to micron viral size. See if this removal of everything via this filter helps. Many machines come with ultra filters available.. don’t know if you are using these ‘pollen filters’ or not, but the HEPA, is the HEPA. It is unusual to use with CPAP but can be done.

  9. Hello Polly. Sorry to hear about your problems but I would avoid giving up on your cpap even for a short period. I got over my sinus problems and Im now convinced it was caused by tree pollen. Have you a humidifier attached to your pump? This will cure the dryness in your throat and nose. Trust me, it makes such a difference.

    My problems have moved on to having a very slow resting heart rate in the low 40s. It would be interesting to hear if others have experienced the same thing with their sleep apnea.

  10. I have been on cpap for 8 years. I am a retired RN with a masters in critical care. I have had to educate myself because the medical community did not give me enough information on treatment. Such a shame that the medical profession puts the least educated as first contact. This is what I have learned over the course of my therapy.
    1. Sleep apnea is a dynamic condition that responds to many external stimuli.
    and treatment modalities should be adjusted accordingly.
    2. I have lived in 4 states and realize that the quality of air has an impact on my sinuses and ears with Kentucky being the worst. I used a micron filter but still endured sinus and ear infections. Since that time I have moved to the gulf coast with minimal problems. I think the salt air has helped.
    3. My heart rate is usually 42 without any symptoms. I exercise and have no problems or symptoms until it drops below 40. Still haven’t been able to find much research on sleep apnea bradycardia. Israel has a nice volume of research related to sleeping disorders and I continue to search.
    4. I have found a sleep hygiene program that works well for me. I perform a few tongue and neck exercises, blow up a balloon 5 or six times for lung exercises and practice relaxation for 5 minutes. My AHI numbers do vary depending on allergy season and range from 1 to 26 on a variable pressure that I do adjust seasonally. I use nasal pillows, a wisp, and occasionally a full mask depending on how the respiratory allergies are affecting me.
    5. I believe sleep apnea, like all chronic conditions, is in a state of flux depending on external stimuli. It is that stimuli that we as patients can alter and change to improve our ability to live a quality life with a chronic condition. I hope this rather lengthy missive helps.

  11. Read your reply with great interest Anita. I had terrible sinus problems which were checked with a camera. Nothing found. However as the trees (im in uk) began to get into full leaf the irritation and blood stopped.

    What caught my attention in your reply was your resting heart rate. I too have started dropping down to 40 but none of my medical practitioners are worried as my pulse is always up and steady when I see them. Its racing in the 60s 🙄!

    Im reasonably fit but i am diabetic and they have been struggling to control my high bp with medication. Ive read that if you have a resting heart rate as low as ours that we are regarded as athletes. Believe me im no athlete!

    Ive had a low resting heart rate for a couple of years now which I first noticed at 49bpm. Now its 40! So im getting fitter a year away from 60?? My apnea specialist said it was nothing to worry about but how low does it have to go before it is a worry?

    Thanks for your reply.

  12. This is a follow up to my post of 7/31 at 11:02. Reading all these posts has really enlightened me and given me different options. I went to my GP yesterday and told her that I’ve had 7 sinus episodes since using CPAP. After looking at the dates of those episodes it appears they mostly occur between April and October (with exception of one in Februar). She suggested that I start taking Allegra right before the Spring and continue through October (along with (Fluticasone nasal spray) since she feels my allergies along with CPAP are possibly causing my problems. I’m hoping this will help as now I’m on an antibiotic. I’ll update at a later date with everything I try and see if they help me.

  13. Good for you, observing and questioning what is happening to you is the best way to find out what the heck is going on
    A slow resting rate is a problem if your body cannot meet it’s metabolic needs and causes symptoms of dizziness, shortness of breath, cold hands and feet, and extra heart beats, ect That is probably why your doctor is not too concerned.
    . My take on bradycardia:
    The body’s response to a change in a feedback loop. I believe my Blood pressure is up in response to the slow rate to compensate for the delay in the cardiac output. I believe our entire biological system is a feedback loop to some biological changes happening as a result of internal or external stimuli . The question is what has changed to cause the slower rates?
    I believe the whole is greater than the sum of its parts with external stimuli contributing to body responses. Unfortunately, medicine is a reductionist science and attempts to isolate and compartmentalize the scientific response. That is changing slowly.
    As for an athletic heart, the heart is a muscle and enlarges in a athlete because of consistent life long exercising that demands fuel for muscle contraction resulting in increased ventricular wall thickness of the good type. More functioning muscle more power.
    That is not the case in our bradycardia. Heart rates are dependent upon multiple feedback (there is that word again) loops to beat and respond. Sorry about being verbose but I can get on a roll when the medical community does not provide a good knowledge base for their patients. That being said, remember, this missive represents my opinions based on my knowledge base. Good luck with your sleep apnea treatments
    respectfully Anita