Could a CPAP Humidifier Work for You?

What’s the big deal about using a CPAP humidifier? Why would you want to add another piece of equipment beyond the CPAP machine and mask? It’s just something else you have to buy, fill each night with water, clean or add to your CPAP bag when you travel; so, why bother?

Consider these statistics: According to Fisher & Paykel Healthcare, a leader in CPAP humidifier technology, patients over 60 years old are five times more likely to require heated humidification, while CPAP users taking two or more medications are six times more likely to need the same. CPAP users with chronic mucosal disease or who have had uvulopalatopharyngoplasty (UPPP) surgery for obstructive sleep apnea are also four times more likely to need heated humidification. Meanwhile, patients who prefer to sleep in a cold room are most likely to experience condensation.

Also, consider the list of common complaints from CPAP users below. Do any of these complaints sound familiar?

• CPAP makes me sneeze;
• CPAP makes my mouth dry;
• CPAP makes my nasal passage burn and it disrupts my sleep;
• CPAP makes my nose runny;
• CPAP makes my nose stuffy, so I can’t breathe;
• I wake up with mucus in my mouth and throat;
• Water drips into my mask at night;
• My humidifier water chamber is empty long before it’s time to wake up;
• The water chamber collects a residue that looks like mold and it’s hard to clean;
• My humidifier makes gurgling noises and spits water at me.

These complaints can all frequently be resolved with proper use of a heated CPAP humidifier. Here is what you need to know:

For simplicity’s sake, think of your CPAP as a fan in a box. When you turn it on, it pulls in the air from your sleeping environment. The fan ramps up that air, and delivers it back to you via the tubing attached to your mask, forcing a highly pressurized blast (your CPAP pressure setting) directly into the nostrils, and mouth if you wear a full-face mask. Remember that the temperature of your bedroom is the same temperature of that delivered air.

Most of us prefer sleeping in a cool bedroom and sleep experts all say we should. Furthermore, you probably find that when you turn on your furnace during the winter it causes a drying effect. As an example, in the winter, I set my household thermostat on 60, which means the hurricane-force wind striking my nasal passages is really cold and dry. In summer months, my bedroom is kept cool with air conditioning and ceiling fans, so my nostrils are still blasted with cold air. Room humidifiers help, but really have little impact on our CPAP use. No matter what the season, for CPAP comfort, I require the addition of heated humidification every night.

CPAP does not work well if we can’t breathe through our nose (or mouth, if you use a full-face mask). The nasal passage is highly vascular and lined with turbinates. When you have a cold or an allergy, the turbinates swell and cause nasal congestion – or, the dreaded stuffy nose. When the nasal lining is dry, it may trigger a sneeze, which is the body’s way of returning moisture. Dry mouth or a dry airway can trigger the natural production of secretions, such as mucus. This explains why some of us awaken with mucus in the mouth and throat. It also explains why some of us experience a runny nose from CPAP use, despite not having a common cold or allergy issue.  When we keep the nose and mouth adequately humidified, everything works nicely together to accomplish CPAP success.

CPAP humidifiers vary brand to brand so make sure you know how yours works. Be proactive if you have doubts or questions: Call or visit your CPAP provider to learn the specifics of your unit. Remember that it’s warm moisture we really need, not necessarily high heat. My best suggestion for finding your optimal heat setting is to start at the lowest temperature level and turn it up only as needed to accommodate your bedroom temperature on any given night. Your heat setting will change from season to season.

The higher our CPAP pressure and the higher our humidifier temperature is set, the more water the machine uses. This explains why some of us run out of water before morning. If you require high CPAP pressures and run out of water too early, consider lowering the heat setting. Ask your CPAP supplier about the availability of chambers with a larger water capacity. When we turn the heat setting too high, it causes excess condensation in the tubing that can drip back in to our masks. It can also cause “rain out,” which explains the wet mist on our face around the mask area. If this is happening to you, turn down the heat a notch or two. Use a CPAP tubing cover to help insulate the hose and reduce excess condensation. Be careful not to overfill the water chamber, because it will cause a gurgling noise and spit water; think of it like a pot boiling over on the stove.

All manufacturers suggest distilled water. It has to do with water quality. It’s ok to use tap water occasionally; it won’t harm you. But for the longevity of your water chamber, use distilled water. It is also recommended that we empty any leftover water in the chamber each morning. This helps assure that no bacteria is left to grow which might appear as a white or pink residue. Empty and rinse the chamber each morning and leave it to air dry.  Clean the chamber with a sudsy mix of water with a mild soap such as Ivory dishwashing liquid. At least once each week, clean the chamber with a vinegar water solution soak, then rinse with clear water and air dry. This routine will remove any residue and disinfect the water chamber. Never use bleach, antibacterial soaps or other harsh chemicals in the water chamber. Please do not risk ingesting anything harmful into your lungs.

More humidity means more comfort. Nightly heated humidification is one of the most effective tools to complete your therapy and make the CPAP experience successful.