Some more questions from a newbie

[kennyjoon]

Thanks again to everyone on this board. This is such a great resource.

I have a few more questions as a newbie that I am hoping someone can help me with.

1. I have read a lot about the need to regularly clean the various parts of the CPAP machine. I have heard that I can use dish soap or vinegar in some parts, but I am a germaphobe and need to keep things simple. I saw at the grocery store some sanitizing wipes made by Seventh Generation that claim to use only botanical ingredients. It even says it can be used on surfaces that come in contact with food. Do you see any problem with me using these to clean the machine, humifier chamber, tube, and/or nasal pillows?

2. My ResMed S9 has a feature to adjust the EPR, which I understand reduces the pressure when I am exhaling. It can be adjusted from 0-3. My DME did not mention anything about this to me when I picked the unit up, but it was set to 1. Should I adjust this? Is there any benefits or drawbacks to a higher setting?

Thank you!

[Pugsy]

2. My ResMed S9 has a feature to adjust the EPR, which I understand reduces the pressure when I am exhaling. It can be adjusted from 0-3. My DME did not mention anything about this to me when I picked the unit up, but it was set to 1. Should I adjust this? Is there any benefits or drawbacks to a higher setting?

Maybe one potential drawback and only a maybe for some people...sometimes the drop in pressure during exhale using EPR (which is a 1 cm drop per setting so a setting of 3 equals a 3 cm drop) reduces the overall effectiveness of the pressure in its job of keeping the airway from collapsing. It sort of depends on what the original setting is/was if it will impact the events or not.
So sometimes using EPR lets some events sneak past the defenses and sometimes it doesn't.
My suggestion is to play with it to see if the other settings feel better or not..then use what feels the best and evaluate the reports and then see if it has impacted the AHI or not. It doesn't always create a potential problem...just sometimes for some people.
It's more important to be comfortable and sleep well. If need be the pressure can be altered so that the comfort of EPR is allowed and still deal with the events effectively.

I will let someone else tell you about their cleaning regiment. If you are a germaphobe ....you wouldn't be comfortable with mine because I don't do much. Weekly washing of my nasal pillows and that's it. That would freak out a lot of people but hey, it works for me and I am the only person I have to please.
You are the only person you have to please so you can do whatever it takes for you to be comfortable with the cleanliness of your equipment. We have some other germaphobe forum members who will likely chime in and offer what they do.

Vinegar stinks...I hate the smell but if you don't mind it go for it. Cheap, easy and effective for what you want to do.

[archangle]

I saw at the grocery store some sanitizing wipes made by Seventh Generation that claim to use only botanical ingredients. It even says it can be used on surfaces that come in contact with food. Do you see any problem with me using these to clean the machine, humifier chamber, tube, and/or nasal pillows?

You need to use "real" cleaners. Either stuff made for CPAP, or some sort of cleaner that's good in general. If you use some sort of "natural, organic" cleaner, you're probably going to end up with "natural organic" germs growing on your equipment. For almost anything made by plants, there's some sort of organism that feeds on it. Be especially careful of cleaners that leave some sort of goo behind like scents or lotion.

"Natural" organic stuff is likely to have residue in it that can serve as food for germs. It's also a lot more likely to have something that will cause an allergy. For instance, many people are allergic to natural rubber, but few are allergic to synthetic rubber.

About the only "organic" cleaners I would trust for CPAP would be grain alcohol or hot water. Most brands of CPAP equipment have sterilization guidelines that include an option to use a carefully controlled hot water sanitization process. I wash most of my parts in the dishwasher with an extra rinse cycle and really hot water. It's not appropriate for some parts like the headgear and hoses.

My ResMed S9 has a feature to adjust the EPR, which I understand reduces the pressure when I am exhaling. It can be adjusted from 0-3. My DME did not mention anything about this to me when I picked the unit up, but it was set to 1. Should I adjust this? Is there any benefits or drawbacks to a higher setting?

Give it a trial. EPR is definitely a trial and error thing. It may make breathing out easier. Some people find their apnea gets better or worse with more EPR.

[locust78]

As far as the cleaning goes, I've found that the SoClean device works good for me. It does a thorough job of sanitizing my entire system. Some people may not feel the need to go to this level of cleanness, but I have very sensitive sinuses and feel compelled to do whatever I can to ward off potential problems.

[TalonNYC]

I turned EPR off, as I found it didn't make a huge difference in comfort (this is a totally personal thing) and can - that is might - reduce the overall efficacy of the therapy for some folks.

As to cleaning, I use a CPAP wipe each day after I wake up (our sponsors sell some, you can also find them elsewhere online or from a DME), and once a week I use Control III Disinfectant in some very hot water to soak the mask, hose and tank after cleaning with dish soap to remove excess oils, etc.

Also, look into getting some strap covers/pads, such as those from Pad-a-Cheek (the manufacturer is also a member of this forum). These slip over the straps and forehead cushions of most masks. The benefit there is that you can simply get a few sets, and swap them out regularly so that the straps themselves are not resting against your face, the covers/pads are. You put on the new set, and launder the used set. Next week, you swap them out again, repeating the process.

Hope that helps.

[Sheriff Buford]

I wipe my mask down every morning using Pampers Thick Wipes for Sensitive Skin. You can also use the generic brand. Be sure the baby wipes have no alcohol or aloe. Alcohol will damage the mask plastic and aloe will leave a film. There is a Walgreens close to my work that sells cpap supplies and I get cpap wipes when they have them. I also wash my mask every weekend with a toothbrush and baby shampoo. I then soak the mask in a plastic tub or a few hours in baby shampoo and water solution. I then rinse the mask very well. If I don’t the baby scent will upset my tummy. Watch out on using vinegar. Look at the website of the mask manufactuer. Some don't recogmend vinegar, but I suspect a little won't hurt.

Sheriff

[archangle]

As far as the cleaning goes, I've found that the SoClean device works good for me. It does a thorough job of sanitizing my entire system. Some people may not feel the need to go to this level of cleanness, but I have very sensitive sinuses and feel compelled to do whatever I can to ward off potential problems.

I'm very skeptical about the SoClean device or any other home ozone "cleaning" device.

[locust78]

Archangle, I can see why you would be skeptical. Ozone is a powerful substance. At the same time, there's no question about its ability to sanitize. I feel that the way the SoClean works with ozone is safe and effective. I also own a stand-alone ozone generator that I use to 'shock' various rooms of the house, and my window air conditioner. I set the timer, let it run for an half-hour or so (with the door closed), and give it enough time to dissipate before re-entering the room. I know that the home use of ozone isn't that widespread in the States, but it's more common in Europe. I came across a paper from Infection Control and Hospital Epidemiology that related how ozone was used to clear a hospital worker's home of MRSA, when no other approach could seem to do it. After decades of allergy injections, and other issues, I feel the need to do whatever I can to try to improve my lot. So far, I like what ozone has done for me. If I ever decide differently, out the door it will go...

[archangle]

I also own a stand-alone ozone generator that I use to 'shock' various rooms of the house, and my window air conditioner. I set the timer, let it run for an half-hour or so (with the door closed), and give it enough time to dissipate before re-entering the room. I know that the home use of ozone isn't that widespread in the States, but it's more common in Europe. I came across a paper from Infection Control and Hospital Epidemiology that related how ozone was used to clear a hospital worker's home of MRSA, when no other approach could seem to do it. After decades of allergy injections, and other issues, I feel the need to do whatever I can to try to improve my lot. So far, I like what ozone has done for me. If I ever decide differently, out the door it will go...

Sorry, but your home ozone air cleaners are simply a scam.

The EPA has dubunked ozone room air cleaners. They DON'T WORK and may be dangerous. Chemicals exposed to ozone may actually be more hazardous after the ozone exposure. http://www.epa.gov/iaq/pubs/ozonegen.html

Connecticut's warnings for room ozone generators: http://www.ct.gov/dph/lib/dph/environme ... _sheet.pdf

Consumers reports info on ozone generators Note: "Ozone may also worsen asthma and compromise the ability of the body to fight respiratory infections."

Note that is all for room ozone generators. Ozone CPAP cleaners are a somewhat different animal. I'm still skeptical.

Is this the study you refer to? http://www.freshgear.com/study-ozone-mr ... nitize.pdf

This was done professionally. The carpet, couch and curtains in the house were all disposed of. The rooms were hermetically sealed for 24 hours, the homeowner had to leave the home for a week. The devices produced an estimated 12 ppm (parts per million) ozone concentration. This is at least 120 times as high as the allowable exposure for workers in an industrial setting.

This was working to kill one specific type of bacteria, MRSA.

This was one single incident. Other attempts to kill MRSA with ozone have failed.

[locust78]

Those data sheets are correct. Ozone is very powerful and can do serious damage to any living organism, including human, which is why the SoClean is designed to allow for zero human exposure to it. As far as the unit I use in my home, it is not an "air cleaner", and isn't designed to be used like one of those. Those air cleaners that have been rightly warned against, emit ozone during their operation and are designed to be operated in the presence of people. For ozone to be potent enough to do anything, it would also be harmful to anyone present during its operation. Besides, ozone doesn't actually "clean" anything. It has the ability to eradicate mold, bacteria, etc., but doesn't filter or remove matter.

[KEQ5]

I wipe my mask down every morning using Pampers Thick Wipes for Sensitive Skin. You can also use the generic brand. Be sure the baby wipes have no alcohol or aloe. Alcohol will damage the mask plastic and aloe will leave a film.

I have some of those as well. They're good for a general wipe down every day or three. I dump my water tank out most mornings and let it air dry during the day. Running hot tap water through the hose weekly and letting it hang to dry.

Haven't had to do the vinegar wash yet.