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How do I prevent rainout for 48 hours after washing Cpap tube
#21
Have you tried lowering your humidity for a day or two as another solution?
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#22
I don't understand the hesitation in using wet tubing that has just been washed. It has a nice fresh smell to it and I don't get any rain out except perhaps a drop or two.

I would be reluctant to let it dry by hanging it up for a few days. It seems that would be a good place for mold to grow. Some people dry the tubing by letting the machine blow air through it. I just noticed that Supplier #1 sells a cleaning kit that includes a wick for drying the tubing. They also sell an electric tubing dryer.  

I would be reluctant to use bleach. I use only nontoxic cleaners such as antibacterial soap with no moisturizers. I just now used some Control III disinfectant for the first time to clean my humidifier tub and mask cushion. I see lots of forum users talking about this product, and a friend of the forum sent me some quite a while back so I thought I'd try it. It got everything squeaky clean and the odor is not unpleasant or overwhelming.
Sleepster
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#23
(03-12-2017, 01:52 PM)Sleeprider Wrote: Melman will appreciate this.  They have studied people with chronic sinusitis and cultured their humidity resoervoirs and tubing and found "Having a positive culture in the CPAP reservoir does not seem to lead to an increased symptomatology of CRS: although the reservoirs often become colonized, there seems to be no clinical impact."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716664/

Unfortunately, in the first study, they did not use methodology that would quantify the numbers of bacteria, so we don't know if they were actually thriving and growing in the reservoirs, or just present in low numbers.  This is important because all of the organisms listed could be recovered by swabbing the surfaces of "clean" objects in our homes. They are widely distributed in the environment and on our skin and we shed a number of them onto virtually everything we handle.

I could recover a similar distribution of organisms  by swabbing the dishes and silverware in your cupboards and, I suspect, new reservoirs, tubing, and masks just removed from their packaging. There are a few listed that can be pathogens but also are part of the normal flora of many healthy people (e.g. Staph. Aureus)  It’s interesting that they mentioned Naegleria fowleri. I did my graduate thesis on properties of that organism and it is genuinely scary. If I thought there was any chance of it growing in my CPAP reservoir I be happy to live with untreated sleep apnea. But there is a greater risk that I would encounter it swimming in a lake than in the water in my CPAP. That it was traced to tap water in Louisiana surprised me.

So, although I agree with the conclusions, it wasn’t really a very well designed study.
 
Pathogens and bacteria do not seem to live in CPAP tubing. The environment just doesn't provide an environment where they can live, reproduce and become a problem.

I’m not sure how you arrive at this conclusion. The tubing is plastic and often moist, not dissimilar to the chamber with the exception that it’s not filled with water.  The results of the study showed a significant incidence of positive cultures in the tubing as compared with the chamber. There were more positive cultures for some organism from the tubing than from the mask or reservoir. Some bacteria will grow nicely wherever moisture is present with no apparent source of nutrients. They are commonly found, for example, in steam sterilized, sterile water distribution systems in pharmaceutical plants.  I have no doubt that there are a number that grow in the tubing; but not in numbers to represent a risk.

 They do however thrive in the humidifier chamber, and can be transmitted through the tubing if the humidifier is contaminated.  Apparently if you want to culture bacteria in your humidifier, you can prevent them from infecting tubing and you by using a filter.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556912/

The second study was much better but had one glaring flaw. There is no way a 0.2 micron filter could achieve a 4 log reduction of a bacteriophage. It would be comparable to a motorcycle not being able to fit through a railway tunnel. Something was seriously wrong with their methodology.
Please note the disclaimer “This study was funded by Pall Corporation. All authors are, or were at the time of the study, employees of the Pall Corporation.” Pall is a leading supplier of sterilizing filters to the pharmaceutical industry (I used their filters at Pfizer). But they also have a history of publishing data of questionable scientific merit to promote some of their products. They are in the business of selling sterilizing filters.

I would never put a hydrophobic sterilizing filter on my APAP system. Hydrophobic sterilizing filters are use on the vents of sterile water tanks in the pharmaceutical industry, but always in heated housings to evaporate condensate and prevent damage to the system due to a blocked filter.  A wet hydrophobic filter will not pass air and having it elevated is not a sufficient protection against blockage.


So what I get here is, a humidifier can become colonized, and that's pretty yucky, but it doesn't seem to matter in terms of getting sick, however if it makes you queasy, you can either clean the humidifier or use a filter.  Smile

Of course it can and does become colonized. If you buy distilled water at the grocery store it is already colonized. It's not sterile. (I assume your not buying sterile water for irrigation which costs $10-12/liter.)  Yucky is rather subjective. The numbers in the 2nd study (10E7 CFU/mL) were inoculated, not what naturally grew up in the chambers. I doubt the numbers get that high but even if they do, in the microbial world that's not a high number. Normal human saliva contains around 10E9 CFU/mL. Left long enough without any cleaning the chamber, and I believe the hose would become yucky. That is, a slimy biofilm would develop. But I think it would require at least a month, maybe more, with the system remaining stagnant.

You're welcome.

Sorry Sleeprider,

I couldn't help myself. Grin This stuff was my life for decades and I miss it in retirement; so much so that I went into consulting for several years but my wife couldn't stand having me gone all the time. Unfortunately for the members of this forum, I have found an outlet. Oh-jeez

This was not intended as a putdown. I respect your expertise and appreciate the help you have given me.

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#24
(03-12-2017, 02:45 PM)Sleepster Wrote: I would be reluctant to use bleach. I use only nontoxic cleaners such as antibacterial soap with no moisturizers. I just now used some Control III disinfectant for the first time to clean my humidifier tub and mask cushion. I see lots of forum users talking about this product, and a friend of the forum sent me some quite a while back so I thought I'd try it. It got everything squeaky clean and the odor is not unpleasant or overwhelming.

Quaternary ammonium sanitizers are not non-toxic. See the MSDS: http://cf1.bettymills.com/product/MSDS/MON12004100.PDF

They are safe if you handle the concentrate carefully and rinse equipment thoroughly after cleaning, but don't consider it none-toxic.

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#25
Melman...it was a setup. Smile

But thanks for your interpretation. I don't have much concern about contamination in the equipment, but I have seen a stubborn pink slime form when I've been particularly negligent. I get what appears to be the same organism in the pool, and it's surprisingly resistant to chemical attack.
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#26
yup, I know it well. Organisms in water systems form a complex biofilm which can be extremely resistant to chemical treatments. In the pharmaceutical industry we use we use strong acid treatment at high temp to remove it from stainless steel piping. not recommended for home use.

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#27
Melman,

I ask the following question as a matter of my curiosity and not anything else. Why do you say that the distilled water purchased at a grocery store is already colonized?

Best Regards,

PaytonA
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#28
(03-12-2017, 02:45 PM)Sleepster Wrote: I would be reluctant to use bleach. I use only nontoxic cleaners such as antibacterial soap with no moisturizers.

Bleach is no big deal, I only use a small amount in a fairly large amount of water. Also, hot water de-activates the bleach ... I rinse the tube thoroughly - there is a bit of a residual bleach odor, but it's very mild. I have quite a bit of experience sanitizing beer bottles and cornelius kegs with bleach - lots of rinsing is the order of the day.

FWIW I only clean the tube and reservoir maybe once every 2 months. Maybe.

Antibacterial soap is evil. The antibacterial is not 100% effective, as such you're creating an evolutionary process and are breeding "stronger" bacteria. Also, the stuff gets in the environment and kills some stuff but not everything. Also not good. Soap, by itself, works well as it detaches bacteria from surfaces effectively ... no need for the antibacterial ingredients (other than paranoia).

-Dave
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#29
Distilled does not mean sterile. I'm sure distilled water purchased at the supermarket is not produced in a sterile system or packaged in sterile bottles in an aseptic environment. It would be a lot more expensive if it were. Since the equipment, container, and the environment are not sterile there will be bacteria in the water. It is, therefore, colonized.

Anyone who wants sterile water should get USP sterile water for irrigation or injection at their pharmacy. The downside is it will cost at least $10/L rather than under $1/gal.

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#30
(03-12-2017, 06:04 PM)Melman Wrote: yup, I know it well. Organisms in water systems form a complex biofilm which can be extremely resistant to chemical treatments. In the pharmaceutical industry we use we use strong acid treatment at high temp to remove it from stainless steel piping. not recommended for home use.

I use Star-San as a rinse after cleaning CPAP equipment...how do you like my chances?
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