Distilled water is recommended but don't stop there, also recommended to dump the leftovers and wash water chamber daily. Topping-up clean water to already used water is not good enough and defeat the purpose of using distilled water in the first place .....
Lung disease linked to the use of contaminated well water in a CPAP machine
Although the patient's illness was moderately severe and lasting, Dr. Raymond and colleagues point out that it was very unusual—it would not likely result from using normal tap water in a CPAP machine. The recommendation to use distilled water in CPAP machines is related to preventive maintenance, rather than avoiding contamination. Infections related to CPAP machines are rare, and most often related to poor cleaning of the machine.
However, the case report shows that, in unusual circumstances, using contaminated water in CPAP machines has the potential to cause respiratory illness. Dr. Raymond and co-authors conclude, "We do believe that caution is warranted in CPAP humidification using tap water from wells in remote locations such as the North Carolina mountains."
What types of water are safe to use in nasal rinsing devices?
Distilled or sterile water, which you can buy in stores. The label will state “distilled” or “sterile.”
Boiled and cooled tap water—boiled for 3-5 minutes, then cooled until it is lukewarm. Previously boiled water can be stored in a clean, closed container for use within 24 hours.
Water passed through a filter with an absolute pore size of 1 micron or smaller, which traps potentially infectious organisms. CDC has information on selecting these filters, which you can buy from some hardware and discount stores, or online.
(09-29-2015, 10:46 AM)PaytonA Wrote: *kalk=limestone or lime.
Are some of the colonizations actually from the user's exhalations?
In the mask and hose near the the mask joint, yes, we found colonisation that can matches human contamination, but in one extreme case we did find contamination in the mask that matched colonies found in the tank and tube. You would have to use pretty bad water and not wash, dry or change the water for a week to get that effect, though, and I cannot imagine the mechanism that carried the contamination that far that fast.
Based on our testing, I can recommend the following as good practice - if you can, use distilled water. Change your water daily and blow the tank, mask and hose dry between uses by letting the compressor run on the machine for a minimum of 25 minutes or until water droplets disappear from the tank completely. Clean you mask with fairy liquid every second day, drying it as recommended. Clean your hose once a week or every two weeks with fairy liquid or vinegar and blow it dry, more often if you do not use distilled water properly stored in a refrigerator and if you do not blow your hose dry daily. If you have a dishwasher and your tank is dishwasher safe, wash it in the dishwasher once a week, if not, rinse it out with fairy liquid once a week and blow dry with the machine. Disinfect or wash in fairy liquid all connectors and tubes once a month at the maximum, more often if you do not change your water daily and blow dry the whole thing.
Do not use a sponge with your fairy liquid - rather distribute it around your tank and mask by hand and wash it in hot running water, repeat. Do not use a handy dish towel to dry it - shake it out and return it to the machine and blow it dry.
This seems to work best and covers most water types, but as I said, kalk and other precipitates seem to gather no matter what when you do not use distilled water, just more slowly perhaps, if you wash your tank daily.
Archangle, I compared your list to the list of criteria for the thesis, and it seems most of those bases are covered and a few you haven't thought of - it is a far reaching study, one which will trigger more studies once published, I warrant.
points 2,3,5, 6, 7 and 20 were looked in in our study already, 10 has been the subject of at least three studies I know of, one by the Eidg.WasserKontrolle, 17 and 18 are being looked at in several hospitals for other reasons, and early results are interesting, 22 is essentially correct, so long as you don't sneeze into a tank or have water that is already infected, either way, few virii are hardy outside a carrier, 23 is really good question, one for the Germans or the Spaniards, where this problem is more common than here, I'll pass it on to a colleague in Madrid. 24 is not known to be an issue, and was studied to be acceptable when the devices were first passed for sale by the health authorities, 25 is unlikely except in moist environments, 26 is a sort of yes, but not in medical grade plastics, which are used in CPAP devices passed for sale in Switzerland and the UK (same for the US - Resmed does not vary the formula of their plastic from country to country - that would be nuts). CPAP devices are built to hospital standards even if they are primarily for home use.
Doc, I just must ask - What the heck is fairy liquid???
(09-29-2015, 01:59 PM)MobileBasset Wrote: It has been my understanding that all the ResMed tanks are hand washable but the nonstandard tank can be put in the dishwasher. When you all refer to washable vs standard is this what you mean or am I misinformed?
As far as I know there are 3 different type of tanks available for the S8 and S9. The S8 tank could not be opened and then reclosed without it being a major project. Apparently the early standard S9 tanks were the same based on what Archangle says. I would call these the standard tanks.
The later S9 tanks were 2 piece to facilitate cleaning but not dishwasher safe. We might call these hand cleanable. The non-standard S9 tank is 3 piece with a stainless steel bottom replacing the aluminum and is dishwasher cleanable.
If I have missed something, someone please chime in.
Glad to hear someone is looking into this stuff other than the manufacturers.
I'm intrigued by the Naegleria comment. I always assumed it was mostly a non-issue. Heck even the neti users only get a case every 5 years or so here in the US.
As for viruses, I'm mostly thinking that they might be able to live for a while in the water, but they can't multiply there, unless they're growing inside bacteria or something.
Get the free SleepyHead software here
for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
(09-29-2015, 09:24 PM)PaytonA Wrote: Doc, I just must ask - What the heck is fairy liquid???
Dish washing-up detergent
09-29-2015, 09:49 PM
(This post was last modified: 09-29-2015, 09:53 PM by surferdude2.)
09-29-2015, 10:07 PM
(This post was last modified: 09-29-2015, 10:24 PM by surferdude2.)
Sponges are notoriously germ laden. Instead, I use a new product that my wife actually bought by mistake. It's made by Procter & Gamble. It's Bounty paper towels with Dawn. The Dawn is activated when you wet the towel. It works well for cleaning things without risking infecting them from something you cleaned earlier, which is why sponges are never good for the final cleaning of any surface.
ps. You can imagine how surprised when I found out the hard way that these weren't normal paper towels. I'll just say, don't try drying your hands with them.
For all the criticism I heaped on Mrs. Dude for getting the wrong thing, it turns out I love these soap infused towels and we'll be keeping them around forever. That is not to say that Dawn (or any soap) is germicidal but having the equivalent of a clean soapy cloth immediately available, all in one package, beats hell out of a previously used sponge!
The Bounty/Dawn towels look interesting. I'll be looking for those.
I haven't cleaned either the tank or hose very often, but I do clean the mask every two or three days. I do use distilled water and top it off every day, but after reading this, maybe I'll replace it daily and rinse out the tank. That's not much hassle. But running the machine for a half hour to dry everything out is inconvenient. I just know I'll forget to turn it off.
Since it is hard to carry distilled water when traveling and it isn't often available in hotels, I'd like to find a substitute. I'm wondering whether bottled drinking water would be a usable. It is filtered, but not distilled, and it has some minerals added for taste.