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?

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203 thoughts on “CPAP And Sinus Infections

  1. I’ve been using CPAP (nasal pillows) for about 10 years, mostly without too many problems, but now I am getting horrible sinus irritation, pain and headaches to the point I have to sleep without the mask for a few nights to get rid of it. This is getting worse as I get older (I’m 75). It’s a catch22 situation because I either risk sleep apnoeas or a sinus infection, so I have little choice.

  2. Been on CPAP for 15 years. Have horrible sinus issues, constant congestion. Recently diagnosed with a sinus disease and arthritis in my jaw. Saline solution, Afrin nasal spray and Mentholadum is the only way I can sleep. Wake up several times during the night with nose stopped up. Was using CPAP machine over 10 years on recall for the sound prevention material coming apart and being ingested.

  3. My doctor recommended an additional filter.. shaped like a circle in the middle with 2 plastic arms for inserting between the line and the mask.. found it on Amazon. Haven’t had an infection in the 2 years since adding this.