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Just heard from a sleep tech that her sleep center, located within a  highly prestigious hospital in one of America's largest and most affluent metropolitan centers, fills patients humidifiers with tap water on CPAP titrations.  furthermore, a 7 year-old child contracted Legionnaires Disease and died from being titrated with a CPAP humidifier filled with tap water.

Make sure you insist on distilled or reverse osmosis/ purified bottled water for your CPAP titrations in the sleep center.  The life you save may be your own.

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Thanks Richard and I just don't know why we can't easily get it here in the UK.  I can assure you that most people here don't use distilled water because they can't get hold of it.  I'm told chemists can order it in for the few who do use it.  However, I get shot down when I bring up the subject, and am told our water is ok.  Well I live in a hard water area and can smell chlorine in it, so am using bottled water.  I recently looked into getting my own distiller and this post has spurred me on to do so.

Richard said:

I use reverse osmosis-filtered water (I have my own RO system). Tap water can contain many 'contaminants' - bacteria, minerals and chlorine among them. There was a comment about UK vs US water - I am from Vancouver, where the water is extremely soft (no minerals) and chlorinated to kill the bugs - but even there the sleep docs told my Mom to use distilled water. I now live in Northern California, and I would never use the tap water directly.

Boiling water for at least 10 minutes - at sea level - will kill most bugs, but does not remove minerals or other non-living contaminants (like the stuff from a local disk drive plant that used to be near my home!). I'm surprised that distilled water is so hard to get int the UK - in the US and Canada it's found in just about every food and drug (chemists) store, but I looked at the Tesco and Boots web sites - nothing!

Water distillers are available on amazon.co.uk, but they aren't cheap (150+ pounds). If I were in the UK, I'd be comparing the cost of electricity for a distiller vs. the cost of water for an RO system - they use extra water to back flush - get a high-efficiency unit to keep these costs down. Decent RO systems are in the same price range as the distillers. I have a four-stage Watts Premiere unit, and recently received the high-efficiency adapter (which I need to install - water isn't cheap here either - and shouldn't be wasted!).

I would not use tap water - even when I go home to Vancouver, I still use distilled of RO water. Considering the health issues, I wouldn't take chances with tap water.

It's just the one that came with my resmed vpap. I didn't know there were ones you could take apart. I would love to get one of those. The one I have is really hard to clean.

While I currently use bottled distilled water(I watch for sales), I used to own a tabletop, water distiller. They are expensive and I never did the math to see if practical.  This info is FYI only.

Wade Hampton said:

Hello everyone,

It says right on my S9 water tank to use only distilled water.  This is in plain English 

imprinted on the tank.  Can't people read?  Also it is not difficult to make your own

distilled water.  

Thanks  H. Hampton

I try to give my tank a vinegar and water "bath" every two weeks or so to kill off possible bugs.

I rinse it out daily in VERY hot water and allow it to air dry. Now I'm beginning to think that I should follow the baby-shampoo and tap water cleaning routine followed by a final distilled water bath.

fwiw. I also keep a mixture of white vinegar (one part) and water (10 parts) in a small bottle and reuse it every other day or two in my hose. I pour the solution down one end (holding the other end up so that it doesn't spill out) then hold each end of the hose and move the vinegar-water up and down the entire length a few times before I re-pour the solution into its bottle. This kills bugs (I hope!) and I think is a more economical use of the white vinegar. (I'm the Queen of Cheap.)

Most bottled water has minerals in it, either 'naturally', or added in. There have also been lots of stories of bad bottled water here in North America. If I'm stuck when traveling, I'll risk one of the larger brands (Dasani or Aquafina) for a night - or go without the humidifier - but not for long.

Most UK water *is* pretty clean, but is very 'hard' compared to water here on the west coast of NA. Growing up in Vancouver I had troubles drinking water from almost anywhere else - and got sick on the water in Newcastle in the '80s, which was supposed to be some of the best water in the UK.

It took my move to California to retrain my body - I can now drink water in most 'safe water' cities where I travel, thanks to the lower quality of California tap water compared to Vancouver. ;-)

This does convince me to use distilled or pure RO water whenever possible.

From pure conductivity tests with an RO meter, my RO system doesn't remove everything, but it does bring conductivity down to about 2-5% of our tap water. Distilled water registers zero on the meter - so is the real standard to match.

Given that my equipment isn't exactly sterile either (even with the best of cleaning), I believe that my risk level is pretty low with RO water (and I do my own RO maintenance, cleaning, and periodic testing to keep it as safe as I can). I originally installed the RO system because I don't like the taste of local tap water, so it serves both purposes for me. If your tap water is acceptable to drink, I'd agree that a distiller is the way to go.

One downside of drinking RO (or distilled) water - there can be useful minerals in hard tap water (calcium, magnesium, etc.)  that I supplement - but there can also be heavy metals, solvents and other contaminants that get removed in the process. If you want a real scare, try sending a local water sample out for independent analysis...

White vinegar is pretty cheap, especially in the large economy size from the big warehouse stores - do you really want to have the possibility of storing vinegar-resistant bugs in your bottle and reintroducing them to your hose?

I would just pour less vinegar/water into the hose each time, but definitely pour it down the drain after using it!

If you're only rinsing with vinegar every two weeks, that means that you're storing this solution for many months - the chances of contaminating your solution go up with time.

ZolliStar said:

I try to give my tank a vinegar and water "bath" every two weeks or so to kill off possible bugs.

I rinse it out daily in VERY hot water and allow it to air dry. Now I'm beginning to think that I should follow the baby-shampoo and tap water cleaning routine followed by a final distilled water bath.

fwiw. I also keep a mixture of white vinegar (one part) and water (10 parts) in a small bottle and reuse it every other day or two in my hose. I pour the solution down one end (holding the other end up so that it doesn't spill out) then hold each end of the hose and move the vinegar-water up and down the entire length a few times before I re-pour the solution into its bottle. This kills bugs (I hope!) and I think is a more economical use of the white vinegar. (I'm the Queen of Cheap.)

     Thanks for letting me know about the danger of reused vinegar. (The Queen of Cheap thought she was being so clever!)

     The ever-splendid Rock told me about this product: http://www.cpap.com/productpage/Control-III-Disinfectant-Germicide-...

      I think I'll switch to using it every week or so for a thorough cleaning -- unless there's something else I should be aware of.

       Is there??

Richard said:

White vinegar is pretty cheap, especially in the large economy size from the big warehouse stores - do you really want to have the possibility of storing vinegar-resistant bugs in your bottle and reintroducing them to your hose?

I would just pour less vinegar/water into the hose each time, but definitely pour it down the drain after using it!

If you're only rinsing with vinegar every two weeks, that means that you're storing this solution for many months - the chances of contaminating your solution go up with time.

ZolliStar said:

I try to give my tank a vinegar and water "bath" every two weeks or so to kill off possible bugs.

I rinse it out daily in VERY hot water and allow it to air dry. Now I'm beginning to think that I should follow the baby-shampoo and tap water cleaning routine followed by a final distilled water bath.

fwiw. I also keep a mixture of white vinegar (one part) and water (10 parts) in a small bottle and reuse it every other day or two in my hose. I pour the solution down one end (holding the other end up so that it doesn't spill out) then hold each end of the hose and move the vinegar-water up and down the entire length a few times before I re-pour the solution into its bottle. This kills bugs (I hope!) and I think is a more economical use of the white vinegar. (I'm the Queen of Cheap.)

If you have the Resmed S9 VPAP with the H5i humidifier (the current models), the chamber is part number 36800, available on cpap.com for $33. I had my local supplier (Apria) find one for me, but they don't normally stock them - they'd rather ship me a disposable chamber every month and charge my insurance - no thanks!

The disposable chambers are flimsy and impossible to clean properly. The reusable chamber has a stainless steel base, sturdier plastic, and comes completely apart for a real cleaning.

Nunya Bizness said:

It's just the one that came with my resmed vpap. I didn't know there were ones you could take apart. I would love to get one of those. The one I have is really hard to clean.

I don't reuse the vinegar (gross). I pour a mixture of water and vinegar into the chamber, let it sit for a couple of hours, then rinse it out. I use a bendable brush to clean off any gunk.

As far as this whole issue of tap vs distilled water goes, I've been on CPAP for 12 years, have never used anything but tap water, and have never had any problems. I googled the matter and couldn't find any reason to not use tap water, other than having to clean the mineral deposits left behind.


Even the Resmed site says tap water is fine.

Mike,

I work as a respiratory therapist and I routinely reinforce and retrain my CPAP/BiPAP patients on proper water to use for humidification. I will check their home units and I notice the gunk in the water reservoirs. I clean and sanitize the chamber explaining that this gunk is getting pressure-forced into their sinuses and respiratory tract. Not very sanitary, so I inform them that the best water to use is sterile water. Any drugstore has sterile water, but it is pricey. The next best option is distilled water. There may be some lime deposits in the water reservoir due to the heat and water reaction, but this can always be cleaned. The last option is boiling your tap water, but once again, the most important thing to do is CLEAN and SANITIZE your water reservoir at least once a week. AND, NEVER leave any water standing in your unit if not in use. After use, empty out the reservoir and let it dry. BTW, I do inform my patients that IF they can tolerate the CPAP/BiPAP without water in the reservoir, that is another way to avoid any water-borne contamination.

Mike, can you provide a link to the news article on the 7-year old child who died? I did a cursory google search and got no hits.

Thanks! And happy sleeping!

Respectfully,

Enrique

ZS,

Your cleaning process for hose and machine is sound. If any CPAP/BiPAP user is suffering from repeated sinus infections and/or URIs, then I would zero in on the causes and my first impulse would be to check how clean the water reservoir looks.

Enrique


ZolliStar said:

I try to give my tank a vinegar and water "bath" every two weeks or so to kill off possible bugs.

I rinse it out daily in VERY hot water and allow it to air dry. Now I'm beginning to think that I should follow the baby-shampoo and tap water cleaning routine followed by a final distilled water bath.

fwiw. I also keep a mixture of white vinegar (one part) and water (10 parts) in a small bottle and reuse it every other day or two in my hose. I pour the solution down one end (holding the other end up so that it doesn't spill out) then hold each end of the hose and move the vinegar-water up and down the entire length a few times before I re-pour the solution into its bottle. This kills bugs (I hope!) and I think is a more economical use of the white vinegar. (I'm the Queen of Cheap.)

I'm with Enrique--it's all about sanitation, not type of water. Tap water usually is treated with chlorine or another antibacterial that should make it harder for the legionella bacteria to survive. Well water is another matter--as I learned after my brother-in-law almost died from Legionaire's, the bacterium is very common in household wells. 

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