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Would a Full Face Mask be Better for Medical Emergencies (Like Corona Virus)

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Biguglygremlin +0 points · 14 days ago Original Poster Sleep Enthusiast

There is a high probability that many CPAP users will eventually be exposed to the Corona Virus

If I/they/we become seriously ill will we be able to manage the equipment effectively.

The CPAP could be a life saver for someone with an acute respiratory disease when respirators are in short supply.

But what if someone became seriously congested and dependent on others to manage everything?

If I found myself in that situation would my current equipment still be effective?

I've been using nasal masks for almost 5 years now but they only work with preemptive measures to ensure that the sinuses are clear and constant vigilance to maintain correct positioning, direction and tension etc.

I doubt that others could or would manage these factors effectively on my behalf.

Would a full face mask be more versatile and more manageable in extreme circumstances?

I'm thinking of purchasing one specifically for this kind of situation but which one would be the most practical choice?

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Sierra +0 points · 14 days ago Sleep Patron

In all of this TV coverage with all kinds of medical experts offering their advice on COVID, I recall one doctor responding to a question about using a CPAP instead of a hospital ventilation device. The answer was basically, "no", that a CPAP cannot function like a ventilator in that it essentially cannot force a person to breathe. In my non medical professional opinion I think a CPAP could help assist breathing though. There is a slightly different version of the CPAP called an ASV that is often used for central apnea, that does monitor your breathing and actually can step in and to some degree force the breathing. There are also some BiLevel machines that have a backup rate, which attempts to force breathing to a certain extent at a fixed rate. A BiLevel machine can also do more to assist breathing more than a CPAP. A CPAP typically can only put about 3 cm of pressure on inhale compared to exhale. A BiLevel machine can provide quite a bit more pressure support, and it also can go up to 25 cm of pressure, compared to 20 cm with a standard CPAP (or APAP).

But, back to your question, both myself and my wife came down with a very nasty cold back in January. The symptoms were very similar to what is attributed to COVID. I found that my APAP which is currently set to a fixed pressure of 11 cm and no EPR after I go to sleep, provided a lot of assistance in breathing while I had the cold. I suppose it might have provided more assistance with a higher pressure and the EPR turned on at 3 cm, but I never found it to be necessary. As for your mask, as long as you can use the CPAP without opening your mouth at the pressure you need, a nasal mask should be just fine.

Hope that helps some,

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Biguglygremlin +0 points · 14 days ago Original Poster Sleep Enthusiast

Yes it seems to me that those of us with very severe Apnea would need a working CPAP at least up until a respirator became necessary and especially when difficulty breathing is one of the dominant symptoms and I do believe that the CPAP does help breathing even without the Bilevel function.

However I really don't think that the nasal pillows are manageable by a third party, especially if they have no real experience with this equipment.

I'm not sure that a full face mask would be much better because I have had almost no experience myself with a full face mask but it seems to me that medical carers would feel more confident or have more familiarity with the concept of a full face mask.

The chaos of this virus is costing money in many unexpected ways. Money that I just don't have, so I am not looking to spend money if it serves no purpose but I suspect that a full face mask, as much as I dislike the idea, might be a good investment in the long run.

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Sierra +0 points · 14 days ago Sleep Patron

I have a ResMed F20 full face mask that is sitting in a box somewhere. I hated it. At the time I tried using it I had my machine in auto mode with pressures going up to 15 cm or so. It seemed determined to leak, making farting noises, and blowing air into my eyes, despite all attempts to make the straps looser and tighter. I just gave up on it, and I would have to be really desperate to try it again. I have heard that some people use a full face mask when they get a cold because their nose becomes congested. The cold I got was a dry cough type and there was minimal nasal congestion. And, even when I do have nasal congestion, I find that the air pressure keeps one side or the other, or both open.

What I found most effective with the cold we got was Benylin Dry Cough Nigh syrup. That was what got us through the cold. It stopped the cough and let me sleep. We have stocked up on it, just in case we get the COVID.

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Biguglygremlin +0 points · 14 days ago Original Poster Sleep Enthusiast

Ok thanks Sierra for your good advice.

I might try to get some of that syrup.

I rarely get a cough so I don't usually have anything like that on hand.

If I was really sick and had wound up the pressure to compensate for congestion it would be more than just the mask that was making farting noises, but I think I'd be a bit beyond caring at that stage.

So you figure that what you had was very similar to the new virus?

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Sierra +0 points · 13 days ago Sleep Patron

My wife is convinced that we had COVID, but I think it is virtually impossible. We were in Mexico from Jan 6 to Jan 20, and got the "cold" almost immediately after our airline trip home. The first case in Canada was diagnosed about Jan 23, and I recall all of the first wave of cases were clearly related to travel from China. It seems really unlikely that the virus could have gotten to Mexico or on the plane that quickly. That said about the only symptom we were missing from a full COVID diagnosis was that neither of us had a high fever. The main symptom was a brutal dry cough.

One thing to keep in mind if you do get in trouble is that your CPAP may have the ability to accept oxygen. You would need a doctor to prescribe it, but I believe some people with breathing issues use an oxygen supplement as a normal practice.

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SleepDent +0 points · 13 days ago Sleep Commentator

I am a dentist working in dental sleep medicine. Unfortunately, I have some really bad news for the people on this forum. In a post dated 3/22/20 the American Academy of Sleep Medicine states that the use of CPAP by patients with COVID-19 infections does, indeed, pose a significant risk to other family members in the household because it disseminates the virus into the air regardless of what face mask you use. Please check out the FAQs on their web site about this. There is also some risk of spread during the routine cleaning process. Oral sleep apnea appliances are specifically cited as being a safer alternative, as are some other things. Now, I am not suggesting that you dump your CPAPs, but you MUST be absolutely sure that you are totally isolated from other household members and it may make some sense to move some very vulnerable family members(or yourself) to a different location. Arthur B. Luisi, Jr., D.M.D.. The Naples Center For Dental sleep Medicine.

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Sierra +0 points · 13 days ago Sleep Patron

If one is in full isolation due to having COVID you have to stay in a separate bedroom and bathroom, with no interaction with other family members. Without that, all members in the house will get it sooner or later. We all have to exhale one way or another, and I don't really see how a CPAP would make it any worse. One of the main suspected mechanisms for the rapid infection rate in Italy has been blamed on family members not self isolating in the home, from other family members.

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Biguglygremlin +0 points · 13 days ago Original Poster Sleep Enthusiast

Oh how I do love 'experts' and statistics, although what I was able to find at the above site, was more like a disclaimer, with no rationale provided.

I wracked my poor brain for a while to find a situation in which that potential might apply, and once I got past the point that Sierra makes, which is essentially that the only viable alternative was to simply stop breathing, and my own view that most of us 'oldies' are more likely to be the destination than the source, it occurred to me that if we transplant the scene into a hospital ward then the CPAP machine might become problematic, depending on what containment systems are in place, and certainly there would be issues to do with cleaning and maintenance.

I really can't see how it would increase the risk at home. In fact a full face mask or chin strap would serve to suppress any droplets from coughing. Not that that would make any difference because anybody else sharing the same space will be infected anyway.

I had wondered about the oxygen. It might be interesting to know more about although I really hope things don't get to that stage.

I didn't intend this thread to become apocalyptic.

I am not personally stressed or anxious about this virus, although obviously new rules and concepts do apply. For me it is interesting and challenging. Yet another puzzle to be solved.

I intended this thread to be about being prepared and if SleepDent's observations reflect the views of the medical staff at large then it is something we do need to be aware of.

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Sierra +0 points · 13 days ago Sleep Patron

I did a quick search and found this article:

The Complete Guide to Using Oxygen with a CPAP

It looks like any CPAP can be used with the purchase of a $5 adapter to get the oxygen into the air stream. However the cost of the oxygen tank and regulators may be quite a bit more than $5.

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SleepDent +0 points · 12 days ago Sleep Commentator

Remember that the exhaust air coming out of the vent ports on the masks is STILL PRESSURIZED. There would clearly still be potential to expel virus particles out of these vent ports for a significant distance. Dr. Luisi

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Sierra +0 points · 12 days ago Sleep Patron

Yes, that is a bit of an issue. Some masks are much worse than others however. Full face masks use the most purge air, and the nasal masks the least. Some masks attempt to diffuse the air stream, while others do not. The worst mask I have used for blowing air in a high velocity is the ResMed Swift nasal mask. The exhaust is like standing behind a jet plane. There is zero attempt to diffuse the exhaust. The best mask I have used is the ResMed AirSense F10 nasal pillow. It does an excellent job in diffusing the exhaust. You can't feel it or hear it.

BUT, the important point is that if someone is in bed with you or even in the same bedroom, and you have COVID-19, then they are going to get it too, regardless whether or not a CPAP is used. That is virtually 100% certain. The only way to contain it is to use a different bedroom, bathroom, and maintain the 2 meter physical distancing.

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Sherry +0 points · 6 days ago Sleep Commentator

This is what I heard: There is concern that CPAP machines may aerosolize the virus. This should be addressed by moving to a separate room and even asking housemates not to enter that room for several hours after the CPAP was in use to minimize any virus in the air. Some Doctors may be advising against use of CPAP for those infected as a conservative approach to minimize transmission to others in the household. I would check with your provider for direction in using CPAP with the virus.

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Biguglygremlin +0 points · 5 days ago Original Poster Sleep Enthusiast

For those of us with very severe Apnea not using the CPAP is not an option, unless there is another device available. (like a ventilator)

I understand the concerns but a good sneeze would have the same effect, so if we are going to apply every possibility of proximity and drift and airflow and duration and surface contamination etc etc then add in the human factor, we would need to move to another planet.

All we can do is be informed, be sensible and be careful.

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Sierra +0 points · 4 days ago Sleep Patron

The main difference between a ventilator and a CPAP/BiPAP/ASV) seems to be that the ventilator is more invasive compared to a normal mask. A tube is actually inserted to direct air/oxygen to and from the lungs. Air exhausted is filtered to remove an virus material to prevent contamination of the room. Here is a news article that explains a bit about it.

What is a Ventilator?

For those of us on a CPAP it seems to me that staying at home and self isolating may be a better approach than going to a hospital if medical advice supports that approach. Our treatment in the hospital may be compromised to prevent spread of the virus, by taking away our CPAP. Something to be discussed with your doctor if one does get diagnosed with COVID.

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Biguglygremlin +0 points · 4 days ago Original Poster Sleep Enthusiast

I suspect that many older people who don't get out much will have to deal with this virus without getting diagnosed.

Not that it's a good idea to avoid diagnosis but many of our governments, for reasons mostly to do with politics and economics, are not making testing available to the majority of their citizens no matter what symptoms they might have.

So I figure that it will be treated by many of us like most other infections that we deal with at home, unless it becomes life threatening, at which point medics, doctors and hospitals will need to be involved and, if it is serious enough, they will run diagnostic tests for their own safety.

I can see the point you are making about avoiding hospitals Sierra, and agree with it in pretty much all circumstances including this virus, while ever it is safe and sustainable, but I doubt that a GP would have any leverage with the hospital system and I don't think any hospital in Australia would offer credible assurances in advance because many of their decisions are made and unmade on the spur of the moment, so it would all come down to changing cirumstances, availability and priority.

I guess that is a good argument for effective preparation and communication.

Perhaps preparing a brief medical history clearly noting relevant details and medications as well as the severity of Apnea and the machine settings.

Letting those we share our lives with know about the medical history and showing them how to pack and prep the CPAP in case it is possible to use it later.

One of the greatest risks is that the patient might be too sick to do what needs doing and perhaps even too sick or confused to communicate effectively.

Hopefully none of these considerations will be needed but, according to the concepts espoused by Murphy, being unprepared is not a good option.

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