Infections, Bacterias, Bugs that Haunt the CPAP hose

[Denial Dave]

I've been using my climate line hose for almost 8 months now.... I washed it when I first received it to get dust, etc out.... I haven't cleaned it since.

I may be wrong, but fungi might be able to grow if you don't use distilled water and don't dump the tap water out every day...

[mollete]

A review of the OP previous posts reveals that he was told to use baby shampoo to clean the equipment, which I do not believe to be appropriate advice. One should use "dish detergent" because it rinses away completely.

From the ResMed instructions on cleaning masks etc. "We recommend plain Ivory® liquid soap or baby shampoo."

Well then I guess ResMed doesn't give the appropriate advice, either.

The point in cleaning these things is that the chosen agent must rinse clean without leaving residue. And while there may be a baby shampoo that may do that, many do not, having conditioners, fragrances, etc. designed to be left behind. For instance, in this popular baby shampoo product there is

[mollete]

OTOH, instead of cleaning, perhaps it was more appropriate in this case to be disinfecting, using a vinegar solution, Control III, etc.

[Kate M]

I've been using my climate line hose for almost 8 months now.... I washed it when I first received it to get dust, etc out.... I haven't cleaned it since.

I may be wrong, but fungi might be able to grow if you don't use distilled water and don't dump the tap water out every day...

Fungi don't really care whether the moisture is from distilled water, non-distilled water, sweat, or saliva-- all they care about is that it's moist

[Kate M]

A review of the OP previous posts reveals that he was told to use baby shampoo to clean the equipment, which I do not believe to be appropriate advice. One should use "dish detergent" because it rinses away completely.

From the ResMed instructions on cleaning masks etc. "We recommend plain Ivory® liquid soap or baby shampoo."

Well then I guess ResMed doesn't give the appropriate advice, either.

The point in cleaning these things is that the chosen agent must rinse clean without leaving residue. And while there may be a baby shampoo that may do that, many do not, having conditioners, fragrances, etc. designed to be left behind.

Thanks for sharing that info. I assumed that the manufacture would be the most reliable source for the best way to clean their equipment, but you make a good argument here. I have read so much conflicting info on what to use -- Use Dawn / Don't use Dawn; Use antibacterial soap / Don't ever use Antibacterial soap; Use baby shampoo /Now I am hearing don't use Baby shampoo. It's hard to know who is giving good info and who is not! I think I have settled for now on Palmolive. (I stopped using the antibacterial soap because of something else I read!)

Blessings,

Kate

[HoseCrusher]

If the paper that Kate referred to is correct there may be a biofilm forming on the surfaces of the mask and hose. This can be quite serious. This would require more than just cleaning.

At our last CPAP meeting this was discussed and it seems that the biofilm impregnates the silicone and makes it very difficult to remove. This is the main reason for the generous replacement schedule.

We discussed hard core disinfecting but that can breakdown the silicone and cause other problems.

The number of people that are less than frequent with their cleaning and still suffer no ill effects seems to indicate that this may not be a big problem but since ringo had a problem it is still a problem never the less.

The idea of using dish soap over baby shampoo is sound. Not only will it be more aggressive on removing oils and biofilm but it also washes clean. After cleaning the next step is disinfection where care must be taken to avoid damage yet the concentration needs to be strong enough to get the job done.

[avi123]

No matter how long it takes to dry a CPAP hose (either by hanging it, waving in the air, or just blowing it out with a hair dryer or any other device to dry the damn thing) the micro water droplets in the interior hose after rinsing still stay in it... all day... in it's curled dark internal state... in a moist bathroom or wherever) will attract bacteria and it's nasty offspring that can ultimately end up in the human lungs. It happened to me! Diagnosed by my doc today. Fungal infection. Never had a problem before. I am anal about cleaniness and followed all the instructions and due diligence from the DME and the hospital sleep center and now face a horrible fungal infection in my lungs. I don't smoke, live right, and my house is CLEAN! Did this CPAP BS for 5 weeks and after this bout I'm going to an oral appliance. Beware of the bugs that may haunt you!

Comment,

In my case, the SlimLine air hose, hanging on the machine, dries out during the day. I don't see any droplets left there after a few hours. So no bacteria would grow in a dry hose. Ditto with a wooden cutting board that is washed and left to dry during the day. Every two weeks I alternate the hose with another SlimLine hose that been "drying out" , that long, while lying in a drawer, and wash the "used" one.

Dryness kept Bacteria from ruining dry fruit over thousands of years

[knightlite]

I firmly believe in disinfecting the mask and hose . Every week I clean the oil off the mask with dawn or whenever it starts a sealing problem . At least once every 2 weeks I rinse the hose and mask with a cap full of bleach to a gallon of hot water. Every other time I use a solution of 4 parts hot water and 1 part vinegar . Occasionally I will do a rinse with hot water and 1 tablespoon of baking soda to help remove oil . I have very oily skin so I wash my face just before putting on mask- it helps a lot . My concern is mold and bacteria . Legionnaires' (legionella) disease comes from water systems , air conditioners etc. Here in Florida it has happened in brand new hotels. We have to treat our air conditioning drain lines with bleach every few months or they will clog up with mold . Its in the air. Cpap systems move a lot of air over water ,combine that with your normal bacteria from your breath and it can grow.
I am going to replace my hoses and masks every six months anyway but the bleach and vinegar hasn't harmed them yet . I don't throw them out, I disinfect them and pass them on to those who can't afford them . If I get extras I pass them on too.
Its your health and doctors are expensive relative to equipment costs. Lung problems are easily fatal once you go over the edge so do the best for your own health. I'm not asking everyone to agree with me so don't go there ---' I just hope this will help some with weak immune systems(I'm old so I fall into that bracket) to use due care .

[DreamStalker]

... Maybe it's your clean living life style that lowered your immune system that's responsible for your infection, the bugs you are trying to avoid, are making me healthy. ...

Exactly! I've used a xPAP device for almost 25 years at this point. I change my hose about every 12 months. I change my mask every six months. I change my mask cushion about every two months.

A few times (three or four) I've had the smell of a fungal infection on my breathing circuit. I get VERY serious about cleaning it then.

I've had NO such problems. I don't wash and rinse everything every day. I don't do anything extraordinary. But then we're not neat freaks. I occasionally come down with a head/chest cold. But I would anyway.

In fact, since starting my xPAP therapy almost 25 years ago, I only rarely come down with a cold. I used to get them four or five times per year. I would have bronchitis at least twice per year. I now get a cold about twice a year and bronchitis about once every four years.

So, if anything, I would say that xPAP therapy has greatly improved my lung health.

While your mileage will vary, I know from what others have posted, my experience is much more of the norm that that of the original poster.

Same here. Prior to CPAP, I used to get sinus/respiratory infections like once a month and at best every other month. Since CPAP, not once. It has been over 7 years since I last had any kind of sinus or respiratory infection, flu or cold or allergy symptoms. I have not washed my hose in over 6 years (my CPAP hose that is .... I wash my other hose as often as I can ). My nasal pillows I have not washed in about 6 months now. I never washed my HC150 humidifier either but I quit using it about 4 months ago (simply to re-adapt myself to do without ... have adapted to straight CPAP quite well).

I think it is all the over-cleaning that cause problems, wasted money and effort. Only time I get super anal about cleaning is when I get an open wound and then I wash well with peroxide followed by iodine solution. My cuts usually heal over in less than a week.

[SleepyonMagnoliaSt]

I firmly believe in disinfecting the mask and hose . Every week I clean the oil off the mask with dawn or whenever it starts a sealing problem . At least once every 2 weeks I rinse the hose and mask with a cap full of bleach to a gallon of hot water. Every other time I use a solution of 4 parts hot water and 1 part vinegar . Occasionally I will do a rinse with hot water and 1 tablespoon of baking soda to help remove oil . I have very oily skin so I wash my face just before putting on mask- it helps a lot . My concern is mold and bacteria . Legionnaires' (legionella) disease comes from water systems , air conditioners etc. Here in Florida it has happened in brand new hotels. We have to treat our air conditioning drain lines with bleach every few months or they will clog up with mold . Its in the air. Cpap systems move a lot of air over water ,combine that with your normal bacteria from your breath and it can grow.
I am going to replace my hoses and masks every six months anyway but the bleach and vinegar hasn't harmed them yet . I don't throw them out, I disinfect them and pass them on to those who can't afford them . If I get extras I pass them on too.
Its your health and doctors are expensive relative to equipment costs. Lung problems are easily fatal once you go over the edge so do the best for your own health. I'm not asking everyone to agree with me so don't go there ---' I just hope this will help some with weak immune systems(I'm old so I fall into that bracket) to use due care .

This sounds like a GREAT cleaning regimen. I'm going to write this down. Bleach is a great idea especially if you let it dry out and blow air through it for a bit to get rid of the fumes.

How often do you do hot water and baking soda? I have extremely oily skin

[HoseCrusher]

I decided to take a close look at my equipment. This is "less than scientific" but seemed to make sense at the time.

My idea is that new plastic and silicone is squeaky clean and if a biofilm is forming it would feel slippery and slimy. Prior to my physical examination I degreased my hands by washing them with dish detergent.

My pillows, small hose, large hose, and humidifier chamber were all pretty squeaky. I could only reach into the larger hose about a finger length at each end but that gave me an indication. My small hose was checked with my little finger, then I took a bottle brush and a wet paper towel and ran it through the tube to see if I could detect anything.

I did find one area that was not only slimy but had a pink discoloration. The lid that holds my humidifier tank in place has a silicone gasket and in one of the lips of the gasket I had some slime growing. This was between the gasket and the plastic lid and was not in the main air stream.

I don't remember the last time I took the lid apart but that has now been added to my cleaning procedure. The outside of the gasket was squeaky but the inside part that sets against the lid was slimy.

While this was an interesting experiment it would be more conclusive if I was able to take swabs and grow cultures. I am not sure what is involved with doing that but I am not set up to grow cultures. I think this was a reasonable check because I clean my equipment frequently and don't have weeks or years of accumulation to work through.

[chunkyfrog]

The Absolut in the back of the fridge just gave me an idea. . .

[avi123]

[quote="knightlite"]I firmly believe in disinfecting the mask and hose .

Its in the air. Cpap systems move a lot of air over water ,combine that with your normal bacteria from your breath and it can grow.
[quote]


Question,

So all day long you breathe this air into your lungs without using a CPAP. What's the difference if you breathe the same air thru your CPAP air hose? What would make Bacteria to grow specifically in the CPAP hose but not grow in your airway?

"In a healthy animal, the internal tissues, e.g. blood, brain, muscle, etc., are normally free of microorganisms. However, the surface tissues, i.e., skin and mucous membranes, are constantly in contact with environmental organisms and become readily colonized by various microbial species. The mixture of organisms regularly found at any anatomical site is referred to as the normal flora, except by researchers in the field who prefer the term "indigenous microbiota". The normal flora of humans consists of a few eucaryotic fungi and protists, but bacteria are the most numerous and obvious microbial components of the normal flora."

[knightlite]

SleepyonMagnoliaSt

How often do you do hot water and baking soda? I have extremely oily skin

I do it once a week .
The plain clorox - I use one cap full to a gallon of hot tap water and soak the tub ,mask and hose . I make sure all the inside of the hose gets exposed to the mixture. Every other week I do a vinegar rinse after the clorox treatment.
After 5 minutes or so I rinse all out with hot tap water. Then I usually use baking soda rinse on mask --1 tablespoon /to one gallon of hot water . I find this easy to in the bath tub using a 3-4 gallon plastic tub . drip dry- then dry with paper towels . I usually leave one dry paper towel inside of mask until bed time.
I haven't had any problems with fumes Or smells. I don't use anything scented soap or clorine.
I haven't tried the boiling water with baking soda that some have talked about here to renew the mask cushion only.

To others
I'm not interested in a debate --I'm not a germaphobe --I believe a large amount of air passing over a humid environment in a contained dark space with no uv rays or ozone to keep down the sheer numbers of fungus/bacteria is a heath concern for me. I don't smoke , I do take probiotics for general gut health. I do have a little wine to keep the bad bacteria at bay . I know the stories like my grandmother smoked from six years old till she was hit by a truck at 110 years old. And I've never cleaned my cpap equip in 60 years --never sick a day in my life--well that's not my luck--- but happy trails to you ! peace be with you

[mollete]

This sounds like a GREAT cleaning regimen. I'm going to write this down. Bleach is a great idea especially if you let it dry out and blow air through it for a bit to get rid of the fumes.

"IMHO", there are a few considerations here. First, what kills fungus? The list would include:

•Bleach
•Borax
•Vinegar
•Ammonia
•Hydrogen peroxide
•Detergent
•Baking soda
•Tea tree oil
•Grapefruit seed extract

Is bleach the best choice?

Killing Fungus(es)

Of note, their recommendation is a cup (instead of a cap) per gallon (as is several other sources), so one wonders if a cap really does anything.

Up until a few posts ago, it would seem the best answer is to follow the manufacturers' instructions (and BTW, Respironics says NO bleach). And to their credit, they also say soap with no conditioners or moisturizers, for example:

Wisp