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97: CPAP Rainout and using CPAP while sick

cpap Feb 10, 2024

In winter, the air we breathe is cold and dry.  This means our nasal mucosa can dry out and the colder temperature makes the immune defense system in the nose more sluggish.  Nasal congestion is more common, as are infections with respiratory viruses.  

A moisturized and open nasal passage is not only more comfortable, but it is also a better defense against illness.  

CPAP users have an advantage in the winter because the humidification of CPAP air can be increased to replenish moisture in the nasal mucosa.  But turning your humidity up in a cool bedroom can result in rainout- a gurgling collection of water in your CPAP tubing that can wake you up.  This happens because the air in the tubing cools off quickly as it leaves your CPAP machine.  Water falls out of the cooler air and pools in your tube.  

You can fix this in a few ways, including:

  • Turn your humidifier setting down a little to find that sweet spot where you're getting moisture in the air but not too much rainout.
  • Move your CPAP machine lower than your head so the water runs back down into the humidifier chamber.
  • Use a heated tube (must have a machine that has the heated tube connection) to keep the air in the tube warm- the water stays in warm air better.
  • Use a hose cozy (or is it koozie?) to insulate the tubing so the air stays warmer.  Your CPAP tube needs an extra blanket in the winter, ha.  

If you do get a virus that causes nasal congestion, don’t stop using your CPAP.  Healthy sleep will help you recover from any illness or insult faster.  Step up your cleaning routine while you are actively sick with cough and congestion.  Ideally, that once-a-week water bath increases to daily (click here to get my Fast, Cheap, and Easy CPAP Cleaning Guide).   And you may want to do a few other things differently for comfort:

  • Switch to a full face mask so you have the option of breathing through your mouth during sleep.  
  • Turn up the humidification (see above if you get rainout)
  • Make sure the air filters in your CPAP machine have been changed recently.
  • Use a nasal saline rinse at night (either spray or neti pot) to clear mucus from the inside of your nose and sinuses.  The saline rinse helps break up and evacuate the mucus.
  • If the saline doesn’t improve your nasal congestion, you may need a medicated nasal spray.  Check with your doctor for safety and recommendations.  Examples include Flonase (fluticasone steroid nasal spray), Nasacort (triamcinolone steroid nasal spray) or Afrin (oxymetazoline decongestant nasal spray)) at your drugstore.  Remember that oxymetazoline is very effective but should only be used for 3 days maximum.  
  • Cold remedies and decongestants may also help with symptoms but can cause dry mouth.  Check with your doctor for safety and recommendations.  You might try Xylimelts or Biotene products for dry mouth.  Some people do well with a chin strap or mouth taping. 




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