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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209 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.

  4. Hi
    Chap user 4 years now.
    And Yes I do more basal drios chronic otitis and burning in back of throat and now currently going thru a nasty middle ear infection. So painful and gave me fever chronic pain and oh yes…I always been partially deaf now it’s steadily worse and blocked nose etc etc.I also get ulcers in the back of my throat right where you swallow. They are really sore and painful. I was told my pressure is spit on 12. But I wake up and my nose is blocked and my throat when I swallow burns and is uncomfortable.
    Please help! Any suggestions?

  5. I started c-pap 6 days ago. I don’t have chronic sinus infections. In fact, I can’t remember when I had a prior one. After the first night with C-Pap, I got a runny nose and from there, my sinus have been more and more congested and today, bloody mucus after blowing my nose. I have cleaned the nasal piece and water container daily.

  6. Dear Steven and cpap sufferers. Like Dan a filter to put right before the mask. The ones I know of and use are somewhat bulky and may shift the mask so it may leak. The newer the mask the better. You have to find the best placement for the hose because the filter has to sit next to the mask if you use the humidifier.
    It could be allergy or oversensitivity to material in the machine itself but the machine filters are not tight so it could be anything outside the machine too.
    Read on the site where you can buy (Philips)Respironics 342077 so called”bacteria filter” or hose filter and read peoples comments there. has Intersurgical Beatmungsfilter Flo-Guard 1690000 -3-A (140030)
    which also is 30g weight and has even lower flow resistance but has increases diameter therefore a little bulkier.
    It may not work with all cpap mask types. I have Resmeds Mirage FX Nasal Mask sys-eur2 62101.
    This mask Resmed has changed since 2012 -2022 and not telling customers or changing the specification number it is smaller and so it gives less air in my opinion. I had to change the settings to Whole face mask to get more air therefore.
    With these bulky hose filters I have to let the hose go down the chest from the mask and hose filter since reflux problems has me try to sit up while sleeping.
    Acid reflux is another cause for sinus problems that Steven Park has been adressing elsewhere. One has to stop eating and drinking like 4 hours before bedtime which is hard and may not alltogether help. Drink 1/5 of a teaspoon sodiumbicarbinate; make an sodium alginate “raft” , a gel, use the IQoro device may help some…

  7. I rinse my nose 2xs daily, plus 2 nasal sprays & oral decongestent, I have not had a sinus infection for 1.5-2 yrs. Ive used cpap machine for 8 days. 1st night on cpap woke 3xs, in the morning, nasal congestion, headache, cough & felt like I was on lung machine, chest ached. Nights 2-4 woke up 2-3 times each night, very tired, head preasure, chest ached. Messaged my doctor after 3rd night. Night 5 nasal drainage, woke spasm coughing 3xs, congestion, very tired. Night 6 took mucinex dm, woke up 2xs, congestion, Night 7 took mucinex, did not use cpap machine, slept thru night, woke up to nasal congestion, discolored, head preasure, negative for Covid, not as tired. Have not had message from my doctor.