Respiratory aerosol

[astracan]

One doubt, when using humidifiers in CPAP machines, respiratory aerosols are created, do you think it can cause Legionella or perhaps Pontiac disease?

[mesenteria]

We're all different.  Some are immune compromised, some have other weaknesses and disorders, some are robust and will live to 110 no matter how they abuse themselves.  Life's not fair, and certainly it's complicated.

I can only speak for myself:

a. I clean my mask routinely.  I think it's about every ten days by now, and growing;

b. I clean hose and headgear about every three weeks, but that's growing too;

c. I fill my reservoir right to the tip-top and leave it until it needs refilling three or four days later.  I never clean it.  Ever...like, never; and

d. My mask and hoses are as old as my machine.  I got the machine in February 2018.  All still going strong.

As am I.

It behooves each of us to make our way.  If doing that involves daily cleaning and sterilizing, then I would heartily recommend you do what helps you to sleep well.  As long as it's not immoral, illegal, or fattening, I give you the thumbs-up.  I don't seem to need to do all this maintenance.  I haven't had a cold since commencing PAP therapy, whereas I would get one near Christmas each year. Something is working for me.

[jaswilliams]

I would think no as the water is not areolised it is evaporated so cannot carry waterborne pathogens Especially if your humidifier is regularly cleaned and potable water put into it. I would think there’s more chance in a bath or shower

[Sleeprider]

Legionella became a problem in evaporative cooling systems where conditions were conducive to reproduction of bacteria in warm recirculating water with no disinfection or blow-down to reduce populations. If you empty your humidifier chamber daily, and follow reasonable hygiene, there is no risk of infection. Ideally, empty your humidifier daily, wash lightly, and allow it to dry. Next best is empty before reuse and wipe dry. It would take gross negligence of any routine maintenance to allow pathogenic bacteria to colonize the system.

[Big Guy]

I think I'd stand a better chance of being struck by an intoxicated bear driving a pink, rag-top Cadillac. 

My humidifier tank gets emptied and wiped dry each & every morning w/o failure.

[astracan]

I think I'd stand a better chance of being struck by an intoxicated bear driving a pink, rag-top Cadillac. 

My humidifier tank gets emptied and wiped dry each & every morning w/o failure.

[astracan]

As far as I know, cpap is based on "condensing" the air and expelling it to our lungs continuously, through the tube, adding the steam produced by the humidifier. I believe that aerosols do form. What I don't know is if in sufficient quantity to generate problems. That was my question. 
On the other hand, the use of the type of water, whether potable or distilled, (the recommended is distilled water - which is NOT potable - I suppose that to avoid problems with lime and extend the life of the humidifier) is indifferent to the Legionella pneumophila proliferation, this bacterium is not selective with the type of water. We do, of course.  .
Obviously, let's use the water we use for the humidifier or even if no humidifier is used, hygiene is essential and scrupulous cleaning of all equipment and especially the tube is a universal recommendation for these equipment. Let us never forget that the air that passes through the cpap (and its tube) has direct access to our lungs at all times. 
I asked if there is any known case of legionella or Pontiac disease documented in the use of cpap.

[Sleeprider]

astracan, the PAP humidifiers is not based on condensing air. The humidification systems are all based on evaporative increase in relative humidity with the target being about 80% RH. In order to prevent condensation, we use heated tubes or tube covers to avoid cool surfaces that could cause condensation prior to entry to the airway. Our airway is designed to further increase the temperature and humidity of air before it reaches the deeper parts of the lung such that humidity is near 100% at body temperature at the alveolar interface. The use of a humidifier merely reduces the work the body must do to heat and moisten air to be suitable for respiration. Without humdification, many people experience drying and cooling of the upper airway, which is uncomfortable.

Expired air is laden with moisture and near body temperature, and it will condense if you exhale into cold air or blow on a cold surface. Many people without CPAP will exhale under covers on very cool nights, which allows for warmer, moister air to be inhaled. That option is not avalable with CPAP, so the humidifier fills in nicely. Your perception of how humidification works is simply the opposite of what is actually going on. What can I do to help you understand? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC137263/

[Melman]

Although there is some aerosolizzation from CPAP humidifiers it is much less than from other common uses of water. We probably inhale more aerosolized water while taking a single shower than in years of CPAP use. Substantial aerosols are generated when we run water to wash our hands or brush our teeth. Any activity involving water creates aerosols.

[astracan]

We do not talk about the same. Try to follow my reasoning, please: the humidifier does not produce aerosols, the humidifier only heats the water deposited inside it by means of a plate and the air that passes through that duct is heated and humidified by the action of that vapor, as if It was a cloud that absorbs water vapor, nothing more. Aerosols are produced by the operation of the cpap. A CPAP is an air pump that pressurizes the surrounding air and blows it carefully in our throats. The interface to get us this air is a tube connected to a mask. Plain and simple. Obviously, the machine is very sophisticated and its algorithms to do its job well are increasingly complex. But in general, it is exactly what I just said: an air pump that pressurizes the surrounding air and sends it through a tube and a mask to our lungs. Well, the definition of an aerosol is also exactly that: pressurized gas in a container that is expelled, nothing more. I understand perfectly the usefulness of a humidifier and there are many people who use humidifiers in the rooms, of course. Those humidifiers without cpap have no chance of causing problems because they do not form aerosols, do you understand? Nor do I talk about the condensation of the tubes and the way to make them more comfortable. I speak of pressurized air passing through the tube to our throat. I am talking about these aerosols going through the tube, which is also hot and humid in case we use a humidifier in the cpap. I'm talking about that is one of the habitats preferred by legionella pneumophila, that's all. I hope I have made myself understood, I see that happy language is an important handicap. The spray is created by the CPAP by pressurizing the air. Regardless of whether humidifier is used or not. My mind is very curious and is always asking questions, I do not want to generate a controversy, I leave the subject. Thank you.