saline solution in heated humidifier

[JimW159]

Have you ever been to Utah? If not, Google "Bonneville Salt Flats" (without the quotes) - the images you will find may give you an idea of the residue left behind when a "saline solution" evaporates. I would rather not deal with the cleanup, myself. In addition, virtually none of the salt evaporates with all the water giving no appreciable therapeutic effect from breathing it.

[HoseCrusher]

When you think your home, subjective, observational, undefined any measurement test has the same credibility as the lab in the linked study, I don't think we can go any further. It reminds me of this "Don't confuse me with facts, my mind's already made up".

https://youarenotsosmart.com/2011/06/10 ... re-effect/
The Backfire Effect
The Misconception: When your beliefs are challenged with facts, you alter your opinions and incorporate the new information into your thinking.

The Truth: When your deepest convictions are challenged by contradictory evidence, your beliefs get stronger.

Having worked in labs and translated complex lab proceedures to field tests, I think my effort is representative of what is going on.

Once again I throw out the challenge. Duplicate my tests and show me where I have gone wrong...

There are 2 questions being explored here.

1. Does the xPAP humidifier only produce water vapor, or are there conditions where it also produces an aerosol.

My test results indicate that a 4 cm water the flow is low enough that no aerosol is formed. At a little over 10 cm water pressure aerosol is formed at the mask vent rate.

If you are after certified lab results, send me $10000 and according to the local lab that should cover the cost of a "formal" test supervised by a pulmonologist.

Or you could run a test yourself and see what you come up with...

Try this. Put some water in your humidifier tank and turn the machine on. Watch the water in the tank. Does it dance around...?

2. Is the amount of salt produced by the aerosol theraputic?

"Formal" testing of this is more involved. In discussing this with a pulmonologist at a research university $1000000 - $1500000 should be enough to yield some preliminary results.

This is a little rich for me so I am going with the reproducable prolonged placebo effect.

[HoseCrusher]

Have you ever been to Utah? If not, Google "Bonneville Salt Flats" (without the quotes) - the images you will find may give you an idea of the residue left behind when a "saline solution" evaporates. I would rather not deal with the cleanup, myself. In addition, virtually none of the salt evaporates with all the water giving no appreciable therapeutic effect from breathing it.

After over 6 years of adding salt to my humidifier water I have not seen salt build up. It seems the concentrations involved are different.

[ajack]

I'll pass no comment on your abilities, I did post the link that shows it doesn't happen, Your response to the link was humorous.

Until something more credible comes along, I'll stand by what I posted from a real study..
"this study refers to bacteria or other particles/solutes and salt would be defined as a solute. They were unable to be transported. I would also say bacteria can be more easily transported than salt molecules, though I haven't looked up the volume and molecular weight of both.

https://www.ncbi.nlm.nih.gov/pubmed/16236866/
Sterile water is unnecessary in a continuous positive airway pressure convection-type humidifier in the treatment of obstructive sleep apnea syndrome.

The convection-type humidifier produces water vapor but does not aerosolize the water. We conclude that bacteria, other microorganisms, or even solutes that may be contained in the water cannot be transported into the air and thus will not be deposited in the lung. In order to avoid respiratory tract infections, sterile water is not required, at least in this particular humidifier. We suggest that nonsterile tap water is probably a safe alternative."

[FishLips]

Two wikis to review:
Distillation
Desalination

[chunkyfrog]

I have a distiller. It is a space hog, but makes all the distilled water I need for the price of electricity.
Since the local utility is publicly owned and one of the lowest-priced in the country, I love it.
I only buy water when I travel; and my salt stays in the kitchen, where it belongs.

[FishLips]

I have a distiller. It is a space hog, but makes all the distilled water I need for the price of electricity.
Since the local utility is publicly owned and one of the lowest-priced in the country, I love it.
I only buy water when I travel; and my salt stays in the kitchen, where it belongs.

Not quite my point. My point was that your humidifier is essentially a distillery, removing contaminants and salt from the water as it evaporates and makes it's way to your lungs.

[chunkyfrog]

I agree with you.
I just like not having to de-lime or de-salt my humidifier tank.
Lazy frog, no other excuse.
The thing about ocean smell is not salt--to me it is dead fish and rotting kelp.

[ajack]

@hosecrusher
Supposing for a moment you are 100% right and salt will travel to the mask and lungs. That also means all other contaminant minerals and bacteria from the water will also be contained within the air. They will also travel. That only strengthens the use of distilled water and would also make the case, that it should be sterilized before use.

It's a funny position.
If you are right, you should use sterile, distilled water.
If you are wrong, you can put salt or other minerals into the water, because what's in the water, stays in the water.

[HoseCrusher]

In 2010 I read a couple of articles that got me questioning what was going on with my xPAP humidifier.

The first article was a doctors report about treating a patient with a lung infection. Everything pointed to the use of contaminated "surface" water in the humidifier as the source of the infection. The second article was this one...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556912/

You will notice that they comment on the sterile water study.

With this background I then contacted my local pulmonologists and respiratory therapists and discussed both articles. They immediately referenced cases where minor respiratory conditions cleared up as soon as the humidifier tank which was growing a garden was replaced. Not exactly a formal clinical trial but interesting.

I then decided to test this and came up with my test results.

After discussing my results with the medical professionals I decided to "enhance" my xPAP therapy by adding a little salt to my humidifier water.

With the renewed interest in this topic I went back and contacted some of the people I originally discussed the details of my test with and now I have another data point.

A pulmonologist actually got permission to run a test on a mechanical ventilator that is used in the ICU that has a humidifier similar the the Sirius unit. The results were that pure water in resulted in pure water vapor out. Salt water in resulted in pure water vapor out. If you get put on a ventilator in the ICU you can rest assured that humidifier doesn't produce an aerosol.

The bottom line is that hospital grade equipment performs according to the theory. However xPAP grade equipment seems to have a ways to go. I believe the designers of xPAP equipment will continue to improve their equipment and this issue will go away. In the interim they cover their liability by recommend cleaning the humidifier tank often and only using distilled water.

[ajack]

Can you let me know when you find something about salt? Again you are taking one factual thing and trying to conclude another. You didn't post the said article about the doctor and lung infection. However I would think a humidifier chamber that is contaminated by surface molds, fungi, algae, some airborne bacteria and such that do air transport or release airborne spores, they can enter the nasal cavity/lung. This particular fact neither supports nor disproves your point of minerals in water.

The article was interesting on biofilters, It is a field that is well studied. You do realise that both Brevundimonas diminuta and Serratia marcescens are both airborne transported bacteria? Under the right conditions, being aerosolized is one of the ways they naturally transport. Though it wasn't stated, I would guess it was the excessive airflow that pushed water into the tube and enabled the bacteria to move to the hose, I know with my s9, it will spill water into the hose from a full tank, without a mask attached. In fact it makes a hell of a mess. Frankly, I feel we are both getting well out of our depth.

You haven't shown any of your test results, It seem you have hearsay, self observation so far. If you have any test results, I would like to see them.

[HoseCrusher]

...Though it wasn't stated, I would guess it was the excessive airflow that pushed water into the tube and enabled the bacteria to move to the hose, I know with my s9, it will spill water into the hose from a full tank, without a mask attached. In fact it makes a hell of a mess...

Thanks for verifying that the xPAP humidifier is capable of forming an aerosol under certain conditions and it doesn't just evaporate water...

The question is what air flow rate does it take to form an aerosol...?

If you go back and read my original thread I give details on the test results and the air flows used for the testing. You really should run your own test so you can get a hands on feel for this. Theory is fine for discussion but many times real life doesn't completely follow theory.

I used salt for the test because I didn't want to deal with the dangers of air born pathogens. My focus was on if an aerosol was formed and if so at what pressure it was formed. You can do a search on salt therapy and do your own review on that. I don't have a large population to draw from and of the 60+ people that have tried this only about 80% have reported back indicating that it helped with their congestion from using the xPAP machine.

On the other hand the salt may just be a strong persistent placebo...

[ajack]

Your link I referred to was the ability of bacteria to move from the humidifier to the hose, only in some of the test results. About 20% of the time even these easily transported bacteria couldn't even make it to the tube. This is your definitive study?

Under the full flow of air, with the hose off, pushing water out the back of my s9 machine, as one fact. Then trying to use that to support an unrelated claim. That salt is magically taken up in water vapour. It seems to be an ongoing thing with you. The reason I said was because the link was using 60 l/m flow, something that isn't normally seen on normal cpcp operation. It was giving the bacteria the best chance to migrate and even they couldn't do it all the time.

[HoseCrusher]

I think I missed something here... Am I suppose to take comfort that 80% of the time bacteria can assault my respiratory system? I would feel much better if no aerosol was formed and I was exposed 0% of the time

Remember that water vapor doesn't support bacteria and salt ions. An aerosol does.

I ran the test using a Swift FX mask. At 20 cm pressure the vent rate has a flow of 49 liters per minute and then you have to add taking a breath and any result of mask movement that forms leaks. Is it possible that adding all these together brings the total close to 60 liters per minute?

http://www.resmed.com/au/dam/documents/ ... nz_eng.pdf

I tested at three flow rates...

4 cm pressure only using the vent rate of 20 liters per minute. The result indicated that no aerosol was formed.

12 cm pressure once again only looking at the rate from the mask vent of 37 liters per minute. The result indicated that some aerosol is formed at this flow rate.

My pressure is 10.6 cm. I estimated the flow rate to be 35 liters per minute. The results once again only looking at the flow from the vent indicated that some aerosol is formed at this flow rate.

My conclusion is that at 4 cm pressure my equipment follows theory and only water vapor is produced.

However my pressure is higher than 4.

[AUEagle]

First, thanks for the info on AYR saline gell (w/Aloe); was a great relief on my very painful, dry-as-leather nasal passages. Not sure of the cause, but was 3 days ago.

I've been using a Neti pot on&off for 3 weeks, and found it to be an asset to my breathing, due to narrow nasal passages.

I asked my pharmacist if it would be OK to use a saline solution in the water used for the heated humidifier. He said "Definitely". So, I used it last night for the first time, and my nostrils remained clear, and I didn't wake up w/congestion. Even our blood vessels carry the blood in saline, so why not give it what it needs? I'll let you know the results after a week's use, and I expect it to be positive. Offerocker/Kathleen (unable to logon with my Registered name.

I've been using a CPAP for 10 years. For the first 8 years, I had no problems with congestion and then started having severe congestion starting at year 8. I went to the ENT and he really had no solution. I tried the steroid inhalers, antihistamines, decongestants.... still not much luck. I started using saline (0.9% nacl) with no preservatives in my humidifier and it did wonders. I keep my reservoir clean to prevent the salt build-up. I've read other comments suggesting the saline is not getting into your sinus cavity because it is evaporated out. That's total nonsense. Think about it, NS (sodium chloride) boils out of water at 212+ degrees F which means you would be inhaling steam which is 212 degrees hot. Do people really believe CPAP's are producing steam at boiling temperature which is then directly inhaled? The humidifiers work with minimal warming and the larger effect of humidity is produced by the blowing from the machine. Very similar to how cold air humidifiers work. Furthermore, the reservoir is located after all the mechanical parts and the moisture is not going to "ruin" your CPAP any more than not cleaning it regularly would destroy it. Admittedly, you do have to keep the reservoir clean and clean it more frequently, but that is the only draw back. As for the comment regarding "saline in the lungs", there already is saline in your lungs with or without using saline in your CPAP. I would caution against using saline with preservatives. Other than that, you're instincts were correct. Of course, you won't find a manufacturer recommending using anything other than distilled water and doctors would certainly not risk the liability by telling you something contrary either.