Study Raises Concerns About Sales of Secondhand CPAP Devices Interview with:

Ken Kunisaki, MD, MS Associate Professor of Medicine Minneapolis Veterans Affairs Health Care System and University of Minnesota

Dr. Kunisaki

Ken Kunisaki, MD, MS
Associate Professor of Medicine
Minneapolis Veterans Affairs Health Care System and University of Minnesota and

Roxanne Prichard, PhD Associate Professor of Psychology and Neuroscience University of St. Thomas

Dr. Prichard

Roxanne Prichard, PhD
Associate Professor of Psychology and Neuroscience
University of St. Thomas What is the background for this study? What are the main findings?

Response: CPAP devices, or continuous positive airway pressure devices, are used to treat obstructive sleep apnea, a common condition that causes people to intermittently stop breathing during their sleep. This leads to poor sleep quality and often results in symptoms like excessive sleepiness in the daytime. In the United States, CPAP devices are classified by the Food and Drug Administration as Class II medical devices with possible risks; their sale requires a medical prescription. We were aware of online advertisements for secondhand, used CPAP machines, but we have not seen publications that have analyzed this practice.

Once a week, our research team monitored online advertisements for secondhand CPAP devices on in 18 U.S. cities and areas over a one-month period. During that time, we found 270 advertisements, most of which did not describe who previously had used the device or why it was being sold. Only 5 of the advertisements mentioned anything about the legal requirements of a prescription and 61 percent of the devices included a used mask without information about its age or how it was cleaned.

CPAP devices create air pressure and attach to a nose or face mask that delivers that pressure to a patient’s airway, thereby keeping him or her breathing during sleep. The amount of air pressure delivered by the devices is adjusted for each patient and usually is determined by a medical exam that includes an overnight stay in a laboratory. Our study found that most of the Craigslist advertisements failed to mention the devices’ pressure settings—settings that were prescribed for the original owners.

The average price for a CPAP device listed on Craigslist was $291, much less than the $600 to $2,000 cost of a new device. What should readers take away from your report?

Response: Our results raise concerns about the safety of these devices and how effective these secondhand devices are.

However, we recognize that for patients with obstructive sleep apnea, but who do not have health insurance to pay for a CPAP device, these secondhand devices represent a less expensive alternative to purchasing a new device. What recommendations do you have for future research as a result of this study?

Response: Although we have concerns about the unauthorized sale and use of these secondhand devices, more research is needed to determine how often these online advertisements result in an actual sale and how often use of these secondhand devices result in a positive or negative outcome. Is there anything else you would like to add?

Response: An alternative to the Craigslist consumer-to-consumer method of online sales is the American Sleep Apnea Association’s CPAP Assistance Program (we have no affiliation with this association or this program).

This program collects used CPAP devices in good condition, cleans them, reprograms them based on the patient’s prescription, ships the device and a new mask to the patient or their doctor, and charges $100.

We believe that this CPAP Assistance Program provides a nice alternative to consumer-to-consumer sales. Similar programs should be developed to improve access to CPAP for the growing number of patients being diagnosed with obstructive sleep apnea, but who have limited resources to afford treatment. Thank you for your contribution to the community.


Peine MI, Prichard J, Kunisaki KM. Unauthorized Online Sales of Secondhand Continuous Positive Airway Pressure Devices. JAMA Intern Med. Published online August 08, 2016. doi:10.1001/jamainternmed.2016.4506.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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