Is my cough caused by CPAP?

Is my cough caused by CPAP?

Reading time: 6 minutes

What’s inside?

  • What are some common side effects of CPAP use?
  • Why do some CPAP machines have humidifiers, anyway?
  • What risks are linked to CPAP?
  • How do I clean my CPAP kit?
  • What if I already have a respiratory condition?


Up front: Nothing provided here is medical advice. I’m just a CPAP patient, not a doctor.


What are some common side effects of CPAP use?


Dry air

Some CPAP users find the constant airflow dries them out.

To combat this, it is common for many of us to go for the humidifier tank and heated hose.

This CAN work. After all, our airways are supposed to be a little moist. Otherwise, we wouldn’t just get dry coughs but swallowing food would become a problem too.

For humidifiers to have a chance of working, you need to get the balance right. Too much humidity in a cool room and you could find yourself dealing with rainout… where that humid air cools as it travels through the hose and turns back into water before it gets to your mask.

Not a good experience.

Too little humid air and you won’t see any benefit at all.


Is it the mask?

If you’re a mouth breather then you will most likely be using a full-face mask.

These are great for getting more air through the tubes and keeping them open. However, this also means you have a wind-tunnel strapped to your face, and the constant flow around your teeth and tongue COULD be enough to cause you to dry-up and give bugs a place to start work.

That doesn’t necessarily mean stay away from full-face… nasal masks can do pretty much the same thing to the nasal passages, which end-up in the same place at the back of the throat. So, finding the right balance for you is crucial.

Many of us accept the mask given to us with our first machine and never question it.

If you suffer from anything that could be related to your mask or mask-fit, it may be a good idea to get yourself back to your sleep professional for a check-up. Change could be on the horizon.


Is it reflux?

Acid reflux, or GERD, can be annoyed by high-pressure airflow, like that provided by CPAP.

If you feel like that trickle of something uninvited travelling the wrong way up your airway, it could be another good reason to get down to your doctors asap.

Over time, acid reflux can wear away at the lining of your windpipe, so not something to be ignored.


Why do some CPAP machines have humidifiers, anyway?

As mentioned above, standard constant airflow can dry out your airways.

Humidifiers do exactly what it says on the tin… they provide a little humidity to the air you breath.

There is no one-size fits all with CPAP though, so experimenting with your mask, humidifier and heated hose settings is crucial to finding your own personal sweet spot.

This can make huge difference to your sleep comfort.

But there is always a balance to be found…


What risks are linked to CPAP?

This study, approved by the University of Malta, provided a considered view on the positives and negatives of CPAP and humidifier use.

The basic questions it asks are ‘Is there a link between CPAP use and respiratory problems?’... and, if so, ‘What uninvited bugs are getting to us?’.

One conclusion, which most of us can agree with, is that humidifiers can help restore some comfort to otherwise dry airways.

However, they can also – in the study’s words cause ‘pathalogical bacterial colonisation’, or a build-up of bad bugs living in our kit. They go on to say this can cause airway infections.

Want to know more?... It is right here.

Without causing alarm, one extreme health issue, where water or water vapour is allowed to come into contact with hidden surfaces is Legionnaires Disease.

One US lawyer, as lawyers do, has pulled together some marketing information intended to improve their chances of getting some work. The assumption here, right or wrong, is that – given he’s a lawyer and he’s decided to make these public – there’s some validity in the claims.

Regardless, of whether that is true, the story of how Legionnaires Disease got its name is interesting enough to stand on its own.


How do I clean my CPAP kit?

So, bugs can find a home in our moist CPAP kit.

Do we give up or is there a way to keep them at bay?

I’m interested in the answer to this too coz, for months now, I’ve had a nasty cough... and yes, I use a humidifier.

I clean the tanks regularly with a 3 to 1 vinegar solution.

I have a spare tank so I don’t need to rush this cleaning task just to get the tank back into service again.

I clean my mask daily in soapy water.

The heated hose gets a warmy, soapy bath once a week.

And the straps get removed and put through the washing machine in a mesh back at least once a week, often more.

This all seems to meet or exceed the recommendations from the UK’s NHS here, but is it enough?

This official Resmed video covers cleaning of the Resmed 11, but most of the actions will be the same for most CPAP machines.

One thing I spotted in this video is the markings on the humidifier tank stating, ‘Distilled water only’.

I can already here the voices extoling personal preferences and recommendations.

I’m no different.

I’ve been using boiled tap water, from my soft-water supply, ever since I started on CPAP – which is nearly 4-years ago now.

Is this wrong?

I genuinely don’t know.

One problem is every statement or advice comes with the simple fact that it is someone’s opinion.

They may be a professional or expert on the topic, but it is still just an opinion.

I guess you have to decide for yourself how much digging and questioning to do before settling on a way forward.

That bit isn’t easy, and I don’t pretend to be the one to tell you what is right or wrong. I’m simply trying to give you more information to make a decision that suits you.


What if I already have a respiratory condition?

Finally, there’s the question not of picking-up a bug but making an existing condition worse.

For those with asthma, chronic bronchitis or anything similar, which treatments to go for can be a difficult call to make – given the extra information you may need to consider.

Another study found that while CPAP did improve the general condition of patients with chronic coughs, the number of hourly apnea/hypoapnea events and whether acid reflux exists can be important factors causing a chronic cough in the first place.


Is that it?

That depends on whether you think more digging is required for your own circumstances.

This was never meant to be medical advice. It says so right at the top… I’m not a doctor and have no intention in playing the part of one.

The purpose was, and is, to provide a high-level guide to some of the factors that could be playing a part in those of us who are CPAP users and have a chronic cough – that’s one that lasts longer than 8-weeks in adults or 4-weeks in children.

It is a huge pain in the jacksie. So, the intention here is to simply help others who may be suffering similar symptoms and perhaps give a little nudge towards seeking qualified medical opinion… eh, sorry… advice.


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