Tap water not a good idea

[sleepy1235]

I see three issues that should be considered in avoiding tap water.

1. Scale buildup can involve silica as well as calcium and magnesium carbonates. Vinegar would remove the calcium and magnesium carbonates, but won't affect the silica. There might also be other materials that will build up as well, such as organics, bacterial cell walls, etc. With heat these can be cooked on.

2. Chlorine might be corrosive and damaging to your motor, other components of your CPAP. Tap water in America is full of chlorinated organics due to the chlorination of water. Gaseous Cl2 is used. The organic chlorides are often subsequently broken down to oxidized compounds and released HCL. Additionally I suspect that there might be surpluse Cl2 in the water either as Cl2 or various chlorous acids.

3, To get effective mass transfer from a liquid medium to a gas and to get the final concentration of the liquid into the gas at a controlled point most systems are designed to use what is called "bubblers." That is the gas is bubbled through the liquid. This works well to define very precisely the vapor concentration of the evaporated liquid into the gas flow.

In the case of the CPAP the liquid is water and the gas is air.

The thing about bubblers that they generate aerosol, small mist, which is inherent with bubbling, which goes along with the gas flow.

The design of these systems often is to have a post bubbler filter to eliminate the mist generated by the bubbling.

http://www.fphcare.com/respiratory/infa ... ap-system/ shows CPAP bubblers.

So with tap water you might be getting droplets of tap water with concentrated dissolved solutes. Even without bubblers there can sometimes be what is called entrainment. The mist might be building up inside your air lines and leaving solids.

I would use distilled water to make sure that your bubbler doesn't or humidifier of anytype doesn't send mist into your lungs.

[JDS74]

sleepy1235 makes good points about the drawbacks of using tap water in a CPAP humidifier.
There is one error worth mentioning: CPAP humidifiers don't use bubblers and I suspect for the reasons stated.
Airborne water droplets would be passed into the inner workings of the blower, collect on surfaces there, and cause problems.

Distilled water is definitely the way to go to eliminate all the stated problems.

[Wulfman...]

I hate to burst everyone's bubbles, but........... (copy the link to the pdf file and take out the spaces)

http : // journal . publications . chestnet . org/pdfaccess . ashx?ResourceID=2117327&PDFSource=13

The title is:

"Sterile Water Is Unnecessary in a Continuous Positive Airway Pressure Convection-Type Humidifier in the Treatment of Obstructive Sleep Apnea Syndrome*"

By: Markus Wenzel, MD; Matthias Klauke; Frank Gessenhardt; Dominic Dellweg, MD; Peter Haidl, MD; Bernd Schönhofer, MD; and Dieter Köhler, MD


From a personal standpoint, I've almost always used distilled water, but on occasion have used Brita filtered tap water.


Den

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[dae3dae3]

Distilled water costs about a dollar a gallon depending on where I buy it and I can't go through more than about a gallon a month. I just top off the container every night. Maybe I'm just financially blessed but I can swing a dollar a month.

Whatever floats your boat. I'm not going to argue with anybody about it but unless you have some mobility problems and just can't get out to get it or cost is a lot different where you live I don't understand why somebody wouldn't just use it. It is universally recommended by the equipment manufacturers. In five years of using distilled water I haven't had to do more than loosely rinse and wipe out the container with soapy water. I've never even come close to having any deposits I had to soak or scrub.

[Goofproof]

I see three issues that should be considered in avoiding tap water.

1. Scale buildup can involve silica as well as calcium and magnesium carbonates. Vinegar would remove the calcium and magnesium carbonates, but won't affect the silica. There might also be other materials that will build up as well, such as organics, bacterial cell walls, etc. With heat these can be cooked on.

2. Chlorine might be corrosive and damaging to your motor, other components of your CPAP. Tap water in America is full of chlorinated organics due to the chlorination of water. Gaseous Cl2 is used. The organic chlorides are often subsequently broken down to oxidized compounds and released HCL. Additionally I suspect that there might be surpluse Cl2 in the water either as Cl2 or various chlorous acids.

3, To get effective mass transfer from a liquid medium to a gas and to get the final concentration of the liquid into the gas at a controlled point most systems are designed to use what is called "bubblers." That is the gas is bubbled through the liquid. This works well to define very precisely the vapor concentration of the evaporated liquid into the gas flow.

In the case of the CPAP the liquid is water and the gas is air.

The thing about bubblers that they generate aerosol, small mist, which is inherent with bubbling, which goes along with the gas flow.

The design of these systems often is to have a post bubbler filter to eliminate the mist generated by the bubbling.

http://www.fphcare.com/respiratory/infa ... ap-system/ shows CPAP bubblers.

So with tap water you might be getting droplets of tap water with concentrated dissolved solutes. Even without bubblers there can sometimes be what is called entrainment. The mist might be building up inside your air lines and leaving solids.

I would use distilled water to make sure that your bubbler doesn't or humidifier of anytype doesn't send mist into your lungs.

I must have missed out with my equipment, I didn't get a XPAP BUBBLER, I don't know how I've been getting by these 9 years without one. I may have to modify my hh with a fish tank pump, I could run my O2 line into the hh. Jim

[newsnore]

This topic keeps bubbling to the surface from time to time . I have been using tap water in my humidifiers for the past 2 years, and so far no issues. My H5i humidifier tank (which I have been using for the past 13 months) is as good as new. We do have filtered tap water which is generally what I use - but when traveling I just use whatever is on hand which is usually straight tap water. I give the H5i a good rinse out between fills (usually 3 nights per fill) and very occasionally I give it a rinse with vinegar (but it really doesn't even need that). Interesting link (PDF) Wulfman will read it properly later.

[BlackSpinner]

I used tap water for 3 years, the only result being a little scaling in the humidifier. I started using it when I had pneumonia in February and hiking along icy streets with a gallon of water was not an option.

I really don't see how chlorine water particles can fly up wind to the motor.

[sleepy1235]

1. I didn't say every CPAP machine used a bubbler. But from the link I provided you can see that some do. If they use a downstream demister then they might be fine. If they don't you might have a problem.

2. For gas flow over liquid you can still get accidental entrainment but I think this is a small risk.

3. The issue of your tap water releasing chlorine in various forms still is a possibility.

[martywalks]

I've been in the water business for about 22 years now, and it might be useful to some to get a little different opinion.

(1) The water you use in your humidifier should not have many pathogens (I think water must be treated to achieve 99.999% pathogen removal prior to use). In the US, all surface water (water not from deep wells) must be (a) filtered, (b) disinfected, and (c) leave the filtration plant with a chlorine residual - usually about 1ppm. This last requirement is so that any pathogens that may enter between the time it's processed until it's consumed may be inactivated.

(2) Filtration is required to get the large size pathogens. Think cryptosporidium, and giardia lamblia. These cannot be killed off by chlorine of reasonable concentration. Disinfectants like ozone can inactivate giardia, but they won't maintain a residual for any significant length of time. Distilled, R/O, or municipal water pass this test.

(3) Chlorine or Chloramines (treatment with both chlorine, usually gaseous, and ammonium hydroxide mixed together) inactivate bacteria and enteric virus, much smaller pathogens.

Remember, if one uses distilled water from the store, it does not have a chlorine residual and is not sterile. One could purchase USP grade sterile water for their humidifiers, but for both, the cost would be prohibitive. If one uses distilled water, you're taking a small chance -- especially not knowing it's storage parameters after leaving the distiller. One could boil or disinfect such water (using chlorine or ozone, for example) prior to use and eliminate most risks.

Tap water, mineral-wise, can be very different depending on the water's source. Here in the West, municipal water typically has very high hardness and leaves deposits. Water elsewhere may leave very little. But, if it's surface water in the US, it will have in it a chlorine residual from it's source. Be glad about this. If it's well water, then all bets are off.

It is suggested, if you use distilled or R/O (reverse-osmosis) water, especially if there's any questions about the efficiency of your immune system, that you arrange to disinfect the water. Municipal water, water boiled just prior to use, or ozonated. This is becaused a warm humidifier may support pathogen growth. When I fill my humidifier tank, I use a bottle to transfer it from the water cooler. When that bottle is not in use, it has tap water in it to keep it disinifected.

A SoClean (or other brand of ozonator) could be used for disinfection, using regular R/O water from a bottled water supplier. For me, I think my immune system is OK, but I just don't want to take the chance.

BTW, 1 ppm clorine is too small a dose to cause significant corrosion problems in a CPAP machine.

[Goofproof]

1. I didn't say every CPAP machine used a bubbler. But from the link I provided you can see that some do. If they use a downstream demister then they might be fine. If they don't you might have a problem.

2. For gas flow over liquid you can still get accidental entrainment but I think this is a small risk.

3. The issue of your tap water releasing chlorine in various forms still is a possibility.

That must be why I burp, got to get rid of tha chlorine gas, after that glass of killer tap water. Since I can read I'll use distilled water in my hh, when I can, and tap water with my dinner, and my bubbler in my aquarium. Jim

[Sludge]

There is one error worth mentioning: CPAP humidifiers don't use bubblers and I suspect for the reasons stated.
Airborne water droplets would be passed into the inner workings of the blower, collect on surfaces there, and cause problems.

And just how are these droplets going to jump into a 35 LPM headwind (at least) and fight their way back into the blower?

This is not a straight yes or no issue.

If you are using well water (or if your water supply vendor is cheap), run downstairs and look at you pipe system.

If it looks like this:



you might want to think twice about using tap water.

[xyz]

All things considered, using distilled water is a good idea.

The cost (based on Walmart prices) is about 6 cents per night.

Throw out the unused water daily.
Or else you lose some of the advantage of using distilled water.
That is around a 3 cents per day decision.
(My humidifier uses about half the water I put in it.)

[Hose_Head]

[quote="martywalks"]I've been in the water business for about 22 years now, and it might be useful to some to get a little different opinion.

(1) The water you use in your humidifier should not have many pathogens (I think water must be treated to achieve 99.999% pathogen removal prior to use). In the US, all surface water (water not from deep wells) must be (a) filtered, (b) disinfected, and (c) leave the filtration plant with a chlorine residual - usually about 1ppm. This last requirement is so that any pathogens that may enter between the time it's processed until it's consumed may be inactivated.

(2) Filtration is required to get the large size pathogens. Think cryptosporidium, and giardia lamblia. These cannot be killed off by chlorine of reasonable concentration. Disinfectants like ozone can inactivate giardia, but they won't maintain a residual for any significant length of time. Distilled, R/O, or municipal water pass this test.

(3) Chlorine or Chloramines (treatment with both chlorine, usually gaseous, and ammonium hydroxide mixed together) inactivate bacteria and enteric virus, much smaller pathogens.

Remember, if one uses distilled water from the store, it does not have a chlorine residual and is not sterile. One could purchase USP grade sterile water for their humidifiers, but for both, the cost would be prohibitive. If one uses distilled water, you're taking a small chance -- especially not knowing it's storage parameters after leaving the distiller. One could boil or disinfect such water (using chlorine or ozone, for example) prior to use and eliminate most risks.

Tap water, mineral-wise, can be very different depending on the water's source. Here in the West, municipal water typically has very high hardness and leaves deposits. Water elsewhere may leave very little. But, if it's surface water in the US, it will have in it a chlorine residual from it's source. Be glad about this. If it's well water, then all bets are off.

It is suggested, if you use distilled or R/O (reverse-osmosis) water, especially if there's any questions about the efficiency of your immune system, that you arrange to disinfect the water. Municipal water, water boiled just prior to use, or ozonated. This is becaused a warm humidifier may support pathogen growth. When I fill my humidifier tank, I use a bottle to transfer it from the water cooler. When that bottle is not in use, it has tap water in it to keep it disinifected.

A SoClean (or other brand of ozonator) could be used for disinfection, using regular R/O water from a bottled water supplier. For me, I think my immune system is OK, but I just don't want to take the chance.

BTW, 1 ppm clorine is too small a dose to cause significant corrosion problems in a CPAP machine.[/quote

Good post. But it's incomplete. You forgot to mention UV Sterilization of water. A proper UV system will sterilize your water as effectively as chlorine (but without the residual effect).

Also, if you have chlorine in your tap water, you can effectively get rid of most of it by letting the water stand in an open container for a few minutes.

[HoseCrusher]

Den, speaking of "bursting bubbles" let's examine some of the limitations of that study.

Each revision of xPAP equipment involves differences in the air flow path. I don't believe anyone is still using equipment that was manufactured in 2005 when that study was done.

The next limitation involves air flow. It is common sense that lower air flows would create less turbulence. A ResMed full face mask has a vent rate of around 50 L/min at 20 cm pressure and in addition to that you can have 24 L/min and still be below a leak concern. They used a maximum of 46 L/min. A more realistic flow would have been 75 - 100 L/min.

In addition they ran their test for 10 minutes. Most of us use our xPAP for much longer than that. What do you think would have happened if their humidifier ran dry? It would have been a much better study if they ran their tests for 5 - 6 hours and explored what happens if the humidifier runs dry.

A more "realistic" conclusion would be that if you use an xPAP pressure of 8 cm or less and have minimal leaks and never run out of water in the humidifier you can expect to have no problems...

[Goofproof]

I'm still using my 2005 xpap, in fact when it breaks I have two more of the same type to go to. Not all of us have to have new, we are willing go settle with the Best!

As far as leak rates if it ever gets over 40 LPM, I correct the problem, in reality it's 38 LPM @ 14.5 C.M., I set as a personal limit. If I still used water in my HH, it would be distilled, I don't use any water for 2 years, but since I can read it would be distilled... Jim