Why Humidification With CPAP?

Been on CPAP for a little over a month. Currently using the Remstar Pro II with integrated heated humidifier that my DME set me up with. But, I've not been heating the humidifier. I put water in it, but that's all. So, only the water that will evaporate at room temperature, 70 degrees, gets added to the air.

My question: why bother with the humidifier. Can't be doing that much. And my DME left instructions to '...empty the reservoir and clean every day. Allow to dry before use.' Does that make any sense? And, I use distilled water in it, which is rapidly consumed with the above maintenance regimen.

Further, the logic of the humidifier escapes me. I've been breathing room air when I sleep for my entire life. Never used a room humidifier. Once lived in a house with very humid air in the summer (No AC) and very dry air in the winter. "But, we always cracked a window to combat the dryness.) Now, we use AC for most of the summer here in florida and a little heat in the winter. We still crack the window in the winter.

Why should CPAP require humidification? ( I tried heating the humidifier one night, but found it to be 'unnatural'. I couldn't feel the 'normal' cool air entering my nose.) I suppose the inclination is to say, 'But, you are increasing the air flow." I don't think that is the case. I think our flow is the same, i.e., whatever is required by the lungs to oxygenate the blood. Granted, if we are in apnea or hypopnea a lot, we are not getting as much air flow, but that is the purpose of CPAP, isn't it: to reduce the apneas and hypopneas to 'normal.'

BTW, when I post, I don't use a lot of 'IMO's', because since I'm the poster, it is obviously 'IMO'.

Any thoughts?

Jerry

Heated or Passover? I think location and time of year is very important in the "heated" issue.

Personally, at home in southern Arkansas which is usually humid even in the winter, I have my humidifier set on 1. But on a trip to northern Missouri last week, I got a horrible dry throat and had to bump it up to 4. It was very cold (0 degrees one morning), plus the heat in the building was very high and dry (my hair looked like I had an Afro). Boy was it nice to get home

A lot more air is moving, this tends to draw moisture from your tissues. Next time you are driving in the summer, stick your head out the window like a dog. The moving air will dry you out, unless you have dog genes in you. The dog is better prepared for hanging out the window, his mouth is part of his built in A/C.

BTW: Check for cops before hanging your head out of the window, most of them won't take kindly to the experment.

Jerry,

Goofproof is right in that cpap depletes the natural humidity in your throat. The humidifier, whether heated or not, is adding some humidity to replace what is lost due to cpap.

I notice you live in Florida. You may not need the heated humidification as much as those in colder dryer states, but there may come a time you could really benefit from the heated humidity. Better to have it and not use it heated than to find you need it later.

If I were you, I'd at least keep it as a passover so you're getting some moisture replacement even if not heated.

Also, you shouldn't have to replace the water or clean out the chamber every day. That might be necessary if you used tap. But most of us simply keep a jug of the distilled near the humidifier and refill. Maybe clean it rarely as needed, but distilled water keeps it pretty clean.

As an aside. I've been on cpap a year now.
Before that I used to have colds often. I swear, since the day I started cpap I've not had a single cold (knock on wood). I thought this was just a fluke, but I've heard some people report the same. Now that might not happen for everyone, and it might not have anything to do with using a humidifier, but I ain't changing it, just in case!

When I was a kid my folks added a house humidifier (not heated) and that made a world of difference in our home, and I feel there were less colds as well, for our whole family. Fluke? Maybe. But who knows.


Linda

One thing is for sure. When it comes to humidity its all relative.

Just find out for yourself. Hop on a plane to Chicago in the winter . Don't forget to turn on the heat in your hotel. When you awaaaake with your mouth glued shut you will know why we use heated humidification. You'll also learn why we praise the heated hose !

:twis ted:

The poll shows most people, by far, tend to use heat with their heated humidifier...Duh.

I'm using mine now without water (and heat, hopefully). So, I cast the only vote for that choice.

So, even though I don't care to inhale warm, moist air, a lot of you do. Maybe I'll try it again one day.

Thanks for responding.

Jerry

Jerry, your situation is different. You live INSIDE a heated humidifier. (aka: Florida). Last time I visited your state I lamented not bringing a bag of dry smoggy California air, just so I could breathe. I swear, a fish would feel perfectly comfortable anywhere, above or below water.

My worst night on APAP was my first night, the humidifier had not arrived. My nasophyaryngeal membranes, with the extra load of all that dry air totally dried out, cracked, fell on the floor in tiny pieces. Very painful. I gave up trying to put them all back in proper order. Took me a week to grow a new one. And meanwhile no APAP.

After that I panicked, used it full blast, level 5 on the REMstar Auto. Of course rainout. Then the Australian heated hose. Fixed the rainout, but I felt like I was suffocating. Now I use it without heat, but WITH the water, and still leave the Australian hose on (just for the rainout, although I probably don't need it). Seems to be a perfect balance for what I'm used to and what feels comfortable. But I miss the smog, probably gets caught in the filter, I'm having withdrawals. (Truthfully the air is not soooo bad here nowadays, but PUH-LEEEEEZE don't tell anyone).

Jerry, I'm still scratching my head over the concept of a heated humidifier with no water and now, no heat. Seems like you should be able to acquire one of those quite reasonable.

Ric said,

Jerry, I'm still scratching my head over the concept of a heated humidifier with no water and now, no heat. Seems like you should be able to acquire one of those quite reasonable.

Ric, the only reason I use the humidifier is because the CPAP seems quieter with it in place. I took it off and hooked the hose to the CPAP directly (after removing the ring gasket), but it seemed to make a noise. I'm a noise neurotic.

I'll swear, this CPAP apparatus is driving me crazy! My AHI's are about 2, now (instead of 9.5), but my sleep is being disturbed by the apparatus. So, what is the gain?

I ordered an Aura (Headrest) from CPAP.com today because my DME said it might be 6 weeks before they got their account approved by the the supplier. I struggle with the Breeze contraption: it is top heavy and tugs on my nostrils. The Swift is a nice interface as far as fit and seal are concerned but it sounds like a vacuum cleaner-in tune with my inhales.

I think I've been mis-diagnosed, like one of the really helpful members of this forum. I think I can do without it all. But, I'm going to keep plugging in. Maybe I can get past the apparatus and get some really restful sleep. I'll tell you this, I ain't gonna keep shelling out good money for this and that interface. Like many of the people who post here, I'm getting desperate.

Jerry

I live in Seattle, and despite the rain, the relative humidity falls significantly in the winter, especially indoors. If I don't use the humidifier I wind up with a bad sore throat in the AM.

I use the heated humidifier integrated into my Remstar Auto with c-flex.

A reminder to others using a heated humidifier - we need to keep them very clean to avoid molds, and worse, from growing in them. I sure don't need to be breathing anything like that!

Your need for extra humidity and how it is generated depends on several factors.

1) Your location: Those in very humid places have no or lessor need, those in dry places often require it.

2) Your pressure: The higher pressure you need - the more the moving air can dry things out (note that along with just moving more air through your nasal passages or mouth their is also another factor at the higher pressures: compression of the air - even a little bit - affects the relative humidity of the air and compressed air will then absorb moisture faster).

3) The type of interface: Nasal, or Mouth. Nasal passages are designed to humidify air (as long as they do not get overwhelmed). Mouth breathers need humidity.

4) heated humidifiers generate a lot more humidity than non heated ones. Also, for those up north where room temperatures can be relatively cold - cold humidified air is an experience that you will soon figure out how to avoid.

In general: People in the SE (Florida, Alabama, etc) tend to rarely need humidity (unless they are mouth breathers) - and if they do many times do well with non-heated humidifiers.

People in the North or mountains tend to need heated humidity (especially in the winter). People in deserts tend to need humidifiers and may get by with a non heated one in certain situations.

Concerning humidifier maintenance: If you are using distilled water - and if the PAP can run at idle (some of the new APAP's don't) - just hook up your hoses and mask and let it run for an hour or so to dry everything out (assuming you have good filters on the PAP machine). Cleaning and sterilization might be needed every several months in this case (and I have pushed it up to 6 months on occasion - after years of experience). However, when I travel I Usually end up cleaning it after each trip.

Perry

Heated definitely. My Humidair is only set on 1 1/2 though...with the old one I had to crank it up to about 8

Jerry69 wrote:Ric, the only reason I use the humidifier is because the CPAP seems quieter with it in place. I took it off and hooked the hose to the CPAP directly (after removing the ring gasket), but it seemed to make a noise. I'm a noise neurotic.

I tip my engineering hat in your direction! I had never thought of the HH as a muffler. But an EXCELLENT idea.

When I first got the APAP I also bought a 2ft, 6 ft, and 8ft hose, with connectors so I could have a 2,6,8,10,14, or 16 foot hose, to reach varying distances including in the closet, for the purpose of noise abatement. Now that I have the OZ hOZe I can go 22ft. If that didn't work I was planning to build a little house for it with high-tech acoustical insulation or carpet or something on the inside to make it quiet.

What I learned the hard way is that the tube serves as a stone-age intercom relaying audible signals from the machine to my face. That is, noise. (Not unlike the old-time intercoms they had aboard ships to talk from the captain's deck to the boiler room, etc.). So all the hose was mostly a waste. Actually putting it in the closet is still a good idea because the other person sleeping in the room will benefit from the diminished line-of-sight audio signals.

I had never thought of using a muffler. I see a whole new product line emerging. Great idea! <HIGH-5> <slap>

Have you considered filling your HH maybe half-way with cotton or something acoustically absorbent? No, probably not, sooner or later it would end up inside your mask. Or worse. I say don't.

^
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(that was me, "guested", i guess)

Hi Jerry,

I guess I'm in the minority, too--and there's been quite a bit of snow where I live, lately. I feel smothered by moisture and rainout when I use a heated humidifier.

I tried a heated humidifier for the first couple of years but eventually found that I didn't need it once I finally stopped having mouth leaks. Interestingly, I only stopped having mouth leaks when I switched to an APAP (PB GK420E).

I haven't done the relative humidity calculations, but I have to say that I doubt whether a few cm H20 makes much of a difference--after all, atmospheric pressure is over 30 feet of water. As for more air moving, it's still the same volume going in and out--isn't it. The only exception is if you are having significant mouth leaks; then you will get large amounts of air bypassing the nasal passages, via your throat, and out of your mouth. In that case a heated humidifier would certainly help, but the underlying cause of mouth leakage should be addressed.

I should mention that my Rx pressure is only 7 cmH20 and with my APAP I spend most of the night below 6 cmH20. Still, even when my pressure hovers around 9 cmH20, I never wake with a sore throat or dry mouth. . .


-John M

John M wrote:Hi Jerry,

I guess I'm in the minority, too--and there's been quite a bit of snow where I live, lately. I feel smothered by moisture and rainout when I use a heated humidifier.

I tried a heated humidifier for the first couple of years but eventually found that I didn't need it once I finally stopped having mouth leaks. Interestingly, I only stopped having mouth leaks when I switched to an APAP (PB GK420E).

I haven't done the relative humidity calculations, but I have to say that I doubt whether a few cm H20 makes much of a difference--after all, atmospheric pressure is over 30 feet of water. As for more air moving, it's still the same volume going in and out--isn't it. The only exception is if you are having significant mouth leaks; then you will get large amounts of air bypassing the nasal passages, via your throat, and out of your mouth. In that case a heated humidifier would certainly help, but the underlying cause of mouth leakage should be addressed.

I should mention that my Rx pressure is only 7 cmH20 and with my APAP I spend most of the night below 6 cmH20. Still, even when my pressure hovers around 9 cmH20, I never wake with a sore throat or dry mouth. . .


-John M

You must be an engineer, too, or a physicist. You see the air flow thing the same as I.

Your pressures are great. And, to have an APAP...