Fact-check Malta: Is a power cut deadly to someone with sleep apnoea?

A recent interview between opposition leader Bernard Grech and journalist Tim Diacono from the online media portal LovinMalta was brought to an abrupt halt by an increasingly common occurrence – a power cut.

The incident rightly raised exasperated chuckles from the pair.

“Do you see what problems the country has?” Grech said when the power eventually returned. “You can’t even carry out a simple interview because the power goes out”.

“We can laugh it off, but if you’re at home, asleep, and you use a sleep apnoea machine on which you depend to breathe and if it doesn’t work you could die, then when it’s time to sleep you are afraid that the machine could turn off in your sleep because of a power cut, then it’s not a joke,” Grech added.

This is not the first time that Grech has spoken of the dangers of power cuts to people with sleep apnoea.

On 19 July, as several localities across Malta and Gozo were left in the dark for as much as 20 hours, Grech posted a video to his Facebook page, sharing a story of a person with sleep apnoea who feared going to bed each night lest a power cut stop their machine from functioning.

A few days later Grech went a step further, telling the Nationalist Party’s TV and radio stations that “someone with sleep apnoea can die: if their machine stops working, they will get less oxygen in their blood, which can kill them”.

Several people wrote to Times of Malta in the following weeks questioning whether this was true and whether they should be concerned for their loved ones who suffer from the condition.

What is sleep apnoea?

To put it simply, sleep apnoea is a sleep breathing disorder in which a person’s breathing repeatedly stops and starts, often leading to symptoms such as loud snoring, gasping for air while asleep, poor sleep and headaches or irritability once awake.

Different types of sleep apnoeas exist, with the most common being obstructive sleep apnoea, where the throat muscles tend to relax and prevent air from flowing into a person’s lungs.

Sleep apnoea is far from uncommon, even in Malta, where thousands of people are believed to have the condition in some form or other, with numbers increasing in recent years. Until recently, doctors estimate, around 90% of sleep apnoea cases went undiagnosed.

Untreated sleep apnoea can lead to more serious health problems, including cardiac issues, strokes and higher risk of diabetes over the longer-term.

People who have the condition typically use devices known as CPAP machines to aid their breathing while asleep. This device, which straps over a person’s nose or mouth, uses mild air pressure to keep a person’s airways open while they sleep.

Those with more severe forms of sleep apnoea (known as central sleep apnea) are likely to use a more complex device known as a BiPAP machine.

Will a person die if their machine loses power?This is highly unlikely.

Sleep apnoea experts who spoke to Times of Malta say that this is virtually unheard of amongst CPAP users, pointing out that several of their patients frequently sleep without the device altogether because it irritates them, much to their doctors’ frustration.

Others, they say, often go to bed wearing the device only to remove it in the middle of the night.

 

Nevertheless, a CPAP machine losing power in the middle of the night can be a deeply unpleasant experience for some people.

Doctors say that the person is likely to wake up (sometimes gasping for air) and might find it difficult to go back to sleep. Meanwhile, the condition’s symptoms – headaches, irritability, lack of focus, sleepiness – are likely to return.

But a machine losing power does not mean that a person will be unable to breathe. CPAP masks have built-in safety mechanisms, air vents and exhalation ports that allow users to breathe regularly even if their power supply is cut off.

Speaking to Times of Malta in the midst of the 2023 cut crisis, respiratory expert Martin Balzan said that spending a night or two without a CPAP machine may be uncomfortable, but it will not ultimately be fatal.

Nevertheless, experts say that going for days or weeks on end without using a CPAP machine could potentially lead to more serious complications and, eventually, death.

This appears to be the conventional wisdom across medical circles.

Addressing a series of myths about CPAP machines, the renowned Mayo Clinic describes the suggestion that a person could suffocate if the power goes out as “false”.

“Since the CPAP machine doesn’t help you breathe or provide oxygen, you won’t suffocate, even if the power goes off. However, without the stream of air propping up your airway, it may feel like you can’t breathe, as well,” the clinic says.

Other clinics and services specialising in sleep disorders have a similar take, with some describing it as “extraordinarily rare” for a person to die because of a malfunction or power interruption to their device.

What about more severe cases?

Although far more rare, there are believed to be dozens of people in Malta who suffer from more severe forms of sleep apnoea, including those brought about by conditions such as obesity hypoventilation syndrome and neuromuscular disorders like ALS.

In these cases, patients depend on more complex machines such as BiPAP devices or non-invasive ventilators.

These patients, doctors say, are likely to suffer far more severe, and possibly fatal, consequences if their device stops working.

But, they add, this is why these devices are typically fitted with batteries and backup mechanisms that kick in once the power goes out.

These batteries tend to last for several hours, enabling the patient to safely get through the night even in the case of a blackout.

Verdict

People with the most common form of sleep apnoea, who use CPAP machines at night, need not worry unduly. Although it might be deeply unpleasant to have their machine suddenly turn off at night, the chances of it having fatal consequences are negligible.

Longer-term stretches (usually weeks on end) without using a device, on the other hand, could lead to more serious, and in some cases, fatal consequences.

Power outages could potentially be more dangerous, or even fatal, for people with severe forms of the condition, who use more complex ventilation machines. But in these cases, ventilation devices are typically fitted with batteries and backup mechanisms that act as a safeguard in case the device loses power.

The claim is therefore mostly false as the evidence generally refutes the claim, although some minor aspects of the claim may be accurate.

The Times of Malta fact-checking service forms part of the Mediterranean Digital Media Observatory (MedDMO) and the European Digital Media Observatory (EDMO), an independent observatory with hubs across all 27 EU member states that is funded by the EU’s Digital Europe programme. Fact-checks are based on our code of principles. 

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