CPAP Equipment: CPAP Humidification

What is Humidification?

Humidification adds moisture to the CPAP air, reducing irritation to the nasal passages caused by the increased airflow.

CPAP air is an irritant - to one degree or another - to everyone. In some cases the irritation dries out the nasal passages and may cause bleeding. It may also cause swelling, excess mucous, congestion or sneezing. The irritation also creates a very fertile ground for infections to begin. The irritation may be cumulative, building up over time. The only way to reduce the irritation is to add moisture.

Humidification is therefore a critical part of CPAP Therapy.

What are the benefits of using a humidifier?

Many PAP users experience nasal congestion and dryness of the nose and throat during treatment. This is especially problematic for new users adapting to the treatment. Humidification adds moisture to the air, reducing systems of dryness and congestion.

Nasal congestion also leads to mouth breathing, which perpetuates the problem of dryness. If this is an issue for you, try a heated humidifier.

What is a heated humidifier?

A heated humidifier uses heat to produce moisture. The heat is adjustable for more or less moisture, and the chamber is much smaller than a passover humidifier.

It is our experience from over ten years of specializing in CPAP equipment, that patients who use heated humidifiers have a much higher rate of therapy effectiveness to CPAP therapy.

There are three types of heated humidifiers:

• Stand Alone Humidifiers
• Integrated Humidifiers
• Built In Humidifiers

What is a passover humidifier?

A passover humidifier is a chamber of water added to the CPAP to help moisten the airflow and reduce irritation to the nasal passages.

Air flows from the CPAP, through a short hose to the humidifier, then into the six foot hose to the mask. The air picks up whatever moisture it can as it "passes over" the water in the chamber.

Passover humidifiers may provide sufficient moisture with CPAPs set at lower-end pressures, but if not, there is no way to increase the amount of moisture produced. Furthermore, in cold climates, the water temperature in the chamber will drop, causing the CPAP air to become very cold and reduce the amount of moisture.

What is an integrated humidifier?

An integrated humidifier is a component to a specific CPAP that fits directly to the CPAP, eliminating the need for a second hose and in some heated humidifiers, a second power cord.

The advantage of an integrated humidifier is a more compact unit that uses fewer parts.

A disadvantage is that they may produce less moisture if used as passover humidifiers because the surface area is typically smaller. Also, most integrated humidifiers will function only with the CPAP for which they were designed.

You can see if your machine has an integrated humidifier option by reviewing our compare charts.

An example of an integrated humidifier is the PR System One Heated Humidifier as seen below attached to one of the PR System One line of CPAP machines.

What is a built in humidifier?

A "built in" humidifier is designed so that it is part of the CPAP machine and cannot be removed or separated from the CPAP machine. This is similar to an all-in-one unit eliminating the need for a second hose or second power cord. Usually the water chamber can be removed for cleaning or replacement purposes.

The advantage of a "built-in" humidifier is a more compact unit that uses fewer parts. This design also helps to ensure therapy effectiveness by including the heated humidifier which may provide comfort to the CPAP user they may not have received otherwise.

A disadvantage is that they may produce less moisture if used as passover humidifiers because the surface area is typically smaller. Also, since the humidifier is "built in" to the machine, the ability to detach the humidifier is not an option. This can be an issue for frequent travelers. Lastly, if the machine or humidifier stops working, the entire unit must be sent in for repair or replaced, not just the component that failed.

An example of a machine with a built in humidifier is the Sandman Info HC CPAP Machine with Built In Heated Humidifier as seen below.

What is a stand alone humidifier?

A stand-alone humidifier is a component that will work with any CPAP and does not attach directly to the CPAP. It uses its own power cord and typically a short hose is used to connect it to the CPAP. Usually it would sit next to the CPAP machine and is slightly larger than an integrated humidifier.

The advantage of a stand-alone humidifier is superior humidity and control and often a larger water capacity with the chamber. Also, the fact they may be used with any CPAP machine can be useful.

The main disadvantage is that the size is often larger than either a "built in" or integrated humidifier with the short hose are needed to connect it to the CPAP machine.

An example of a stand alone humidifier is the Fisher & Paykel HC150 Heated Humidifier as seen below.

How do I care for my humidifier?

The only care the humidifiers require is that you empty and clean the water tank after use in the morning. Be sure to use distilled water only in the tank.

Why do I need to use distilled water with in my humidifier tank?

Using distilled water helps keep your humidifier clean and mineral deposit free. If you were to use tap water, the water would evaporate to leave a hard white mineral deposit in your tank or lead to mold growth. Cases of lung disease have been connected to using contaminated well water in a CPAP humidifier.* Source

If you can't get distilled water where you live, use bottled water. You will need to rinse your tank out each morning and do not leave standing water in your tank between uses.

What maintenance is required on machines?

The only care required for machines is to clean or change the filters at the air intake of the machine to keep the internal parts from accumulating dust.

There are other suggested actions to care for your machine:

• Keep the area around your machine clean. Remove any dust from around your machine to improve the air quality delivered to your machine.
• Keep the air intake of the machine unblocked. Curtains, bedding, and papers can easily block the air intake of your machine, reducing the airflow to your machine.
• If you have a humidifier, it is suggested that you do not pick up the machine with the humidifier attached. With most machines, it is easy to spill water from the humidifier into the machine and cause damage. To avoid this, it is suggested to remove the machine from the humidifier instead of transporting them together.
• If you have a humidifier, it is also suggested that you empty the water from the chamber every morning. Accidents happen. If a family pet, or family member moves the machine and humidifier, when there is water in the chamber, it is more likely an accident could happen where water is spilled into your machine.

How can I get help from a CPAP Expert?

• Ask A Question. Question Submission Form.
• Email Us. cpap@cpap.com.
• By Phone. 1-800-356-5221 (7 AM -10 PM CST Mon-Fri; 8 AM - 6 PM CST Sat)
• By Fax. 1-866-353-2727

Can I use my Heated Humidifier with my machine if I am running on Battery Power?

Using a heated humidifier on a 12volt battery power source will significantly reduce the amount of power provided. In most cases, usage is reduced to less than half the estimated operational time. CPAPs or BiPAPs requiring inverters reduce the power time even more.

Please note that some heated humidifiers are not capable of being operated on 12volt battery power sources. The later M Series heated humidifiers with the 6'' 'pigtail' connectors are capable of running on 12volt DC power sources. Earlier model M Series heated humidifiers without the pigtail are not 12Volt capable, nor are the Legacy model REMstar and stand-alone H2 humidifiers.

For optimum performance of your battery, plan to use your CPAP without the heated humidifier. You may also have the humidifier connected and filled with water, but without the power turned on. This changes a typical heated humidifier into a passive humidifier.

We suggest testing the battery setup you are planning to use with your machine in advance. To determine the actual amount of power time you will receive and whether or not heated humidification is required for your comfort, test the battery at home before traveling.

Does this product contain BPA?

Yes, all CPAP masks and CPAP humidifier chambers either contain BPA or their manufacturer has not released a statement calling their products BPA free. Here is a statement released by Respironics:

Government of Canada Takes Action on Another Chemical of Concern: Bisphenol A

April 25th 2008

To Whom It May Concern

This document represents Respironics' position regarding the use of Bisphenol A in Respironics Sleep and Home Respiratory Devices. On April 18, 2008, the Government of Canada, banned the use of Bisphenol A (BPA) in polycarbonate baby bottles, claiming that the exposure to BPA on newborns and infants up to 18 months of age, could potentially present a health risk to this patient group when the polycarbonate baby bottles are exposed to high temperatures.

At this time, we are able to provide the following information to our customer: NONE of our Sleep and Home Respiratory products which are either breathable or skin contacting are intended for use with newborns or infants under 18 months of age. Therefore, Respironics is in compliance with Health Canada's position for exposure for the identified at risk patient population.

Although Health Canada's restriction for BPA does not include products used for ages above 18 months at this time, Respironics is evaluating its product portfolio and will take the appropriate actions to determine and mitigate any potential risk from use of its products or potential exposure to BPA. It should be noted that NOT all polycarbonate resins contain BPA. In response to the direction provided by Health Canada's device licensing division, Respironics will be evaluating all of our Class II and III medical devices to determine if the resins used in the manufacturer of its products contain BPA.

Further, none of our products or accessories using polycarbonate are labeled for exposure.

In closing it is Respironics position that our products do not pots any increased risk of exposure to BPA for our users and thus our products remain safe for use.

If you have any further question regarding this topic, please feel free to contact me at zita.yurko@respironics.com or at 724-387-4120.

Regards,

Zita Yurko Director, Regulatory Affairs Sleep and Home Respiratory Division Respironics, Inc.

• Use Distilled Water in Humidifier Tank
• Mold: How to Avoid it and hide the evidence

• Distilled water is recommended for use in your humidifier as it has less minerals and may be more sanitary.
• Humidifiers add moisture to the air you breathe so your airways don't get dried out from the pressurized air.

CPAPtalk.com Wiki Articles

• List of CPAP Essentials
• Humidification... Worth it?
• A conversation about humidifier use
• Heated Humidifier
• Tips for Newcomers to Sleep Apnea

Research Articles

• Lung disease linked to the use of contaminated well water in a CPAP machine.

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