Living The Clean Life

By: Tracy R. Nasca - December 4, 2009

Your CPAP equipment is expensive and an investment in your sleep health; take good care of it. Masks, CPAP tubing, machine filters and CPAP humidifier chambers all need proper cleaning to maintain effectiveness.  They also need to be replaced on a scheduled time frame.

Are you aware of the CMS Reimbursement Schedule?  CMS stands for Centers for Medicare and Medicaid Services.  Check with your local home healthcare provider about your coverage for reimbursement. 

The current CMS Reimbursement Schedule:
Mask or nasal pillow interface	1 per 3 months
Cushion for use on nasal mask interface	2 per month
Nasal pillows for combination oral/nasal mask	2 per month
Full face mask	1 per 3 months
Headgear	1 per 6 months
Chin strap	1 per 6 months
Tubing	1 per 3 months
Filter, disposable	2 per month
Filter, non-disposable	1 per 6 months
Humidifier water chamber	1 per 6 months

Today’s masks are made for better comfort and seal.  The fragile material used in mask cushions will last longer if you take the time to care for them properly.  Daily cushion rinse is recommended to remove facial oils.  Always use a warm, mild and pure soap solution to wash; rinse with clean clear water.  It is important to air dry, away from direct sunlight.  Whether your cushion is traditional, gel or dual walled, handle gently, being careful not to tear with your fingernails.  Leaving a mask cushion to soak in any solution is not recommended.  Antibacterial cleaning products are too harsh and should not be used. Avoid products with oils, bleach or moisturizers.

When it comes to cleaning mask components, I find it difficult to disassemble a mask.  I call it the “Humpty Dumpty Affect”.  Maybe its just me, but when I take a mask apart and clean it, I can never get it back together the same way again!  I take great care in gently cleaning the cushion with mild soap, rinse and air dry.  I clean the plastic frame with cotton swabs.  I find I can get 3-6 months use out of a mask and then simply replace with a whole new unit. 

CPAP tubing is the important element that delivers the air from your machine to your mask.  Tubing replacement is recommended every three months.  Unseen by the naked eye, tiny holes may develop and can compromise the accurate delivery of air pressure.  Tubing is a relatively inexpensive item; don’t forget to replace this vital component.  When I have an infectious cold, flu or illness, I toss my tubing and replace.  Why take the chance of reinfection?

The life of your CPAP machine is approximately 3-5 years.  Replacing filters can add life to your machine.  Out of sight, out of mind, many patients are not even aware of the existence of their CPAP filters.  Just as you would routinely change your furnace or air conditioning filters at home, or the filters in your automobile, you should regularly change the filters in your CPAP for optimum care.  Check your white fine filters every few weeks and replace them when visibly discolored and dirty, about once per month.  The non- disposable filters (usually made of a foam material) should be rinsed often and replaced about every 6 months.

CPAP humidification, in my opinion, is a necessity, not a luxury.  All of the manufacturers recommend using distilled water!  Why, you ask?  Many of our Talk About Sleep members ask about using distilled water vs. tap water or using purified water vs tap water.  According to Wikipedia, “distilled water is water that has virtually all of its impurities removed through distillation. Distillation involves boiling the water and then condensing the steam into a clean container, leaving most if not all solid contaminants behind.”  Using a pure water will definitely add to the life of your water chamber and keep it cleaner looking over the 6 month re-order replacement cycle period.

When is the last time you purchased a new water chamber?   Is your water chamber discolored with a white powdery substance, or has a pink fungus developed?  If so, you need to be more vigilant in cleaning the chamber AND replacing it on a regular basis.  There is nothing grosser than a dirty humidifier chamber – YUK!

 The water chamber should be emptied each morning of any unused water and rinsed clean. To help avoid development of the powdery white substance or fungus, leave the unit upside down to completely dry. 

Check your manufacturers cleaning recommendations.  Some chambers may be disassembled and washed on the gentle cycle on the top shelf of your dishwasher.  I mention ResMed because it’s what I use and am most familiar with; they offer a “cleanable” version (P/N26958) that can be used on the H3i or H4i humidifiers and can be disassembled for easier cleaning.  Click here for helpful ResMed H3i H4i instructional videos.  A thorough washing of the humidifier tub is recommended on a weekly basis.  To clean, disinfect and avoid mineral deposits, white powdery substance or fungus, use a 1/3 vinegar to 2/3 water solution soak and then a thorough rinse of clear water.  Your water chamber should be replaced every 6 months.

If you have a water chamber that does not allow disassembly for a thorough internal cleaning, add vinegar and let it soak.  You can use a baby bottle brush with a wire handle, bend like a hockey stick and insert to scrub any film that has developed.  Some of the chambers include caps to assist in the cleaning process.  To prevent spilling, ResMed’s has a yellow “plug” to close off the opening when agitating the soapy water.  The plug can also be used to measure the proper amount of vinegar when neutralizing calcium deposits.  After completing the cleaning process, rinse well and turn upside down to air dry.

As you can tell, I am a big believer in using CPAP heated humidification 365 days a year.  It just makes the CPAP experience more comfortable.  It greatly reduces or eliminates nasal dryness.  To learn more about the importance of humidification click here.

Now that you are aware of the importance of equipment care, cleaning and necessities of replacement, check with your local home healthcare provider about your coverage for reimbursement.  For your better health and successful CPAP use, keep your equipment in top shape with routine cleaning and replace as often as your insurance provider allows!  Good Sleep!

You may contact Tracy at info@talkaboutsleep.com