Any downsides to heated tube?

[Sleeprider]

The only downside for me is that a heated hose induces central apneas.

Is the air particularly dry where you live? If so, you could purchase one of those inexpensive mist humidifiers at the drug store for your bedroom. These can be a problem, though, if you use hard water.

It may be, though, that you will be fine with just the equipment you do have now. CPAP machines, including their humidifiers, have improved a lot in recent years. I suggest you turn the humidity up as high as you can without getting condensation in your tubing (what we call rain out). You can also insulate your hose to prevent rain out.

A sense of nasal cooling with each inspiration promotes the sensation of adequate breathing due to nasal cooling. Nasal obstruction or nasal anesthesia blocks this sensation a promotes a sense of suffocation and published studies indicate that they trigger periodic breathing and central sleep apnea. Too much heat and humidity prevents nasal cooling and promotes a sense of suffocation. My first night with climateline auto did this and was corrected by lowering the tube temperature.

I'm just getting started and I was prescribed a heated tube. Should I not use the heated feature? I'm in the Silicon Valley area which can get fairly dry.

---

A sense of nasal cooling with each inspiration promotes the sensation of adequate breathing due to nasal cooling. Nasal obstruction or nasal anesthesia blocks this sensation a promotes a sense of suffocation and published studies indicate that they trigger periodic breathing and central sleep apnea. Too much heat and humidity prevents nasal cooling and promotes a sense of suffocation. My first night with climateline auto did this and was corrected by lowering the tube temperature.

I would like to see links if you know where to find this. We deal with a lot of people with idiopathic centrals and this might be helpful.

Would you recommend not using the heated feature whatsoever?

JVweil did not offer any references or cite sources for his assertions. They are unsubstantiated.  A heated hose is usually more comfortable and produces less rain-out. It does not noticeably change the temperature of delivered air, but heats the wall of the tube to prevent condensation.  A heated tube may be heavier or less flexible than some unheated tubes, otherwise they are not associated with any documented issues.

[JVWEIL]

Disturbed sleep and prolonged apnea during nasal obstruction in normal men.
Zwillich CW, Pickett C, Hanson FN, Weil JV.
Am Rev Respir Dis. 1981 Aug;124(2):158-60.
 
The effects of nasal anesthesia on breathing during sleep.
White DP, Cadieux RJ, Lombard RM, Bixler EO, Kales A, Zwillich CW.
Am Rev Respir Dis. 1985 Nov;132(5):972-5.

[Sleeprider]

Looking for any connection to heated tubing during CPAP use here  

Disturbed sleep and prolonged apnea during nasal obstruction in normal men.
Zwillich CW, Pickett C, Hanson FN, Weil JV.
Abstract
Anecdotal observations suggested that poor quality of sleep is a frequent complaint during upper respiratory infections (URI). Nasal obstruction occurs frequently during URI and causes sleep apnea in some infants. Sleep apnea disrupts normal sleep and could explain the complaints of poor sleep quality during URI in adults. Accordingly, 10 normal men had full night recordings of sleep stages and breathing rhythm before and during nasal obstruction. The order of obstructed and nonobstructed nights was randomized after a standard acclimatization night. During nasal obstruction, time spent in the deep sleep stages decreased from 90 +/- 11.2 (SEM) to 71 +/- 12.9 min (p less than 0.05), whereas significantly more time was spent in Stage 1 sleep (p less than 0.03). This loss of deep sleep during obstruction was associated with a twofold increase in sleep arousals and awakening (p less than 0.01) resulting from an increased (p less than 0.02) number of apneas (34 +/-19 during control sleep versus 86 +/- 34 during obstructed sleep). Apneas of 20 to 39 s in duration became 2.5 times more frequent (p less than 0.05) during obstruction. Oxygen saturation was studied in the last 4 subjects using an ear oximeter. Desaturation (SaO2 less than 90%) occurred 27 times during control sleep compared with 255 times during obstructed sleep. These desaturation episodes occurred only during apneas. All men complained of poor sleep quality during nasal obstruction. We concluded that apneas, sleep arousals and awakenings, and loss of deep sleep occur during nasal obstruction and may explain complaints of poor sleep quality during URI.

The effects of nasal anesthesia on breathing during sleep.

White DP, Cadieux RJ, Lombard RM, Bixler EO, Kales A, Zwillich CW.

Abstract

Inability to breathe through the nose is an increasingly recognized cause of disordered breathing during sleep. To test the hypothesis that this respiratory dysrhythmia could result from loss of neuronal input to respiration from receptors located in the nose, we anesthetized the nasal passages of 10 normal men during sleep. Each subject spent 4 consecutive nights in the sleep laboratory while sleep stages, breathing patterns, respiratory effort, and arterial oxygen saturation were monitored. Night 1 was for acclimatization with Nights 3 and 4 being randomized to nasal spraying with either 4% lidocaine or placebo. On the lidocaine and placebo nights (Nights 3 and 4) the nasal passages were also sprayed with a decongestant to prevent increased nasal air-flow resistance resulting from mucosal swelling. To control for the possible effects of this decongestant, an additional night (Night 2) was included during which the nasal passages were sprayed with room air. Parallel studies conducted during wakefulness demonstrated low nasal resistance during the lidocaine-decongestant regimen. Because of the short duration of anesthesia with lidocaine, spraying was done at lights out and 2.5 and 5 h later. On the placebo night (decongestant plus saline) there were 6.4 +/- 1.8 (SEM) disordered breathing events (apneas plus hypopneas) per subject, whereas with lidocaine (plus decongestant) this increased fourfold to 25.8 +/- 7.8 events per subject (p less than 0.05). The majority of the disordered breathing events were apneas and were fairly evenly distributed between central and obstructive events. The magnitude of these changes is similar to that previously reported with complete nasal obstruction. These results suggest that nasal receptors sensitive to air flow may be important in maintaining breathing rhythmicity during sleep.