Travelling With Your CPAP Following The COVID-19 Pandemic
Guidance as of 19th January 2021, third Pandemic Peak: Government advice changes rapidly, and up to date information should be sought
During the COVID pandemic Government advice should be strictly followed, and travel avoided or minimised to reduce the spread of SARS-CoV-2, remembering that you can be infectious without having any symptoms. As rates of SARS-CoV-2 fall, travel between specific areas will be permitted again, but it is still necessary to take precautions.
The danger of using CPAP in a time of SARS-CoV-2, is that IF YOU PERSONALLY HAVE COVID-19, AND ARE USING YOUR CPAP, you can spread it to others in the vicinity. Remember, you may not know you have COVID-19 and be asymptomatic; you may even have had a recent negative test as tests are not 100% sensitive, and things can change day by day. The reason is that when you breathe out through your mask or nasal fitments a standard CPAP turns this into an aerosol that is perfect for distributing the COVID-19 virus throughout the space you are in.
There are presently no restrictions on CPAP carriage or use, however it would seem sensible not use your CPAP in a public space such as a train, plane or airport until community rates of this infection are low. Note that you can still use your CPAP in a hotel room with your usual household members, with whom you are already in close contact.
You should take your CPAP into hospital if you are admitted; the circuit may be modified with a different mask without a hole for the breath out, and a bacterial-viral filter for the air you breathe out.
IF YOU DON’T HAVE COVID-19, then CPAP is no more dangerous than any other equipment you own – a wipe-down to keep it clean is fine, added to your usual cleaning regime.
If you travel regularly or frequently in the UK, we highly recommend that you use the NHS Test and Trace App to identify the places you go to. You may have no symptoms but be carrying the virus anyway, and thus still be a danger to others; it’s essential to follow your movements if you are.
If you are travelling outside the UK, we advise you to consult www.gov.uk for the latest information on the COVID-19 situation. Many airlines/ flight routes require a negative SARS-CoV-2 test from a designated source within 48-72 hours of flight. Ask your airline when considering travel.
Guidance regarding coronavirus (COVID-19) and Obstructive Sleep Apnoea (OSA)
Guidance regarding coronavirus (COVID-19) and Obstructive Sleep Apnoea (OSA):
for people who routinely use continuous positive airway pressure (CPAP), their families and health care workers, 16 December 2020
Compiled by Dr Sonya Craig and Dr Sophie West with the OSA Alliance (incorporating British Thoracic Society, British Sleep Society, Association for Respiratory Technology and Physiology, Sleep Apnoea Trust Association)
General advice
Patients with OSA should follow the government advice re COVID-19: https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response.
There is no data yet regarding the risk of OSA alone in terms of COVID-19 susceptibility in the community.
There is some limited data suggesting that OSA may be common in people admitted to hospital with COVID 19; this is because of the shared risk factors of obesity, type 2 diabetes and high blood pressure.
Home advice
- People with OSA should continue to use their CPAP at home as normal.
- There is no evidence that using CPAP makes you more likely to catch COVID-19, and nothing to suggest that CPAP will make you more unwell if you do catch it.
- If a CPAP user becomes unwell with symptoms suggestive of COVID-19 (new cough and fever > 37.8 C), please follow government guidance regarding self and household isolation.
- We do not know whether CPAP makes virus spread worse within a household. This will be something you will need to consider when deciding whether or not to continue using CPAP whilst you are self-isolating with symptoms of COVID-19. You may wish to distance yourself from vulnerable household members by changing bedrooms or stopping CPAP for a short time.
- Any respiratory infection, particularly with a blocked nose, can make it more difficult to use CPAP. Try and persist, but if wearing CPAP makes you feel worse (e.g. by increasing coughing and disturbing sleep), then stop using it until your respiratory symptoms improve. Sleeping more upright, avoiding alcohol and using a mandibular advancement splint if you have one, may help as alternatives to CPAP in reducing OSA a little in this period. Your OSA symptoms are likely to worsen over the week, but will resolve when you restart CPAP.
- Routine hygiene is adequate for infection control: changing machine filters routinely, cleaning surfaces, cleaning mask and tubing with hand-hot soapy water (washing up liquid) and washing hands regularly.
- Masks and machines should not be shared.
- Please use the telephone number/email address provided by your sleep centre for urgent issues with your equipment or sleep/OSA related symptoms. Do not attend in person unless instructed to do so. Please be aware the team may not be able to respond quickly, as staff may have been moved to Emergency Services.
- A reminder that DVLA says anyone with excessive sleepiness having or likely to have an adverse effect on driving must not drive.
- Avoiding using CPAP in a public place such as a train or aeroplane whilst the pandemic is ongoing.
Sleep out-patient advice for hospitals
- Routine out-patient visits should be minimised, but may still be necessary where face to face assistance or assessment is necessary, including mask fit help, blood gases.
- Remote monitoring and telephone consultations should be an option for most patients now.
- Posting of masks and equipment from Sleep centres should be encouraged, without patients attending.
- Screen for COVID symptoms before any attendance, advising people to stay at home if symptomatic and consult above website for more advice.
- Do face to face CPAP set ups without turning CPAP on where feasible, as this is an aerosol generating procedure.
- When it is necessary to turn on CPAP in face to face consultation, minimise COVID-transmission risk by screening for COVID symptoms before attendance, ensuring an up to date negative COVID swab (if needed for day case attendance according to hospital policy) and use level 2 PPE (gown, gloves, FFP3 mask, visor). Leave the area empty for an hour after using CPAP or maintain level 2 PPE.
Advice for a person with OSA who routinely uses CPAP who is unwell and admitted to hospital due to suspected/confirmed COVID-19
- Bring your CPAP machine into hospital with you.
DO NOT USE YOUR CPAP UNLESS INSTRUCTED BY STAFF: you may be asked not to use CPAP for OSA on an open ward if you have suspected COVID-19, until COVID-19 screening results are back. If you use CPAP for Obesity Hypoventilation Syndrome (OSA, obesity plus respiratory failure) requiring CPAP to maintain ventilation, this should be continued but will need an isolation area (such as side room or negative pressure area), so please be guided by medical staff caring for you. - To decrease any risks of infection from CPAP whilst you are in hospital: your usual mask, which has a vent to allow you to breathe out, may be changed. The new temporary mask will not have this vent, but a bacterial/viral filter can also be added along with an exhalation port in the tubing.
- DO NOT USE your humidifier with your CPAP machine in hospital due to increased droplet spread.
For a copy of this information please click here OSA Alliance CPAP COVID-19 Advice
For advice on how to sanitise, clean and maintain your CPAP equipment, please refer to the “Living With Your CPAP” leaflet or the equivalent A4 Patient Information Sheet (for home printing), by clicking the links below:
Living With Your CPAP – A4 – Sep 2019
YOUR QUESTIONS ANSWERED
With the help of European Respiratory Society (ERS) respiratory experts, the European Lung Foundation (ELF) has created a COVID-19 Q&A which covers a wide range of questions that they have received from the public over the last few weeks. The information is primarily aimed to help people with respiratory conditions but can also be helpful for the general public.
