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DEAR DR. ROACH: I was diagnosed with severe sleep apnea in the early 1990s and have been using a CPAP machine ever since. I’ve just recently begun seeing advertisements on television for a product that cleans the inside of your CPAP machine. It is common knowledge that we must clean the facial mask, hoses and other external parts of the machine on a regular basis, as well as changing the filters, but I have no recollection of ever having been informed by any of my sleep specialist doctors that the inside of the CPAP machine requires regular cleaning. I also do not recall ever seeing any instructions regarding this in any CPAP manual. I notice that this new CPAP cleaning machine costs approximately $250-$300, and I have already read a few reviews posted by people who have had lots of problems with it functioning properly.
Is it really necessary to clean the inside of your CPAP machine? I’ve never been informed of this in all the years I’ve had sleep apnea, and I have gone through several machines. – C.P.
ANSWER: A CPAP machine is a pressurized device used mostly for people with obstructive sleep apnea. I also have seen these advertisements, but a review of the literature suggests that there’s a very low risk of infection or allergic reaction due to a dirty machine, mask or hose. Although the cleaning devices do work, I could find no evidence that they are necessary or offer any benefit beyond regular cleaning with soap and water. This should be done regularly. Filters should be changed every two to four weeks.
DEAR DR. ROACH: If you have had hepatitis B, are you able to donate anything (e.g., blood or organs)? I was never diagnosed with the disease, but I tested positive for the antibodies during a blood donation over 30 years ago. Someone recently told me that I can still donate plasma. Is this true? I signed up on my driver’s license to be an organ donor. Should I uncheck that box? I don’t want to endanger anybody unknowingly. – J.S.
ANSWER: Antibodies to hepatitis B may be developed during natural infection or through vaccination. A doctor can tell which kind from a blood test, by determining whether the hepatitis B core antibody is positive. People who have had natural infection (a positive core antibody) may not donate blood or plasma. People who have been vaccinated (the surface antibody is positive, but the core antibody is negative) may safely donate blood and plasma.
As far as transplants go, before considering using a person’s organs for transplant, the transplant team checks for the presence of active virus with sophisticated DNA testing. The likelihood of your endangering someone is low.
There is such an organ shortage that organs often are accepted from people with a history of viral hepatitis. For example, the medical team taking care of a person who is likely to die imminently without a heart transplant may accept the heart of a person with a history of hepatitis B infection. The person receiving the transplant likely would need antiviral treatment after surgery.
Don’t uncheck the box. Your organs may help extend the life and sight of many people.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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