Coronavirus disease 2019 (COVID-19) can have a potentially serious effect on your lungs. While some people can experience shortness of breath, others can develop pneumonia or a life-threatening condition called acute respiratory distress syndrome.

If you’ve developed COVID-19 and have difficulty breathing, you may need supplemental oxygen or mechanical ventilation.

You may wonder if a continuous positive airway pressure (CPAP) machine would be useful if you’ve developed COVID-19. This is a device that’s most commonly used for people with sleep apnea.

The answer is no. CPAP machines have no use for people at home who have or are recovering from mild-to-moderate COVID-19.

While CPAP machines have been used in hospital settings as a noninvasive way to manage severe hypoxia (low levels of oxygen) from COVID-19, research has found that conventional oxygen therapy is just as effective and easier to deliver.

This article takes a deeper dive into what a CPAP machine is and why it’s not particularly helpful for people with COVID-19.

A CPAP machine works to deliver a consistent amount of air pressure into your airways, which helps to keep those airways open.

Generally speaking, a CPAP machine has a few basic parts:

  • a mask that covers your nose and mouth
  • straps that help to secure the mask in place
  • a tube that connects the mask to a motor
  • a motor that works to supply air to the tube and mask

One of the common uses of a CPAP machine that you may be familiar with is for the treatment of sleep apnea. In sleep apnea, your airways become blocked during sleep, which can lower or stop your airflow. This is called an apnea episode.

The constant air pressure provided by the CPAP machine helps to prop your airways open while you’re sleeping, lowering the frequency of apnea episodes or eliminating them completely. Due to this, a CPAP machine is one of the first-line treatments for sleep apnea.

CPAP machines may also be used in a neonatal intensive care unit (NICU). In this setting, they can help to treat preterm infants who have underdeveloped lungs.

What’s the difference between a CPAP machine and a ventilator?

A mechanical ventilator is a device that works to move air in and out of your lungs. Simply put, it helps to do the work of your diaphragm and other muscles that help you breathe.

Additionally, the amount of air pressure that a ventilator provides can be adjusted according to your individual needs.

In contrast, a CPAP machine only provides constant positive pressure. While this props your airways open and can therefore help you to breathe, it doesn’t assist you with the physical task of breathing like a mechanical ventilator does.

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Research into CPAP machines to treat COVID-19 is limited to individuals hospitalized with serious illnesses, often in intensive care units (ICUs). In these settings, CPAP machines were used as a way to manage low oxygen levels and keep people off mechanical ventilators, similar to oxygen therapy.

One study found that for people experiencing life-threatening respiratory failure from COVID-19, a CPAP machine was beneficial during the first days of hospital admission, but only for infections that cleared within 7 days. For longer hospitalizations, use of a CPAP machine was associated with an increased risk of death.

Another study compared the use of a CPAP machine versus oxygen therapy in people with COVID-19 who were deemed not likely to benefit from mechanical ventilation. The study found little benefit of a CPAP machine over oxygen in terms of clinical outcomes, and the use of a CPAP machine was more challenging.

A third study looked at CPAP machines as a way to keep people admitted to a hospital with COVID-19 off mechanical ventilation. CPAP machines were used on a continuous basis until stable improvement in oxygenation, until intubation, or until death. Of the 53 people on a CPAP machine: 12 avoided intubation, 13 were intubated, and 19 died.

No studies or evidence supports using a CPAP machine for the treatment of COVID-19 in home settings.

Bottom line

The strategy of using a CPAP machine to manage oxygen levels in people with COVID-19 was no more effective than conventional oxygen therapy and was more challenging to use.

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Generally speaking, there are two methods that doctors or healthcare professionals may use to help people with COVID-19 breathe. These are supplemental oxygen therapy and mechanical ventilation.

Supplemental oxygen therapy

Supplemental oxygen therapy focuses on providing your body with extra oxygen. This is typically given through a face mask or a nasal cannula, which consists of two prongs that clip onto your nose.

There’s also a form of supplemental oxygen therapy called high-flow oxygen therapy in which air and oxygen are delivered at a higher rate. Equipment heats and humidifies the air so that it doesn’t dry out the airways.

Since high-flow oxygen therapy can deliver oxygen faster, it can be beneficial if you develop more severe respiratory failure.

Mechanical ventilation

As we mentioned earlier, mechanical ventilation helps you to breathe when you’re unable to do so on your own. It works to move air and oxygen into your lungs while helping to remove carbon dioxide.

Most people who are on a ventilator are in the ICU. Equipment will monitor vital signs such as respiratory rate, blood oxygen levels, and heart rate in these individuals.

When you go on a ventilator, an endotracheal tube is placed into your windpipe in order to deliver the air. A sedative is also often given. Eating isn’t possible due to the endotracheal tube, so nutrition is given via a feeding tube.

If you’ve had COVID-19, your lungs may need some time to recover. During this period, you may find that you have lingering shortness of breath, particularly when you exert yourself.

A 2020 review article notes the importance of breathing exercises as a part of COVID-19 recovery. Here are some breathing exercises that you might try:

Diaphragmatic breathing

Diaphragmatic breathing involves breathing from your belly as opposed to your chest. It helps to improve breathing and strengthen your diaphragm. To do diaphragmatic breathing:

  1. Place your hands onto your stomach.
  2. With your mouth closed, breathe in through your nose. You should feel your stomach expand as you do this.
  3. Breathe out through your mouth. Ideally, breathing out should last two to three times longer than breathing in. You should feel your stomach move back in as you exhale.
  4. Repeat the exercise for about 1 minute.

Additionally, experts from Johns Hopkins University recommend doing your diaphragmatic breathing exercises in phases based off of your individual capabilities.

They suggest starting by doing your breathing exercises on your back with your legs bent. Next, it’s recommended to try them while on your stomach, then while sitting, and eventually doing them while standing.

Yawn to smile

This exercise helps with breathing as well as improving coordination and upper body strength. To do it:

  1. Sit up straight on the edge of a chair.
  2. Yawn widely while you reach your arms over your head.
  3. Bring your arms back down to your sides, smiling as you do so.
  4. Repeat the exercise for about 1 minute.

Humming while exhaling

This exercise works by helping the blood vessels in your body to widen, allowing more oxygen to flow to the organs and tissues of your body. Humming is also a relaxing sound, so it may also help to ease feelings of anxiety. To do this exercise:

  1. Sit up straight on the edge of a chair, placing your hands on your stomach.
  2. With your mouth closed, breathe in through your nose. Try to breathe as you’ve practiced in diaphragmatic breathing, feeling your stomach expand as your inhale.
  3. With your mouth still closed, exhale through your nose while humming.
  4. Repeat the exercise for about 1 minute.

Things to know and precautions

Recovery from COVID-19 takes time. While it’s important to push yourself a little bit, try not to overdo it. If certain exercises cause you to feel too fatigued or out of breath, stop doing them and try again later.

It’s also possible that a doctor may recommend other types of breathing exercises than what we’ve discussed above. If so, be sure to follow their instructions carefully.

Contact a doctor if your shortness of breath continues to persist, becomes worse, or significantly impacts your daily activities. Call 911 or local emergency services if your have shortness of breath with severe symptoms like:

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Some research has found that early treatment with a CPAP machine may be beneficial if you are hospitalized with severe COVID-19. There currently isn’t enough evidence to support the use of a CPAP machine for mild-to-moderate COVID-19.

If you’ve had COVID-19, you may have lingering shortness of breath. Breathing exercises can help to improve your lung and diaphragm function. Additionally, be sure to ask a doctor about other methods that can help to improve your breathing.