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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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hecate
 
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Sterile water is unnecessary in CPAP

Postby hecate on Thu Mar 16, 2006 1:28 pm

Before anyone jumps on me The above subject header is from a study done in Germany. If true, it is good to know. Although I always take a single study with a pinch of study. In fact as a researcher I take a series of findings with a pinch of salt. :)

I don't have a copy of the full article, but here are is the authors and abstract.

Author(s): Wenzel M; Klauke M; Gessenhardt F; Dellweg D; Haidl P; Schönhofer B; Köhler D
Author's Address: Annostr. 1, Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, D-57392 Schmallenberg, Germany.
Source: Chest [Chest] 2005 Oct; Vol. 128 (4), pp. 2138-40.
Publication Type: Journal Article
Language: English
Journal Information: Country of Publication: United States NLM ID: 0231335 Publication Model: Print Cited Medium: Print ISSN: 0012-3692 (Print) NLM ISO Abbreviation: Chest Subsets: Core Clinical (AIM); MEDLINE
MeSH Terms: Continuous Positive Airway Pressure/*methods
Sleep Apnea Syndromes/*therapy
Water/*standards
Aerosols; Humans; Sterilization
Abstract: OBJECTIVE: We investigated the necessity of using sterile water in humidifiers for avoiding respiratory tract infections during nasal continuous positive airway pressure (nCPAP) therapy. METHODS: Water in a convection-type humidifier (Sirius; Heinen and Löwenstein GmbH; Bad Ems, Germany) was labeled with (99m)Tc-diethylenetriamine penta-acetic acid. Low-flow (2 L/min, 4 L/min, or 6 L/min) and high-flow (31 to 46 L/min) rates were applied, rates typical for nCPAP. Heat and moisture exchange filters were placed behind the start of the tube to measure any radioactive aerosol. RESULTS: We demonstrated that no radioactive aerosols were produced, either with low or high flows. CONCLUSIONS: 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.


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Aswab
 
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Postby Aswab on Thu Mar 16, 2006 1:30 pm

I have always understood the requirement for distilled water (not sterile) to be in order to prevent scaling from hard water not for any disease prevention purposes.

David
O.G.S.D.K.

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Nitro Dan
 
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Postby Nitro Dan on Thu Mar 16, 2006 1:48 pm

It was always a comfort thing for me. Hard water out of the tap which may also contain chlorine can be miserable to your sinuses. I have used RO water for years. If I'm heading out of town, I always take a supply with me.
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Postby Neurosurgery NP on Thu Mar 16, 2006 9:20 pm

I used distilled water as well. I actually used bpttled water for a few nights as I ran out of distilled and didn't have a problem at all. No residue. Bottled water will work in a pinch. I don't think I would ever use tap water though unless I had no other options - as Nitro said - chlorine I am sure can't be too pleasant.

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twistedcherokee
 
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Postby twistedcherokee on Fri Mar 17, 2006 1:27 am

I have a PUR water filter so I had to use that a couple of nights. I seem to be twitching alot (not really) No problems as of yet.

Toby

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rested gal
 
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Postby rested gal on Fri Mar 17, 2006 2:59 am

Aswab wrote:I have always understood the requirement for distilled water (not sterile) to be in order to prevent scaling from hard water not for any disease prevention purposes.

David


That's the only reason I used distilled water solely. To prevent scaly buildup on the bottom and sides of the water chamber.

I simply add more as needed. I rarely dump it out. It's a lot less wear and tear on the humidifier to not be removing it very often.

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Postby Guest on Fri Mar 17, 2006 3:05 pm

I'm with David and Rested Gal.The distilled water is for the health of the humidifier only.


born to be mild
 
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Don't change the water?!?

Postby born to be mild on Fri Mar 17, 2006 4:50 pm

Not that I've been looking for an occasion to disagree with Rested Gal, but in this case I must take issue with her suggestion to simply add more distilled water.

I've used distilled water exclusively, and would wash out the humidifier tank weekly. One weekend I missed this step, and thought, "Ah, it doesn't need it anyway..." About a week later, I thought I saw something besides bubbles in the water. Sure enough, there were little crudniks in there. Not sure what they were, but I figured, "thaaat couldn't be healthy."

After that, I went to cleaning out the humidifier tank every 2nd or 3rd day. The value contined within "convenience," or "equipment lasting forever" takes a way back seat to my health. After all, that's why I got it in the first place!


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Snoozie
 
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Postby Snoozie on Fri Mar 17, 2006 6:28 pm

I've used distilled water exclusively, and would wash out the humidifier tank weekly. One weekend I missed this step, and thought, "Ah, it doesn't need it anyway..." About a week later, I thought I saw something besides bubbles in the water. Sure enough, there were little crudniks in there. Not sure what they were, but I figured, "thaaat couldn't be healthy."

That's what happened to me. I now clean it once a week. I just don't take it apart to do it. I use baby shampoo water, then cut any remaining suds with vinegar water and let air dry until I go to bed.


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twistedcherokee
 
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Postby twistedcherokee on Sat Mar 18, 2006 1:35 am

I used to clean mine everyday but have not cleaned it for atleast 5 months now. I use distilled water most of the time and I just fill it up and never dump it unless I am traveling. No crud yet.

Toby


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Postby Guest on Sat Mar 18, 2006 3:40 am

I don't wash the hoses and humidifier very often, so figure that if I use distilled water, there is less chance that microbes will get in there and start growing....


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CheezWiz
 
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Re: Sterile water is unnecessary in CPAP

Postby CheezWiz on Sat Mar 18, 2006 7:17 am

CONCLUSIONS: 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.

This was a test done on ONE humidifier design.
Even they are not willing to extrapolate their conclusion beyond this single unit for fear of litigation.

I was watching my Respironics humidifier last night and with as much agitation as is inflicted on the surface of the water, I would be quite surprised that no aerosol was being produced. Plus, the higher the flow, the more agitation, the higher likelihood that an aerosol will be produced.

However, my guess is that so long as no bubbles are produced in the water and the surface tension of the water is not broken, then no aerosol would be produced. It would have been nice if they would have tested more than one design and would have forced production of aerosol by modifying a design to see what is necessary to cause it..

Here is the one they tested:
http://www.hul.de/pages/beatmung/sirius.htm

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NightHawkeye
 
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An Alternative to Cleaning

Postby NightHawkeye on Sat Mar 18, 2006 7:49 am

Here's an alternative to cleaning:

I simply dump out the humidifier tank every morning when I get out of bed. After reinstalling the tank, I turn the machine on for 30 minutes or so to dry everything out.

Three months of doing this and the tank still looks brand new; no residue whatsoever. No cleaning required and no problems with machine or humidifier. Works for me.

Regards,
Bill



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