Clin Exp Otorhinolaryngol.  2024 May;17(2):160-167. 10.21053/ceo.2024.00025.

Level of Contamination of Positive Airway Pressure Devices Used in Obstructive Sleep Apnea

• Choi JH
• Kwak IY
• Kim KS
• Min HJ

• KMID: 2556006
• DOI: http://doi.org/10.21053/ceo.2024.00025

Abstract

Objectives
. No study has yet evaluated the degree of contamination after the total disassembly of continuous positive airway pressure (CPAP) devices. We investigated the extent of contamination of CPAP devices used daily by patients with obstructive sleep apnea (OSA) by disassembling the systems and identifying the factors that influenced the degree of CPAP contamination.
Methods
. We conducted a chart review of the medical records of patients with OSA for whom the CPAP devices were disassembled and cleaned. Two skilled technicians photographed the levels of contamination of each component and scored them using a visual analog scale. Patients’ clinical characteristics and records of CPAP device usage were statistically analyzed to identify characteristics that were significantly associated with the degree of CPAP device contamination.
Results
. Among the 55 participants, both the external components, including the mask and tube, and the internal components, such as the humidifier and the interior of the main body, showed a substantial degree of contamination. The total and average daily duration of usage of the CPAP device did not show significant associations with the degree of contamination. Age was most consistently associated with the degree of contamination, such as in masks, humidifiers, and interior and exterior main parts. The degree of contamination of the internal components of the device was significantly correlated with the degree of contamination of the external components.
Conclusion
. Age-specific guidelines for managing the hygiene of external and internal CPAP components should be prepared.

Keyword

Continuous Positive Airway Pressure; Contamination; Obstructive Sleep Apnea; Humidifier; Age

Figure

• 

  Fig. 1. Photographs of a continuous positive airway pressure (CPAP) device before and after complete disassembly and cleaning service. The exterior main body of the CPAP device before (A) and after cleaning (B). The humidifier of the CPAP device before (C) and after cleaning (D). The interior main body of the CPAP device before (E) and after cleaning (F).

• 

  Fig. 2. Correlation (Corr) among the degree of contamination of the mask, tube, humidifier, interior and exterior main body of the continuous positive airway pressure devices. The upper-right triangular elements illustrate Pearson correlations, the lower-left triangular elements portray two-dimensional (2D) density mapping with jittered data, and the diagonal elements depict variable density through kernel density estimation. A contour plot visually represents a 3D surface by plotting constant Z-level lines (contours) on a 2D plane. ***Significance of the correlation, indicating P<0.001.

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