SoClean airflow restriction?

[SleepySleepNeeder]

I just purchased a SoClean CPAP sanitizer and I believe the product is a great improvement over daily manual cleanings. I use a mask with nose pillows so I have very little body contact with any equipment. But for the 10 years I've been using a CPAP, I have a constant battle with bacteria.

However, I have noticed since I started using the SoClean that I am not sleeping well. The bacterial issues are gone, but I am waking up in the middle of the night and not feeling rested in the morning. It has occurred to me that perhaps the little tube in the SoClean adapter that runs into the humidifier reservoir might be causing an airflow restriction.

After thinking about it some more and studying the setup, I would say that the thin tubing that goes from the inside of the adapter into the humidifer reservoir blocks at least 10% of the inside of the CPAP air channel where it travels into the reservoir from the adapter. This is significant and must raise the pressure which would cause the CPAP to lower the airflow, which would explain my symptoms. On a whim, I removed the adapter last night and slept without the SoClean attached to my CPAP. Lo and behold, I slept much better and awoke feeling much refreshed.

I wonder if anyone knows of any tests measuring airflow rate changes with the adapter installed? Obviously, either the machine setting should be increased, or the adapter removed every night and reinstalled every morning (which increases risk of breakage). Anyone?

[JDS74]

You could check the pressure with a manometer both at the machine outlet and then at the mask end with the SoClean installed.

If there is a difference, it should show up in the pressure readings.

[chunkyfrog]

It could be a matter of perception.

[SleepySleepNeeder]

@CHUNKYFROG: Perception? I have a science degree, and I can tell you for a fact that the airflow is reduced. Think about it. The adapter that is installed on the machine has a small tube inside of it that threads down into the humidifier tank. This small tubing reduces the area inside of the adapter (which is nominally the same as the area inside the CPAP hose) by the amount of the area occupied by the tubing. With the same airflow, this reduction in area causes an increase in pressure at the tank. This is simple physics. And the reduced area is not insignificant. I would put it at 10% reduction at least.

This increased pressure will cause the CPAP to lower the airflow rate from the pre-adapter airflow rate to keep the pressure within the range specified by your prescription. Meaning you are receiving a lower airflow (and subsequently a lower pressure at the mask) with the adapter installed than without it.

Now then, consider this: your CPAP's pressure setting is determined by a special sleep laboratory titration session, where they adjust your pressure setting up and down and study the results, resulting in a specific prescription setting customized to you. Lowering your pressure defeats the prescription and allows some apnea to recur. How can that be good?

In fact, I have queried the SoClean manufacturer and received a reply, and they basically admit that there is a reduction in pressure at the mask as a result of the SoClean adapter being installed. Why they don't warn of this is beyond me. Clearly they are not medical people. They advise me to increase the pressure setting on my own. While this is possible, for several reasons (not the least of which tampering with the pressure setting yourself is not advisable, and I don't own my machine, the VA does) tampering with the setting may be problematic and I won't do it. I am currently removing the adapter every night and re-installing it every morning, which increases the risk of breakage or premature wearing of parts. The best solution is to inject the ozone directly into the tank without using an adapter that restricts airflow, but that would require an individualized solution for every CPAP model.

Perceive that.

@SETJ: bacterial contamination of CPAP hose and mask (and sometimes humidifier tank) is something all CPAP users must deal with. Most CPAPs are humidified, which means moisture inside the hose and mask. This leads to mold and bacteria growth, which introduces respiratory issues if not dealt with. This is why insurance companies will pay for 4 replacements a year of the hose and mask (and filters). It's also why you must perform continual cleaning of the equipment between replacements. It's a major hassle that comes with the territory.

I still recommend the SoClean as a way to minimize the bacterial issue (it really does work), but it comes with its own set of hassles (increasing the pressure setting yourself which has its own risks, or daily removing and reinstalling the adapter which increases risk of breakage and adds wear).

[MitzyG]

Thanks for posting. I had started feeling bad again and had no idea why. The doctor upped the pressure. I am traveling without the so clean and without the humidifier and i feel even better! I wonder if it was the so clean.

Do you think the same effect would happen if i used so clean without the humidifier? I would remove the tube that would normally go into the water.

[chunkyfrog]

@SSN: But did you measure it?
As a "scientist", you no doubt are aware of how a manometer works, maybe even how to build one.
Just adjust the pressure until the measurement matches what you need.
How hard is that? You can fix it--just do it.

[SleepySleepNeeder]

@SSN: But did you measure it?
As a "scientist", you no doubt are aware of how a manometer works, maybe even how to build one.
Just adjust the pressure until the measurement matches what you need.
How hard is that? You can fix it--just do it.

Of course I haven't measured it, though I intend to try. It's actually no simple task to do so. it's also a stretch to think that anyone can adjust the pressure. My machine is owned by the VA and checked periodically. So it's not as trivial as you make out. And I am not doing this just for me. I'm doing it for all the other SoClean users out there who may be affected by this. And the vast majority of them won't be able to do either. I was hoping someone had done this already and checked the pressure after installing the SoClean adapter to see if it dropped.

And someone has already suggested checking the pressure with a manometer, so your suggestion was unnecessary & snide. If you have nothing helpul to add to the discussion, please refrain.

Thanks for posting. I had started feeling bad again and had no idea why. The doctor upped the pressure. I am traveling without the so clean and without the humidifier and i feel even better! I wonder if it was the so clean.
Do you think the same effect would happen if i used so clean without the humidifier? I would remove the tube that would normally go into the water.

Interesting name Mitzy, same name as the woman at the VA that oversees my CPAP program! LOL Anyhow, I wouldn't removed the thin tubing (my personal opinion), I'd say you want the humidifier tank cleaned along with the hose to ensure the entire humidized pathway gets sanitized, because that is where the bacterial issues occur. If necessary, do like me until a better solution comes along and just remove the adapter at night when you use your CPAP. And when I find out how much the pressure drops and so that machines can be adjusted, I will post it here.

You could check the pressure with a manometer both at the machine outlet and then at the mask end with the SoClean installed.
If there is a difference, it should show up in the pressure readings.

JDS74 - Can you recommend a specific product or setup? I am not that familiar with pneumatic tools. It would be nice if there were a product out there already set up to do this.

[OhHelpMe]

Interesting name Mitzy, same name as the woman at the VA that oversees my CPAP program! LOL

It's the same Mitzy! She is stalking you here to see if you illegally change your CPAP pressure!

[SleepySleepNeeder]

Interesting name Mitzy, same name as the woman at the VA that oversees my CPAP program! LOL

It's the same Mitzy! She is stalking you here to see if you illegally change your CPAP pressure!

LOL!!!

JDS74 - Can you recommend a specific product or setup? I am not that familiar with pneumatic tools. It would be nice if there were a product out there already set up to do this.

https://www.cpap.com/productpage/guage- ... ssure.html




But I would not buy one. The important thing is not what is the numerical value of the pressure reading at the end of the hose that connects to the mask. The important thing is does the pressure control sleep apnea. This is better found by being familiar with your nightly data and tweaking if necessary.

Thank you Seth. I wouldn't get one so much to determine what pressure change to make, I do have a pulse oximeter and will be conducting my own home sleep studies. I have also gotten the VA dentist to make a mouthpiece for me similar to the one advertised on TV that moves your lower jaw forward to maintain open airway, since I sleep in a recliner and gravity makes my jaw want to recede and narrow the back of the throat. Only problem is all the available ones online have an opening to breath through, and my mask has nasal pillows and I have a chin strap to help keep my mouth closed, so i need one without a breathing hole. Anyhow, their first attempt has my lower jaw too far forward, and although I did see some benefit according to the oximeter, it's not much, my lower jaw is pulled out of the mouthpiece part way into the night and I end up with an open mouth. I need another go-round with the lower jaw not so far advanced so it will stay put easier and not put so much pressure on the hinge.

The main reason I would get the manometer (don't really need one now since I have the solution, below) is just to see how much the pressure drop is across the adapter. And I have figured out why I have such an issue with it when others don't seem to. My mask with nasal pillows has a short ribbed tubing that is slightly more narrow than the standard CPAP tubing. This would create a pressure increase just before the mask and reduce airflow. However, the SoClean adapter does basically the same thing clear back at the machine, so the entire 6' length of standard CPAP tubing between the CPAP and my mask is basically acting as a low pressure buffer zone to prevent the machine from detecting the pressure ebb and flow at the mask as I inhale and exhale. And I have obtained pressure change instructions and experiemented a little. Right now I'm running a half pound more than before (without the adapter). Mitzy, don't hurt me! lol

Anyhow, the SoClean manufacturers have provided me with the company (McMasters-Carr) and part numbers for a grommet (1061T13) and a female (51525K283) and a male (51525K273) quick disconnect to run the thin ozone tubing directly into the humidifier tank so I won't have to use the adapter (they cost about $5 each for a pack of 10, total of $15 plus $7 S&H). Excellent solution and voila! Problem solved. I'll have to post with the full solution when I get it done and tested, with pictures.

[rakkwhite]

Anyhow, the SoClean manufacturers have provided me with the company (McMasters-Carr) and part numbers for a grommet (1061T13) and a female (51525K283) and a male (51525K273) quick disconnect to run the thin ozone tubing directly into the humidifier tank so I won't have to use the adapter (they cost about $5 each for a pack of 10, total of $15 plus $7 S&H). Excellent solution and voila! Problem solved. I'll have to post with the full solution when I get it done and tested, with pictures.

When you get the chance, please post your set up with pictures, if you can. I'm a visual learner and it would be greatly appreciated! Thank you!!!

[SleepySleepNeeder]

When you get the chance, please post your set up with pictures, if you can. I'm a visual learner and it would be greatly appreciated! Thank you!!!

RakkWhite, I think we cannot include attachments with our posts. I may create an instructional video and post it on YouTube and link to it here in the future, but it's not a priority right now, sorry. However, it was very easy to do, and here are the instructions:

My setup is perfect for this solution, as I had just enough available space on the front of my humidifier tank above the water line to drill the 7/16" hole (you have to do it in gradual steps starting with a tiny hole and using every stepped-up drill bit size until you get to 7/16" to prevent damaging the tank). I did this by placing the grommet inside the tank up against the upper ledge and marking the center of the hole on the outside for drilling. I then installed the grommet, then I just used the long ozone tubing going to the adapter and the short tubing from the adapter that went inside the tank, and pushed the short piece through the grommet into the back side of the tank, inserted the disconnects into the short and long tubing ends and connected them. Voila! Problem solved. No more airflow restriction, ozone is actually getting delivered more strategically to the farthest back corner of the tank, and I can easily disconnect the hose to empty and dry the tank.

[rakkwhite]

Thank you for explaining this. Maybe this will be a project for hubby.
Take care,
Annette

[Sage Lee]

I am a CPAP user in South Korea. I was considering to purchase SoClean and found this helpful posts. (Thank you so much!!)

Do you think this air pressure problem caused by SoClean would happen, even if I use auto-pressure CPAP machine?

I am not familiar with anything related CPAP machine yet, because I purchased System One only just a days ago.

[SleepySleepNeeder]

I am a CPAP user in South Korea. I was considering to purchase SoClean and found this helpful posts. (Thank you so much!!)
Do you think this air pressure problem caused by SoClean would happen, even if I use auto-pressure CPAP machine?
I am not familiar with anything related CPAP machine yet, because I purchased System One only just a days ago.

That is a good question Sage Lee. I believe the noticeable airflow restriction I experienced may be unique to my particular setup (otherwise, the makers of SoClean would have taken a different approach). That is, because I use a mask (Swift II with nasal pillows) that has a short smaller inlet tubing that also restricts the airflow, I had two pressure drops by the time it got to my mask. I did my titration study with this mask so my pressure setting takes its pressure drop into account. But the two pressure drops also effectively isolate the machine from the pressure changes caused by my breathing.

In any case, I still recommend the SoClean sanitizing unit. If the humidifier water tank has the available space in front above the water line (it needs a 7/16" hole above the water line, just remember to carefully start with a very tiny hole and gradually increase the drill bit size until you reach the correct size, otherwise the tank wall will be damaged) I recommend making the modification that I made and run the thin ozone tubing directly into the humidifier water tank instead of using the adapter. I posted the manufacturer (http://www.mcmaster.com/) and parts list (grommet part# 1061T13, female quick-disconnect part# 51525K283, and male quick-disconnect part# 51525K273), and they are easy to install.

HAPPY CPAPPING!

[Arizona-Willie]

I just discovered this SoClean2 thing this morning and am checking into it.

I use a S9 Autoset, so wouldn't that automatically compensate for any pressure reduction?
I have mine set to a range from 9 - 15 I believe so if the tubing causes a 10% reduction the machine < should > compensate for that ... I hope.