CPAP Humidifiers

For people with sleep apnea and for their healthcare professionals, peer coaching article #13, updated 3 December 2011

Why. One of the reasons that people find PAP (Positive Airway Pressure) therapy uncomfortable is that they don’t use a PAP heated humidifier. For many people, the forced air in PAP therapy (CPAP, auto APAP, or BiPAP) causes the nasal passages to become blocked. Heated, humidified air helps unblock the nasal passages, keeps the nose, throat, and mouth healthier and more comfortable, reduces or eliminates nosebleeds, and makes the therapy more comfortable, contributing to successful treatment. Many people on humidified PAP find that they seldom get head colds. Many CPAP users find that they need to use the heated humidifier every night, even in warm, humid summer months and humid climates. Some turn off the heat in the summer but continue to humidify through passive humidification, air blowing over the unheated humidifier water. A few people need no humidification at all, and don’t get blocked or dry nasal passages or dry mouth. People who use a full face mask because of mouth breathing require heated humidification so their mouth doesn’t get dry. Discussion thread at http://www.cpaptalk.com/viewtopic/t28636/Do-I-need-a-humidifier.html

Selection criteria. For a brief but thorough introduction to heated, passive (unheated), integrated (built-in), and stand-alone humidifiers, see Answers, Humidifiers at http://www.cpap.com/cpap-faq/Humidifiers.html#FGID-61 . If you try unheated humidification, you may find that it does little to keep your nasal passages open and isn’t comfortable, unlike heated humidification. Since a heated humidifier can be turned off and become a passive humidifier, it makes sense to get a heated humidifier for more options. To keep humidity levels high, use an Australian heated hose from http://www.sleepzone.com.au/ To save wear and tear on the end of the hose, use a hard plastic hose connector. A stand-alone humidifier can be used with any machine, in case you need to replace your machine early in treatment or after a few years. A stand-alone machine may hold more water and can deliver higher levels of humidity. An integrated humidifier has the advantage of being compact and built-in, useful for travel. Depending on the angle your hose needs to make from the humidifier, consider using a hard plastic right-angle elbow connector.

Water. People may have memories of unsanitary, portable room humidifiers and vaporizers heavy with mineral deposits, growing and spreading bacteria. CPAP humidifiers are different if you use clean distilled water, emptied daily or frequently. Use only distilled water in the humidifier to avoid mineral buildup. Distilled water is condensed steam, mineral free, sold in gallon bottles for usually less than $1 at grocery stores, for use in humidifiers and steam irons. If you are traveling or run out of distilled water, it’s okay to use bottled or tap water for a few days, but your humidifier may show mineral deposits. To remove deposits, soak the tank in a mild white household vinegar solution and rinse well. Since bacteria, molds, and mildew won’t grow on a dry surface, empty the tank every morning and let it air dry. Depending on the humidifier’s construction, you may not want to dissemble it, and taking it apart may be unnecessary.

After drying, replace the humidifier on the machine. Make sure the humidifier connects snuggly to the machine, to avoid air leaks. To fill, use the user friendly opening or a  funnel in the opening for the hose (with the hose removed). For convenience, store the distilled water in the bedroom. For ideas on filling the humidifier, see http://www.cpaptalk.com/viewtopic.php?t=13397
Some people don’t empty the tank daily and have no problems with things growing in the humidifier. If you don’t empty the tank, consider removing or disconnecting the humidifier from the PAP machine so the inside of the machine can dry out during the day, to avoid growth of mildew inside the machine.

Don’t add anything to the clean distilled water. The air that passes over it goes directly into your lungs. It’s not aroma therapy, it’s CPAP respiratory therapy. If you want to use aroma therapy, use it in another room while awake.

Rarely, a particular humidifier may leak. If that’s the case, to protect furniture, consider keeping the heated humidifier and machine on a waterproof surface in case you spill water or there is a leak. Some options are a cookie sheet with a rim or an inverted plastic lid from a large storage box.

Usage Tips. To preheat the water, turn on the humidifier about 20 minutes before going to bed. Experiment with the various humidifier settings to find the best setting for you. Once you find an optimal heat setting, notice how much water is required nightly, and fill the tank only to that level, if you want to avoid wasting water with daily emptying. Don’t fill beyond the fill line, since overfilling may interfere with correct machine operation. Some users recommend buying a spare, backup water chamber if the cost is low. Also briefly experiment with passive humidification (don’t turn on the heating element) in case you ever need to run the CPAP on battery power during a power outage or when camping, since heated humidifiers can’t be run on DC batteries unless you use an inverter to convert to AC.

Sources: Based on personal experience with obstructive sleep apnea and gleaned from the collective wisdom of cpaptalk.com contributors.

Want more? See the peer coaching articles at http://smart-sleep-apnea.blogspot.com , http://www.cpap.com FAQ Learning Center, or search http://www.cpaptalk.com or post a message there.

Not written by healthcare professionals. The information and opinions offered are not intended or recommended as a substitute for professional medical advice.

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