Replies to This Discussion

Permalink Reply by 99 on October 18, 2009 at 9:03pm

i would say that this is nomally true but remember leigonaires disease

it was freak conditions that caused leigonares disease and so to err on the side of causion is wise

• ▶ Reply

Permalink Reply by Jan on October 18, 2009 at 9:18pm

They refer to a "pass over" type of humidifier and a "bubbling" type of humidifier. Is this a reference to unheated and heated humidifiers respectively? If so, they indicate their results are only for the "pass over" humidifiers and that they do agree that contaminants are aerosolized in the "bubbling" (heated???) type of humidifiers. Am I reading this correctly?

Either way, I figure I have enough problems right now without worrying about shooting bacteria into my nose and lungs. I've got that distilled water on my shopping list ;-)

• ▶ Reply

Permalink Reply by Mike on October 18, 2009 at 10:03pm

Cindy -- thanks for the thoughtful response. The following two sentences might as well be Greek to me. Would you please tell me in a different way what they mean?

There is even debate on whether it is even necessary to humidify the gas at all. Because the upper airway is not bypassed during PAP therapy the theory is that the immune system is still intact

Cindy Brown said:

Mike since the basic humidifiers that are used for CPAP don't actually aerosolize the water it can't aerosolize the bacteria either. There is even debate on whether it is even necessary to humidify the gas at all. Because the upper airway is not bypassed during PAP therapy the theory is that the immune system is still intact. We don't breathe sterile air during the day why would we need to breathe sterile air during the night? That being said it is a good idea to keep things as clean as possible. I have seen patients that use tap water and have no problems with more colds and what not and I've seen patients that use sterile water and have problems with increased colds. I think you're more likely to catch something by coming into direct contact with the "germs" rather than having them aerosolized.

Cindy

• ▶ Reply

Permalink Reply by Jan on October 18, 2009 at 11:16pm

so is the recommendation to use sterile or distilled water in the humidifier?

• ▶ Reply

Permalink Reply by Mike on October 19, 2009 at 12:40am

Here's something I found on another apnea forum. It's a response from the CDC to a patient's informal inquiry on whether a CPAP machine could transmit Legionnaires' disease (i emphasized a portion of the response that I would like to dig deeper on):

"I emailed CDC in Sept. and here was their response:

"Thank you for your inquiry to CDC-INFO. Your request for information on acquiring Legionnaires' disease from a CPAP machine was copied to the CDCs National Center for Immunization and Respiratory Diseases (NCIRD). We are pleased to provide you with their additional input.

NCIRD is not aware of any journal articles or published reports of someone definitely acquiring Legionnaires' disease from a CPAP machine, although they do receive reports of Legionnaires' disease cases that have used their machines prior to becoming ill.

It is unclear if the machine is actually harboring the Legionella bacteria (and maybe causing the exposure) or if the population that regularly uses CPAP machines is at higher risk of developing the disease after any exposure in general (showers, faucets, etc.) due to underlying medical conditions which may affect breathing.
NCIRD recommends following manufacturer guidelines for cleaning and filling the machine. Usually this includes using sterile water in the machine and thoroughly cleaning the machine after each use (and allowing it to air dry).

Finally, your request that NCIRD directly post their response to the Sleep Apnea Support Forum's website has been forwarded to the appropriate CDC office.

Thank you for contacting CDC-INFO Contact Center. Please do not hesitate to call 1-800-CDC-INFO, e-mail cdcinfo@cdc.gov or visit http://www.cdc.gov if you have any additional questions.

CDC-INFO is a service of the Centers for Disease Control and Prevention (CDC) and the Agency for Toxic Substances and Disease Registry (ATSDR). This service is provided by Vangent, Inc. under contract to CDC and ATSDR.

---------------------------------------------------------------------------------------------

Please visit CDC-INFOs Customer Satisfaction Survey and tell us about your recent experience with CDC-INFO. The survey results will help improve our services. The address for the survey is http://www.emtservices.org/cdcinfo/en/email_satisfaction_survey.htm. Thank you."

99 said:

i would say that this is nomally true but remember leigonaires disease
it was freak conditions that caused leigonares disease and so to err on the side of causion is wise

• ▶ Reply

Permalink Reply by Mike on October 19, 2009 at 12:57am

Cindy, I found another study on the internet just now that refutes the prior study: http://www.ncbi.nlm.nih.gov:80/pmc/articles/PMC2556912/. The newer study concludes that basic humidifiers used for CPAP do, in fact, actually aerosolize the water and the bacteria in it. How do you respond to this study (excerpts of which below):

There is a widely held view that passive (“passover”) humidifiers do not aerosolize water but merely help to produce, and allow for the passage of, water vapor. Supporting such a view are the results of a recent study. In this study, the positive control was the use of a nebulizer, filled with 400 MBq of 99mTc-diethylenetriamine penta-acetic acid (labeled DTPA) in 5 mL of water, from which only 28% of all radioactivity could be trapped and detected in just the first of 2 Pall BB50T breathing circuit filters in series, with the second containing no measurable radiolabel. Then a humidifier reservoir was spiked with the same amount of labeled DTPA, and, at the highest air flow tested (46 LPM), no radioactivity was detected in a breathing filter positioned downstream of the humidifier. Given that only 28% of the label was detectable in the control run, the limit of detection of the assay cannot be greater than 28-fold or less than 2 orders of magnitude

Data reported here suggest that, although the amount of bacteria in the heated humidification reservoir was high (approximating 5 × 107 CFU/mL), this is indeed a level at which bacteria can sometimes be found in contaminated water. We recovered levels as high as 103 CFU in the breathing tube. The difference of 4 orders of magnitude is one that cannot be detected in the labeled DTPA study. It is fair to say, however, that contaminated water used in a home environment may persist, particularly if water is added to the humidifier without rinsing between refills. Our study also employed slightly higher flow rates of 60 to 70 LPM, in contrast to the 46 LPM reported in the referenced study. This could also account for observable differences.

Having established that it is possible to aerosolize bacteria, we show that the hydrophobic breathing circuit filter used in this study does not demonstrate drastic pressure drops or decreases in air flow rates when used repeatedly over the course of 7 daily exposures to 10-hour periods of nCPAP use with heated humidification. This suggests the device can be used under the conditions studied and those conditions that simulate clinical use.

Cindy Brown said:

Mike since the basic humidifiers that are used for CPAP don't actually aerosolize the water it can't aerosolize the bacteria either. There is even debate on whether it is even necessary to humidify the gas at all. Because the upper airway is not bypassed during PAP therapy the theory is that the immune system is still intact. We don't breathe sterile air during the day why would we need to breathe sterile air during the night? That being said it is a good idea to keep things as clean as possible. I have seen patients that use tap water and have no problems with more colds and what not and I've seen patients that use sterile water and have problems with increased colds. I think you're more likely to catch something by coming into direct contact with the "germs" rather than having them aerosolized.
Cindy

• ▶ Reply

Permalink Reply by RockRpsgt on October 19, 2009 at 1:49am

I beleive the manufacturers recommend distilled.

Jan said:

so is the recommendation to use sterile or distilled water in the humidifier?

• ▶ Reply

Permalink Reply by RockRpsgt on October 19, 2009 at 2:31am

sitting water is bad.

• ▶ Reply

Permalink Reply by RockRpsgt on October 19, 2009 at 2:33am

I wish that I could explain better about the differences between aerosol and vapor but at this hour I'm a bit foggy. (Insomnia is a b*tch).

hey Cindy i know a guy that might be able to help you out lol. I am laughing with you. sleep techomnia (STO) is horrible. i get it at least once a month. Sometimes on my days off I can't sleep until I see light in the windows. Others not at all.

• ▶ Reply

Permalink Reply by 99 on October 19, 2009 at 3:36am

the more the water is sterile or clean the easier it is to contaminate the water

i would reccommend for every pint of water you add a teaspoon of salt not ionisionized but sea or rock salt

normal salt is poison, from the 1960 additive have been added and it is these additive thaht are poison

the additive make the salt free flowing that is why that is why i reccommend sea or rock salt as no additives are in them

• ▶ Reply

Permalink Reply by Jan on October 19, 2009 at 8:23am

Rinse with white vinegar and water instead of soap and water-- or either is OK. I presume that the vinegar and water would help with mineral build up.

• ▶ Reply

Permalink Reply by RockRpsgt on October 19, 2009 at 8:43am

Both are ok.

Jan said:

Rinse with white vinegar and water instead of soap and water-- or either is OK. I presume that the vinegar and water would help with mineral build up.

• ▶ Reply

▶ Reply to Discussion

• ‹ Previous
• 1
• 2
• Next ›
• Page