Continuous positive airway pressure (CPAP) machines require regular cleaning to prevent bacteria growth. People can often clean CPAP machines using water and gentle cleansers, although device instructions vary. And while automatic CPAP cleaners are available, they are not approved by the Food and Drug Administration (FDA).

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Obstructive sleep apnea (OSA) causes a person’s upper airway passages to become blocked during sleep, interrupting both breathing and sleep. Symptoms of OSA include daytime sleepiness, significant snoring, and headaches. It also increases the risk of stroke, heart disease, and neurological conditions.

However, positive airway devices, such as a CPAP machine, can help people manage OSA.

This article discusses what CPAP machines are, whether they require cleaning, how to clean them, and more.

A CPAP blows pressurized air into an individual’s airways to keep them open, which helps improve their breathing during sleep. To keep the nasal passages from drying out, some individuals may use a humidifier with their CPAPs to keep the pressurized air moist.

A CPAP and all its parts need frequent cleaning. This takes time and has fueled considerable interest in automatic CPAP cleaners. However, none of these cleaning devices have approval from the FDA, which regulates drugs, food, biological products, and medical devices.

The FDA released a warning to this effect in 2020, recommending that people clean CPAP machines by hand and according to manufacturer instructions.

Bacteria and fungi can grow in CPAPs, as can viruses. Allergens, dirt, dust, mold, and pollen can also get into them. Unless people remove these contaminants, they can cause serious illnesses for CPAP users. They can also interfere with the functioning of the unit and make it smell unpleasant.

The best way to clean a CPAP is to follow the manufacturer’s guidelines. Often, this involves using warm water and a gentle cleanser, such as a mild detergent or baby shampoo. Some manufacturers might also suggest using a mixture of water and white vinegar in equal parts.

People should clean the following CPAP parts:

  • CPAP unit
  • humidifier
  • mask or nasal pillows
  • tubing

The American Thoracic Society recommends the following schedule for cleaning a CPAP:

  • Daily:
    • Empty the water from the humidifier and refill with distilled water only.
    • Wipe the mask or nasal pillows with a mild detergent.
  • Weekly:
    • Wipe the CPAP device with a soft cloth. Do not place it in water.
    • Wash the humidifier chamber. Air dry carefully.
    • Wash and rinse the tubing. Let it air dry.
    • Disassemble the mask or nasal pillows and tubing. Wash, rinse, and air dry.
    • Handwash the headgear. Rinse and air dry.
    • Wash the filter if the device has a sponge-like reusable one.
  • Monthly:
    • Replace the filter if it is disposable.

Other experts recommend washing the mask, water chamber, and tubing every day with hot water and soap. Some suggest soaking the water chamber in soapy water for 10 minutes every day.

The American Sleep Apnea Association recommends that people avoid using the following when cleaning their CPAPs:

  • harsh detergents
  • bleach
  • alcohol-based cleansers
  • antibacterial cleansers

There are two main types of automatic CPAP cleaners: one uses ozone as the active ingredient to clean all the CPAP parts, while the other uses UV light. However, neither has authorization from the FDA for cleaning CPAPs.

This means the FDA does not have any evidence or data to show that these types of CPAP cleaners are safe or that they kill germs. Additionally, the organization has received reports that some people experienced breathlessness, headaches, and asthma attacks after using an ozone-based CPAP cleaner.

Failure to keep a CPAP clean can lead to illnesses for users. If a person does not change the water in the CPAP reservoir regularly and replace it with fresh, distilled water, bacteria and mold can grow and cause illness. It may also worsen existing conditions. In addition, after regular contact with the oil and organisms on the skin, the mask can cause a skin rash or infection.

The FDA has not authorized any automatic cleaner for cleansing CPAPs. Agency tests also revealed that devices using ozone generated unsafe levels of ozone gas. In addition, cleansing devices using UV light might not consistently provide enough UV light to disinfect a CPAP machine.

The FDA reported multiple adverse reactions from using an ozone gas CPAP cleaner between 2017 and 2019. These reactions included:

  • trouble breathing
  • coughing
  • asthma attacks
  • headaches
  • nasal irritation

In a 2018 study, a person using a CPAP to manage OSA noticed their asthma symptoms worsened to the point that they wanted to discontinue CPAP treatment. This individual was also using an ozone CPAP cleaner. Instead of stopping CPAP treatment, they ceased using the cleaning device, which improved their asthma symptoms within 2–3 days.

OSA is a common condition that causes people to stop breathing as they sleep. It increases the risk of chronic health conditions but is manageable through treatment with a CPAP machine.

CPAP machines require frequent and thorough cleaning. Most manufacturers recommend using water and gentle cleansers to clean different parts of the device by hand.

While automatic CPAP cleaners are available and often use ozone or UV to clean CPAP machines, there are significant concerns about the safety and effectiveness of these devices. None of them have approval from the FDA.