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Researchers highlight dangers in buying secondhand CPAP devices online

Continuous positive airway pressure devices are "frequently available for sale" on classified advertisement websites, despite the fact that such sales are illegal and may pose significant health risks for second-hand buyers, according to data published in JAMA Internal Medicine.

"Continuous positive airway pressure (CPAP) devices are used to treat obstructive sleep apnea and can improve patients’ blood pressure, reaction times while driving, and quality of life," Marisa I. Peine, BA, BS, in the neuroscience program at the University of St. Thomas, St. Paul, Minnesota, and colleagues wrote. "Health insurance generally covers CPAP devices, but the typical cost of $600 to $2000 for patients without insurance or with minimal coverage can be prohibitive."

In the United States, the devices have been designated as Class II medical devices with possible risks by the FDA and require a prescription, the researchers noted.

They searched Craigslist.org in 18 cities and regions in the United States in October 2014 for any CPAP device listings. The areas were selected to provide a variation in populations, incomes and number of sleep clinics.

In addition, Peine and colleagues contacted 10 sellers in each location and placed ads in each of the 18 areas to anonymously survey CPAP buyers.

The researchers identified 270 advertisements for secondhand CPAP devices on the website. They reported that the number of advertisements in each location was positively correlated with median income (r = 0.53; P = .03), number of sleep clinics (r = 0.5; P = .04) and population (r = 0.7; P = .001).

Their analysis showed that 78.5% of advertisements did not describe who had used the device, 81.9% did not detail why the device was being sold and 85.9% did not include the pressure setting of the device. Further, 61.1% of the advertisements included a device with a mask without information on cleaning procedures or age and 74.1% included a photo.

Only 1.9% of advertisements included that a prescription was a requirement for CPAP devices.

The mean price of the listed devices was $291 and 87% of the devices were $500 or less.

The researchers also noted that their postings were flagged as inappropriate by site users and removed within 48 hours and they received no email responses from sellers.

"Unauthorized online sales of secondhand CPAP devices raise questions about safety and efficacy," Peine and colleagues wrote. "Patients require individualized pressure settings for the CPAP device; a secondhand device may deliver a low pressure that is ineffective or a high pressure that is excessive, leading to discomfort or even central sleep apnea events. The use of auto-titrating devices that were specified in 27 advertisements (10%) may mitigate these problems but do not eliminate other concerns, such as the hygiene of secondhand devices and masks. Similar concerns have been raised about unauthorized online sales of contact lenses. Nonetheless, increasing access to low-cost CPAP devices has benefits, especially when the devices are hygienic, in good working order, and might otherwise be discarded."

They stressed the use of assistance programs to help patients with limited resources, such as the CPAP Assistance Program run by the American Sleep Apnea Association. – by Chelsea Frajerman Pardes

Disclosures: The researchers report no relevant financial disclosures.