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Would a CPAP (Continuous Positive Airway Pressure) Machine Break the Fast?

Answered as per Hanafi Fiqh by DarulIftaBirmingham

Answered by: Alimah Zainab Nakhuda

Question:

A brother with sleep apnea needs to use a machine when sleeping in order to ensure he keeps breathing. This machine has a humidifier, and so along with oxygen, water vapour is also ingested. This brother is a city bus driver by profession, and he often has to work night shifts, so for him to not sleep during the day is difficult. He says that it is technically possible for him to use the oxygen machine without the humidifier (water vapour), but it dries up his nostrils and gives him severe headaches and it is difficult for him to function, and he says that it can even be a risk as he has to drive buses, so it might affect his decision-making ability.

(All this info is according to what the Mustafti told me)

Will such a person qualify for fidyah? And is this scenario similar to what is mentioned in some fatawa that someone who is required to use an inhaler will give fidyah and at the same time fast?

In the name of Allah, the Most Gracious, the Most Merciful

Answer:

Yes, the machine that you are referring to, a CPAP (Continuous positive airway pressure) machine, will break the fast if used with its humidifier settings, because in this case, the water vapour is being ingested.1 This machine can be used without its humidifier settings as you mentioned, and in this case, will not break the fast.

In the Quraan, Allah SWT does exempt the sick person from fasting, but He SWT also commands them to make up for these fasts during other days, i.e. when they recover from their sickness and they are able to keep the fast;

أَيَّامًۭا مَّعْدُودَٰتٍۢ ۚ فَمَن كَانَ مِنكُم مَّرِيضًا أَوْ عَلَىٰ سَفَرٍۢ فَعِدَّةٌۭ مِّنْ أَيَّامٍ أُخَرَ ۚ وَعَلَى ٱلَّذِينَ يُطِيقُونَهُۥ فِدْيَةٌۭ طَعَامُ مِسْكِينٍۢ ۖ فَمَن تَطَوَّعَ خَيْرًۭا فَهُوَ خَيْرٌۭ لَّهُۥ ۚ وَأَن تَصُومُوا۟ خَيْرٌۭ لَّكُمْ ۖ إِن كُنتُمْ تَعْلَمُونَ ١٨٤

˹Fast a˺ prescribed number of days. But whoever of you is ill or on a journey, then ˹let them fast˺ an equal number of days ˹after Ramaân˺. For those who can only fast with extreme difficulty, compensation can be made by feeding a needy person ˹for every day, not fasted˺. But whoever volunteers to give more, it is better for them. And to fast is better for you, if only you knew.

Surah Baqarah, Verse 184

The concession of Fidyah is only for those with such illnesses and conditions which will never allow the person to be in such a state that they can keep a full fast, i.e. those with chronic illnesses or old age. For example, those with extreme asthma, who know that they must everyday utilize their puffer after a certain number of hours, and have no other way around this. Or those with diabetes that must take medication or eat every few hours to control their sugar levels. In conclusion, this concession is for those that do not have the option of fasting at all.

From what you (and the Mustafti) have described, it seems like it would be difficult for him to fast, but not impossible. There are numerous solutions and options that we can try to consider before thinking of completely leaving the fasts and giving Fidyah:

  1. You mentioned that he is a city bus driver. Most city employees have some sort of paid vacation days (usually a few weeks at least). It seems like this brother can take these vacation days during Ramadhaan so that his work does not affect his fasting or vice versa. Similarly, he can request his workplace to give him a day shift for the month of Ramadhaan only, so that he can use the CPAP machine at night with the humidifier, and be free of headaches during the day when he is driving.
  2. The brother works night shifts. This actually provides a great benefit in his case, as he can actually refrain from using the humidifier during the daytime when he is fasting, take medication and use nasal sprays during his work hours at night to help with the headaches and dry nose. The headaches most likely occur because of blocked sinuses (a common reason for headaches whilst using a CPAP machine)2. He can take steam for this before he goes to work (at night when he is not fasting) to clear up the sinuses and prevent headaches. Similarly, many medications are also readily available for headaches, which he would be allowed to take because he is not fasting during these hours of work because of his night shift.
  3. If he absolutely cannot fast whilst working in Ramadhaan, and cannot take off from work either (none of the above options works for him and he insists that he is in dire need of leaving his fasts), then he would still have to make up for them and do Qadhaa after Ramadhaan, on the days when he is able to fast. For example on his off days during the week when he doesn’t have to worry about headaches being a danger while he is driving a bus, and when he can sleep at night using the humidifier so that he will not have headaches during the day while fasting.

As I have mentioned above, it seems that this individual has many options to which he can resort for his fasting, hence the concession of Fidyah would not be applicable to him.

Only Allah knows best.

Written by Alimah Zainab Nakhuda

Checked and approved by Mufti Mohammed Tosir Miah

Darul Ifta Birmingham

Reference

1 Badaai’us Sanaai’, page 90, volume 2, Maktabah Shamelah

وَأَمَّا رُكْنُهُ: فَالْإِمْسَاكُ عَنْ الْأَكْلِ، وَالشُّرْبِ، وَالْجِمَاعِ … فَدَلَّ أَنَّ رُكْنَ الصَّوْمِ مَا قُلْنَا فَلَا يُوجَدُ الصَّوْمُ بِدُونِهِ.

وَعَلَى هَذَا الْأَصْلِ يَنْبَنِي بَيَانُ مَا يُفْسِدُ الصَّوْمَ وَيَنْقُضُهُ لِأَنَّ انْتِقَاضَ الشَّيْءِ عِنْدَ فَوَاتِ رُكْنِهِ أَمْرٌ ضَرُورِيٌّ، وَذَلِكَ بِالْأَكْلِ، وَالشُّرْبِ، وَالْجِمَاعِ سَوَاءٌ كَانَ صُورَةً وَمَعْنًى، أَوْ صُورَةً لَا مَعْنًى، أَوْ مَعْنًى لَا صُورَةً وَسَوَاءٌ كَانَ بِغَيْرِ عُذْرٍ، أَوْ بِعُذْرٍ وَسَوَاءٌ كَانَ عَمْدًا، أَوْ خَطَأً طَوْعًا، أَوْ كَرْهًا بَعْدَ أَنْ كَانَ ذَاكِرًا لِصَوْمِهِ لَا نَاسِيًا وَلَا فِي مَعْنَى النَّاسِي،،

 

2 Common CPAP Side Effects & Prevention | American Sleep Association

Headaches

Although headaches are not a common CPAP side effect, they can occur if the machine’s pressure is set too high or if you have a blockage in your sinuses.

This answer was collected from DarulIftaBirmingham.co.uk, which is run under the supervision of Mufti Mohammed Tosir Miah from the United Kingdom.

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