COVID-19 (Coronavirus) Information for Patients

To provide additional direction to patients with sleep apnea (as well as patients with every sleep disorder) during this time, the AAHS has compiled these frequently asked questions (“FAQs”) to answer questions people have regarding COVID-19 (coronavirus), sleep apnea, the use of continuous positive airway pressure (CPAP), and other general questions. This information has been provided by the AAHS Medical Advisory Committee using current information available and includes information from the Centers for Disease Control & Prevention (CDC), American Academy of Sleep Medicine, and other official sources. This information is provided is for educational purposes only and does not constitute medical advice; contact your medical provider to discuss your specific condition or situation.
Additional resources can be found through: CDC, World Health Organization, or your state Department of Public Health for location specific information. 

Does having sleep apnea make me more likely to get the coronavirus? Will I be more likely to have severe complications if I get the virus? 
COVID-19 is a new disease and there is limited information regarding risk factors for severe complications so it is unknown at this point if sleep apnea will make you more likely to get coronavirus. Based on currently available information and clinical expertise, older adults and people of any age who have serious underlying medical conditions might be at higher risk for severe illness from COVID-19.
Currently, those at high-risk for severe illness from COVID-19 include:
  • People aged 65 years and older
  • People who live in a nursing home or long-term care facility
  • Other high-risk conditions could include:
    • People with chronic lung disease or moderate to severe asthma
    • People who have serious heart conditions
    • People who are immunocompromised including cancer treatment
    • People of any age with severe obesity (body mass index [BMI] >40) or certain underlying medical conditions, particularly if not well controlled, such as those with diabetes, renal failure, or liver disease might also be at risk
  • People who are pregnant should be monitored since they are known to be at risk with severe viral illness, however, to date data on COVID-19 has not shown increased risk

During this outbreak, should I stay home if I have sleep apnea? 
During this outbreak, everyone should avoid close contact with others. It is recommended that everyone stay home, regardless of sleep apnea status.  If you have to leave home for food, medical care or if you have a critical occupation, practice social distancing by maintaining a distance of at least 6 feet whenever possible.
If I do have the coronavirus, will CPAP help me treat it? 
CPAP has not been demonstrated to be specifically effective for the treatment of persons with COVID-19 but should be continued for those with sleep apnea; however, it is possible that using CPAP could increase the risk of spreading the virus to others around you. Be sure to talk to your medical provider about this risk. If you have the coronavirus, it is important to talk to your medical provider before stopping any medical treatments.
Is my CPAP machine the same thing as a ventilator? If not, can I convert it into a ventilator? 
A CPAP is not a ventilator and is not designed to work as ventilator.
If I do have the coronavirus, will CPAP drive the virus deeper into my lungs? Will this cause me to get pneumonia? 
There is no evidence to support that CPAP will make the virus worse or cause you to get pneumonia.
If I do have the coronavirus, is there a risk that using CPAP will infect others around me? If so, why? 
Using CPAP when you have the coronavirus could potentially spread the virus to others around you since the main source of person-to-person spread is from respiratory droplets, and the leak and the vent in the mask can spread the virus longer distances. If you are infected, you should make sure you are isolated from others.
If I have the coronavirus, how do I clean and disinfect my CPAP machine, mask and accessories? 
Masks and accessories, including the water reservoir for humidification, can be cleaned with soap and water. The external surface of the CPAP device can be cleaned with soap and water as well; however, do not immerse the CPAP device in water as that will make the device non-functional. You should clean your device according to the manufacturer’s instructions.
Will a CPAP cleaning machine disinfect my CPAP device and mask?  
The FDA reported that CPAP cleaning machines claiming to clean, disinfect or sanitize CPAP devices or accessories (such as masks, tubing, headgear) using ozone gas or UV light are not legally marketed for this use by the FDA. According to the FDA, it is unknown if these CPAP cleaners are safe and effective; you should clean your device according to the manufacturer’s instructions, which usually include using soap and water.
If I have the coronavirus, should I replace my CPAP accessories more frequently? 
No; clean and replace your accessories as usual.
What do I use in my CPAP humidifier if we have no distilled water? Can I use tap water?
It is best to use distilled water; however, you can use tap or bottled water but make sure to clean the humidifier thoroughly and often as minerals and salts will be deposited in the humidifier chamber/tub. Also, keep in mind that chlorine in the tap water can cause irritation.
Is the coronavirus mortality rate higher in those with sleep apnea?
There is currently no evidence that sleep apnea without other co-morbid conditions increases the mortality rate of persons with COVID-19; however, patients with sleep apnea could have co-morbidities, such as heart and lung diseases, which may increase their risk.

Is there any protective equipment, filters, additives, or chemicals (e.g. bleach) that should be used with a CPAP machine during the coronavirus outbreak?
CPAP equipment should be cleaned daily. Protective equipment and filters are used in the hospital setting.

Am I at a higher risk of infection if my CPAP filter has not been changed recently?
Filters should be changed according to your usual schedule unless they are obviously dirty.
Are children with sleep apnea at a higher risk than others for complications from coronavirus?
Children, in general, are at lower risk to develop complications from COVID-19. There are no studies or data available yet about the increased risk of complications from coronavirus in patients with sleep apnea. However, untreated severe OSA can cause weakening of the immunity. 
I occasionally take Ambien to help me fall asleep when I have a head cold. If I develop symptoms of the coronavirus, is it safe to take Ambien? Should people who have the virus avoid other medications? 
In general, Ambien or sleep aids aren’t recommended for long-term use, and use of all medications should be assessed by you and your healthcare provider. At this time, information is not known about the effect of Ambien on COVID-19 progression or developing complications; however, symptoms of coronavirus include fever, which can contribute to delirium in some patients, therefore, sedative hypnotics should be avoided. If you are taking Ambien or other sedative hypnotic medication daily, you should not stop the medication abruptly. You should consult your healthcare provider to discuss your medication if you have symptoms of coronavirus.
I take trazadone every night and suspect I may have contracted the coronavirus. Should I discontinue use while having coronavirus symptoms? 
There is not enough information known yet about the effect of Trazadone on COVID-19 progression or developing complications. However, trazadone should not be stopped abruptly. Discuss this with your health care provider before stopping this or any other medication.

What sleep position should I use if I have the virus?
There isn’t specific guidance at this time regarding how best to sleep if you have the virus. If you are have trouble sleeping, you can try sleeping on your back, right side, left side, prone, and in a semi-sitting position and use the position or positions that are most comfortable; you should consult your primary care physician to discuss other interventions as well.

Can my CPAP machine be repurposed as a ventilator for COVID patients?
There are several projects currently ongoing determining how to repurpose PAP machines for use by patients with COVID-19 in hospital or clinical settings.  These projects include:
Ventilator SOS
Ventilator Project

If you have additional questions that are not addressed above, contact inquiries@sleepallies.orgyour questions may be helpful for other patients and may be included in this FAQ. These FAQs will be updated as new information is available.