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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.
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). Published 20th March 2020.
- There is no data yet regarding the risk of OSA alone in terms of COVID-19 susceptibility.
- Patients with OSA should follow the government advice re COVID-19:
- Patients with OSA and having other health conditions defined as extra risk have this advice:
NB. If you have a BMI of 40 0r over, you are defined as extra risk
- 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 if 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.
- Please look after masks and tubing carefully as there may be a temporary shortage in the future.
- A reminder that DVLA says anyone with excessive sleepiness having or likely to have an adverse effect on driving must not drive.
Sleep out-patient advice for hospitals
- Routine out-patient visits should be avoided unless urgent.
- Remote monitoring and telephone consultations may be an option for some.
- Posting of masks and equipment from Sleep centres should be encouraged, without patients attending.
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 20 3 20Final
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:
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.
If you have a question please email the Sleep Apnoea Trust Helpline on email@example.com or call 0800 025 3500, leave a voicemail and your phone number.
We do not provide personal medical advice. If you suspect you may be suffering from sleep apnoea please contact your GP who will be able to refer you to a sleep clinic.
This website contains a wealth of information which should answer most of your questions, including those that are DVLA related.
If you need to contact our confidential Helpline, this is now email based on firstname.lastname@example.org
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