I have been told I was wrong..

I know a lot of you like to hear me say that. So. I have been told I was wrong. EDIT: I had thought that hospital and sleep clinic machines are sterilized, inside by a special gas, which is probably both toxic to human life, and we can not get. Personal home machines, like the ones we have, can not be sterilized inside. I was also told that because of the sterilize issue, home machines which had been rented or previously used, could not be sold by DME's. Only private sales. Edit Close: Specifically from the fellow at Second Wind.

"I appreciate your interest, and certainly your observations - there is a lot of misinformation out there, and in some cases disinformation, where individuals will tell you things to steer you in a certain direction, relative to purchasing.

To give you a bit of background, I have been a licensed Respiratory Therapist 25 years, and a CPAP user for 6 years, as I have severe OSA.

Before I started this business 6 years ago, I had worked in the clinical environment (hospital) for 19 years. Hospitals do not sterilize CPAP/BIPAP machines or mechanical ventilators between patient use, nor do DME's, and they are not forbidden from reselling or reprocessing CPAP or BIPAP equipment; if you had been told this, you were misinformed. This is done literally everyday, thousands of times across the country. Matter of fact, the FDA has very little, in the way of regulation/recommendation as it pertains to the reprocessing of CPAP machines, and the NIH (National Institutes of Health) site, sites one overseas study as to the proper way to reprocess these machine. The study, out of Germany (2008), is very comprehensive, and peer reviewed. It also represents the blue print for the way we clean our machines for reuse/resale. That said, I can tell you that the vast majority of DME across the US simply wipe down their rental CPAP/BIPAP machines, and replace the filters - nothing more. That is the extent of their reprocessing. I believe our process is thoughtful, and based on a peer reviewed study on the subject - matter of fact, the only study on the subject."


Maybe I should change the title on this post. What think yee?

You need to be punished - now where did we put the "comfy chair"

I get told I'm wrong every day. Sometimes multiple times. I'm married and have teenagers.

But regarding the reselling of machines, they're not suitable for sterilization. All they do is pump air. There's a filter on the input that filters out dust, and that's about it. Only the parts of the machine that touch the patient need to be replaced. Think of the last time you went to see the doctor. When your temperature was taken, the tech slipped a plastic cover over the thermocouple on the thermometer. When you had your blood drawn, a tech wore clean disposable gloves and used a fresh needle and a fresh collection tube. When the Doc looked down your throat, a clean tongue depressor was used. All are examples of FDA regulated Medical Devices, as is the CPAP machine, the hose and the mask. The ventilator in the hospital is used on multiple patients, but the endo tube or mask are disposable. It makes sense that CPAP machnes can be used by more than one person, so long as the mask and (arguably) the hose are changed. I suppose the hose and mask can be cleaned easily enough. They don't need to be sterile, just clean. But they're so cheap in comparison with the machine they're hooked to, it seems reasonable to simply replace them.

[Edit: The sterilization gas of which you speak is ethylene oxide, usually abbreviated ETO. It is used to sterilize anything that can't withstand steam or gamma (radiation) sterilization. The machine would be destroyed by steam and gamma sterilization, but it could likely withstand ETO. I suppose if a reseller wanted to ETO sterilize their used machines in order to reassure potential buyers that the machine is indeed sterile, but the process is geared toward large volume manufactured goods, not individual pieces. It's also not without cost, and one would first have to make sure that the ETO process wouldn't harm the components of the machine. I doubt it would be worth the hassle.]

My local Kaiser hospital does home titrations on loaner machines. I think that they do between 50 to 100 home titrations per WEEK! They use the machines over and over again. They clean them according to acceptable standards between patients--I think it's basically replace the disposable parts (each patient is given a brand new hose and mask, new filter, no humidifier because they say that is too hard to clean). If people were becoming ill from this, I'm sure they would be the first to stop the practice, since they have to pay for and provide the care when someone becomes ill.

If an individual has a severely compromised immune system, that may warrant further precaution. But most of us share the air with all sorts of germs every day and don't get sick because we have functioning immune systems. It would be interesting to do a medical literature review to see if there are any documented incidents of someone getting ill from using a machine others have used, but I'm guessing that there's no documented cases out there.

I happily repeat that it is my humble opinion that most false statements were invented by a BS'ing or lying DME.

I really LIKE my sleep center. I asked them how they clean their "industrial size" cpap machines they use for titrations and they said they never do! They don't even use distilled water. I've had two other family members tested there and none of us had any problems.

Folks, unless your a real windbag there is almost no way exhaled air gets back to the machine - because of the pressure. Exhaled air is "flushed" out the mask vents, not back down the hose to the machine. If it did there would have to be some sort of exhaust port on the machine - otherwise where does the exhaled air go. I have yet to see an exhaust port on my machine, there is no way exhaled air is going into my machine at 11cm exhale pressure. Just my .02 worth.....

I believe my issue with a rental/loaner would be was it used in a Smokers home, was the Filter replaced as recommended, were there any pet odors from a previous user, etc. Personally I would be concerned about what was drawn INTO the machine before I used it. As stated above, they can't be exhaled into through the hose, but could suck in what ever is in or used in a previous users environment. I don't point these possibilities out to chase someone away from a loaner or rental that has a need that would surpass where the machine came from and how was it used, but rather to inspect any machine the best you can with at the least after a good visual to do a smell test as you won't be comforted on a machine that wasn't previously cared for the way it should have been. If in case this does happen you can request a different machine before you are stuck using it before a clean machine arrives. When my wife is cleaning something with my oversleeping I have woke to the smell of household cleaners coming through the machine just as the therapy scents would. Just a thought for consideration.

I'm shocked, SHOCKED, that you may have been given wrong information by a DME.



I get a laugh from the scammers on Craigslist claiming their used CPAP machine has been sterilized or "sanizized."

Ethylene oxide is an interesting idea. My biggest worry about any chemical sterilization process would be if it would damage any of the sensors like pressure sensors or humidity sensors. I do remember seeing an ETO room in a hospital one time.

I'm doubly skeptical about any of the ozone cleaning gadgets, unless it's a specifically medically approved sterilization device. There have been way too many scam ozone air cleaners to trust any device not specifically approved by the FDA or whoever for sterilizing CPAP.

You might actually be able to get some exhaled air back into the CPAP machine. When you exhale, some of your breath goes back up the hose. It's a competition between how fast you exhale, how much you exhale, and how fast the mask vents air out. I did some experimentation with my CPAP hose, and it looked possible, but not likely to be a problem. You could also get some air back there if the machine is ever not blowing while you're masked up, for instance, when taking it off.

In theory, there's not going to be anything for the germs to feed on and multiply on inside the machine. Also, you're breathing the exhaled air from everyone else around you all the time.

By the way, they DO sometimes "sterilize" masks and hoses. I put quotes around it because it's often specified as something like "water bath at 90C for 10 minutes," which can't actually "sterilize", but I presume it's believed it will kill any germs that are likely to be a problem for CPAP/ventilator equipment. It takes pressure and temperatures around 120C to heat sterilize something, for instance, when canning food. There are also some chemical or other processes used. There are links to ResMed disinfection guidelines for hoses and masks in my signature.

I'd be interested in how many sleep labs actually do the "sterilization" process for masks and hoses, and how many just clean them.

There are also bacterial filters that can be used between the machine and the hose for multi-use machines. Respironics sells them. We should ask the next few people who go into sleep labs to spy and see if there's a filter between the hose and the machine.

Hi my name is Dan. I work in a Sleep Lab at Kaiser. If you think how CPAP works, it uses continuous positive airway pressure(CPAP) to keep your airways open. Positive airway pressure being that the air is constantly blowing in. Some machines like bipap the pressures may change, and with others the pressures are design to fluctuate. Because of this it is not necessary to clean the machine. The air we exhale when we blow out goes out an exhalation port and the machine draws ambient air and blows it in to our lungs. Essentially our breaths never reaches the machine. All the air is blowing ONE WAY only. So it is not necessary to clean the machines.

johnthomasmacdonald wrote:You need to be punished - now where did we put the "comfy chair"

NO!!! Not the Comfy Chair!!!!

RTDAN wrote:

I agree with your comment that it is not necessary to clean the machine. (Except for dusting and maybe a wipe down of fingerprints.)

RTDAN wrote:the machine draws ambient air and blows it in to our lungs

Technically, the machine does not "blow air into the lungs". The machine creates a pressure in the airway and lungs. The flow into the lungs is due to the rise and fall of the diaphragm.

RTDAN wrote:Hi my name is Dan. I work in a Sleep Lab at Kaiser.

You know, one of the other (unrelated) forums I post on, has a little warning message that pops up to say you're responding to a post that's more than 6 months old. Doesn't stop you from posting, but just lets you know, and suggests starting a new topic instead. I don't mind going over common topics more frequently, but responding to someone who hasn't read the forum in years doesn't do them any good.

I don't want moderation, I know managing a board like this is time-intensive... but zombie threads just annoy me.

sc0ttt wrote:

RTDAN wrote:Hi my name is Dan. I work in a Sleep Lab at Kaiser.

You know, one of the other (unrelated) forums I post on, has a little warning message that pops up to say you're responding to a post that's more than 6 months old. Doesn't stop you from posting, but just lets you know, and suggests starting a new topic instead. I don't mind going over common topics more frequently, but responding to someone who hasn't read the forum in years doesn't do them any good.

I don't want moderation, I know managing a board like this is time-intensive... but zombie threads just annoy me.

Shoot, all ya gotta do is read the start date just below the title of the thread and you can see how stale the thread is.

With everything else going on with this forum, it's replying to old threads that worry some people??