When to use humidifier? At what settings?

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Pugsy
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Re: When to use humidifier? At what settings?

Post by Pugsy » Wed Dec 05, 2012 5:05 pm

StuUnderPressure wrote: I may be out of town tomorrow - so let me APOLOGIZE to you in advance if I am wrong.

Their wording of "constant humidity" and "depending on temperature" do seem to contradict one another.
I am pretty sure that the 80% thing just happens to be the default setting and I forget what temperature my machine was originally defaulting to in order to give me that humidity because I have slept too many nights since then.
I have not seen anything that says that 80% is what is delivered to everyone at every temperature setting.
I thought I saw something that referred to varying humidity % with each temperature but I can't find it right now.
I will look around in my "stuff" to see if I can find it or maybe I dreamed it. I am pretty darn certain that if I set the temp at 72 degrees .... while having the climateline set to "automatic" that I won't get 80% humidity delivered to my nose.

I think it is a "constant" whatever % humidity and the % humidity is dependent upon temperature.
I will go see if I can find the documentation that I think I read.

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Re: When to use humidifier? At what settings?

Post by Pugsy » Wed Dec 05, 2012 5:24 pm

Pugsy wrote:I will go see if I can find the documentation that I think I read.
Found it. Also found the mention of 80% that Stu was commenting on. I can see where it might lead a person to think that 80% is delivered to everyone at all temps but I think that the chart below that mention goes on to explain things further.
Image
BTW took some searching but 100 % relative humidity is 44mg/L per Resmed site...http://www.resmed.com/us/products/s9_se ... nc=dealers under humidification tab.
"Did you know?

Relative Humidity varies with temperature. The higher the temperature, the more water vapor the air can hold. The cooler the air, the less water it can hold.

That is why when warm air cools as it travels down the tube, condensation forms on the inside of the tube and mask in a CPAP system. This condensation is known as rainout.
Rainout

Rainout is the water, or condensation, that collects in your mask or tubing. It is a common side effect of humidification.
Why do you need humidification during therapy?

When you breathe normally, your nose and upper airway add heat and moisture to the air. By the time it reaches your lungs, air should be at body temperature (37°C or 99°F) with 100% relative humidity (44 mg/L).

During therapy, higher air pressure can overwhelm your upper airway’s ability to heat and humidify the air. Colder, dryer air can cause a sore throat, dry nose, mouth or throat, nasal congestion and a runny nose.

30 - 70% of patients experience these symptoms."

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Slartybartfast
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Re: When to use humidifier? At what settings?

Post by Slartybartfast » Wed Dec 05, 2012 8:55 pm

StuUnderPressure wrote:
Do you have an early version of the S9 AutoSet.

That problem was fixed in the S9 AutoSets with a later Software Version.

It was definitely fixed by Version 0903, but I think it was even fixed by the 0603 Version.
It would so seem. It appears to be v.0602 purchased August, 2010.
Last edited by Slartybartfast on Wed Dec 05, 2012 9:51 pm, edited 1 time in total.

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Re: When to use humidifier? At what settings?

Post by Slartybartfast » Thu Dec 06, 2012 9:46 am

Pugsy wrote:
Pugsy wrote:I will go see if I can find the documentation that I think I read.
Found it. Also found the mention of 80% that Stu was commenting on. I can see where it might lead a person to think that 80% is delivered to everyone at all temps but I think that the chart below that mention goes on to explain things further.
But that is, in fact, what the table is showing. Those figures are for absolute humidity at different temperatures. They all convert to 80% RH.

At 60F/16C, 10 mg/L represents 80% RH.
. . .
At 86F/30C, 22 mg/L represents 80% RH.

They just neglected to point that out in the table. They should have placed another column to the right with the %RH figures in it, showing that they're all 80% RH.

So the statement that the H5i humidifier and Climateline delivers a constant 80% RH to the mask regardless of temperature is correct. The 44 mg/L figure is saturation, or 100% RH, but only at 99F/37C body temperature.

If you really want to get persnickety, though, absolute and relative humidity are poor choices to describe what's going on because they bear a nonlinear relation to temperature. They should be using vapor pressure deficit (VPD) which is a measure of the difference between the actual water vapor pressure and the saturation water vapour pressure at a particular temperature. Unlike relative humidity, vapor pressure deficit has a simple nearly straight-line relationship to the rate of evaporation, which is what we are concerned with, and it allows one to easily calculate evaporation rates. But nobody but botanists seem to care about evaporation rates.
Last edited by Slartybartfast on Thu Dec 06, 2012 9:59 am, edited 1 time in total.

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Re: When to use humidifier? At what settings?

Post by Pugsy » Thu Dec 06, 2012 9:55 am

Slartybartfast wrote:But that is, in fact, what the table is showing. Those figures are for absolute humidity at different temperatures. They all convert to 80% RH. So the statement that the H5i humidifier and Climateline delivers a constant 80% RH to the mask regardless of temperature is correct. The 44 mg/L figure is saturation, or 100% RH, but only at 99F/37C body temperature.
How can it maintain constant 80% humidity at my house with a temp of 84 degrees and/or a temp of 72 degrees or 68 degrees?
I don't see how it can do that.
What if someone doesn't want or need 80%? Who says that 80% is what the whole world needs and all we need to do is alter temp to our comfort?
What about the clinical manual statement that I circled earlier that says it maintains a
" constant absolute humidity (based on temperature setting)" ?

I don't mean to be argumentative but I just don't see it being able to give everyone 80% at all temperatures.
My own past experience with lower temps on the climateline system in automatic mode tells me that it dried my nasal mucosa out big time. It was not a nice result.

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Re: When to use humidifier? At what settings?

Post by Pugsy » Thu Dec 06, 2012 10:55 am

Okay.... I called ResMed because this was bugging the heck out of me.
I still don't know how they do it but the tech guy said yes, 80% is what the machine strives for when the Climateline hose is used and Automatic mode is selected. He says that no matter what the temperature chosen the machine will strive to maintain 80% target humidity delivery using sensors both at the incoming air end and the end of hose at mask level. Water consumption can vary dramatically depending on room temp and ambient humidity.

So I learned something and will make appropriate changes in my responses in the future when talking about the Climateline and the automatic setting.
Though I still say that cooler temps sure feels drier to me but maybe it is all in my head. Wouldn't be the first time. I

So I stand corrected and happily will eat a bit of humble crow pie.

Side note...since this is apparently the case and automatic is default with the Climateline hose attached and since some people don't do so well with more added moisture then this is something we probably should try to keep in mind when someone is having nasal congestion issues with these default settings. 80% may simply be too much added moisture for some people's nasal mucosa and telling them to turn the temp down may not help...instead we need to tell them to switch over to patient manual mode and start making adjustments there. ResMed assumes that 80% is ideal for the masses and we all know that isn't necessarily how it is in real life.

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Re: When to use humidifier? At what settings?

Post by Slartybartfast » Thu Dec 06, 2012 10:55 am

Pugsy wrote:
Slartybartfast wrote:But that is, in fact, what the table is showing. Those figures are for absolute humidity at different temperatures. They all convert to 80% RH. So the statement that the H5i humidifier and Climateline delivers a constant 80% RH to the mask regardless of temperature is correct. The 44 mg/L figure is saturation, or 100% RH, but only at 99F/37C body temperature.
How can it maintain constant 80% humidity at my house with a temp of 84 degrees and/or a temp of 72 degrees or 68 degrees?
I don't see how it can do that.
What if someone doesn't want or need 80%? Who says that 80% is what the whole world needs and all we need to do is alter temp to our comfort?
What about the clinical manual statement that I circled earlier that says it maintains a
" constant absolute humidity (based on temperature setting)" ?

I don't mean to be argumentative but I just don't see it being able to give everyone 80% at all temperatures.
My own past experience with lower temps on the climateline system in automatic mode tells me that it dried my nasal mucosa out big time. It was not a nice result.
Great discussion! No argument here at all. The problem is the distinction between the term absolute humidity and relative humidity.

Absolute humidity (the right hand column in your table) is the amount of water held by a sample of air. It's like saying a quart jar contains a 50 grams of water. Notice that mention of temperature is conspicuously absent.

Relative humidity is the amount of water held in a sample of air, expressed as a percentage of the total amount of water that sample of air is capable of holding at a given temperature. Or, using the jar analogy, it's a measure of how much water is held in a quart jar expressed as a percentage of the total capacity of the jar. In this case it's a rather odd jar, because the jar gets bigger when it's warm, and smaller when it's cold.

When you take absolute humidity (right hand column) and correct it for the capacity of air at a given temperature (left hand column) to hold moisture, you have relative humidity. And when you do the conversion, all the figures in the table convert to 80% RH. The capacity of air to hold water rises as temperature rises.

To answer your question, "How can it maintain constant 80% humidity at my house with a temp of 84 degrees and/or a temp of 72 degrees or 68 degrees?"
There is a temperature sensor measuring the air entering the S9. Another sensor measures the water temperature in the humidifier reservoir. A third sensor measures the temperature at the far end of the hose. And a flow sensor measures the rate of airflow through the system. The H5i calculates how much heat to supply to the water in the reservoir in order to force enough water to evaporate into the airstream in order to maintain 80% RH based on ambient temperature. It's really a pretty slick setup.

"What if someone doesn't want or need 80%? Who says that 80% is what the whole world needs and all we need to do is alter temp to our comfort?" Fair question. 80% is used only as a default setting. In that case you can go into manual mode and control the reservoir temperature and air temperature separately and achieve whatever level of humidity you like. But I don't think there is the option of dialing in, for example 75% RH or 50% RH. That would be an easy upgrade for Resmed to make, but it's not a current feature as far as I know.

"What about the clinical manual statement that I circled earlier that says it maintains a 'constant absolute humidity (based on temperature setting)?'" Remember what I said earlier. Relative humidity is absolute humidity at a given temperature. The statement "...absolute humidity (based on temperature setting)" is a clumsy way of saying, simply, "relative humidity."

"My own past experience with lower temps on the climateline system in automatic mode tells me that it dried my nasal mucosa out big time. It was not a nice result."

Up to now, we've been talking physics. Temperature, vapor pressure, evaporation rate. Your question touches on physiology. As moisture evaporates from the tissues in the airway, they are cooled, and the capillaries in the surface layers contract, limiting the amount of blood flow, and thus, moisture, available to maintain a humid environment in your sinuses. So your nose dries out and you feel awful. Turn the temperature up and the warmer air causes the capillaries to dilate which provides more moisture. The higher the relative humidity of the incoming air, the less the tissues will be dried. So 80% RH or higher is a reasonable level to set as a default. If they set it higher, the risk of rainout in the connector hose and mask will rise.

While you've got me going, there's a phenomenon related to the vapor pressure deficit I mentioned in another post that's also at work that runs counter everything I just said. The rate of evaporation from a wet surface into 60 F/80% RH air is slower than the evaporation rate into 80F/80% RH air. Clothes hung on a clothesline dry faster on an 80F day than they do on a 60F day, even though the relative humidity is 80% on both days because the evaporation rate increases more rapidly with increasing temperature.

However, in this case, physiology trumps vapor pressure deficit.

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Re: When to use humidifier? At what settings?

Post by Pugsy » Thu Dec 06, 2012 11:12 am

Thanks Slarty...my scientific side of my brain can't wrap itself around all of what you said but I get the gist of it.
I got an A in Physics because the teacher liked my eyes and graded on a curve or I would have been dead in the water.

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Re: When to use humidifier? At what settings?

Post by Slartybartfast » Thu Dec 06, 2012 11:27 am

Pugsy wrote:Thanks Slarty...my scientific side of my brain can't wrap itself around all of what you said but I get the gist of it.
I got an A in Physics because the teacher liked my eyes and graded on a curve or I would have been dead in the water.
Sorry, probably too much information, but you're one of the brightest bulbs on this string, and I figured you'd glean what you needed out of that info-dump. Before selling out and going into Industry I taught high school biology, chem and physics and, coming from a family of teachers, I loved to teach (still do when given half a chance), but school politics and dearth of students who really wanted to learn was what decided me to seek greener pastures elsewhere.

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Re: When to use humidifier? At what settings?

Post by StuUnderPressure » Mon Dec 17, 2012 8:42 am

I bumped this back to the top - because with the colder months approaching, I am sure a lot of people will be adjusting the temperature setting on their S9s.

I had switched mine back to the full Auto default of 80 degrees & 80% humidity when we had a cold night that approached freezing.

But lately the day time highs have been in the mid to upper 70ties & the lows in the 60ties or upper 50ties.

So, just last night, I switched the temperature setting in Auto back to the summer setting of 70 degrees until the cold months actually get here.

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Re: When to use humidifier? At what settings?

Post by Posey » Fri Jan 04, 2013 4:18 pm

Thanks for the bump as I woke up this AM with a bloody nose again

I requested a climateline hose on Nov 29th from Lincare and today they say they "overnighted" it & I will get it Monday.
I put a hose cozy on my slimline tube, set the humidity to 5 and even laid it on a heating pad set on low. Our bedroom last night was at ~69 degrees F w/ 32 rel humidity. Is there any way to judge from temperature etc. about when to up the humidity?
Thanks for any input (and my nose thanks you too.)

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Re: When to use humidifier? At what settings?

Post by cosmo » Sat Jan 05, 2013 8:33 pm

I was afraid of tripping the breaker again so I bought a room humidifier at Target for $30. It blows out a cool mist using tap water and max output is at 30 watts. I keep it in the middle setting and it uses about 14 watts. No worries about tripping breakers again.

Image

I've been doing fine without using the CPAP humidifier/heated hose since I started treatment a month ago. You people are crybabies