SLEEP STUFF: Cleaning gadgets and products for PAP users

Positive pressure airway (PAP) devices have revolutionized sleep apnea treatment. These devices include an air pressurizing machine with filters, a humidifying reservoir, tubing to deliver pressurized air and, of course, various kinds of masks to meet the various needs of patients.

Because the machines deliver therapeutic air pressure via devices that make constant contact with the face and airway, they require regular cleaning and care, not only so that they will work efficiently, but so they do not introduce foreign allergens and pathogens to the skin and airway, which can actually lead to health complications. Keeping them clean will help add longevity to their use so you don't need to replace them so often.

Unfortunately, not all users of PAP equipment understand the importance of keeping their gear clean and sanitized, and this results in poorer performance overall and side effects of usage that can be avoided. Don't think you need to clean your PAP gear regularly? Check out this article on what happens when you neglect to keep it clean.

Keeping your gear clean isn't actually too difficult; it's more a matter of making it a priority. Here are the basics:

Masks
Wash daily in warm water and mild fragrance-free soap or use wipes or spray cleaners specifically designed to clean PAP masks. Rinse with water; air dry on a clean cloth or paper towel away from direct sunlight (silicone can break down or discolor if exposed too long to sunlight). Before putting on your mask, cleanse your face and skip the moisturizer (which can break down the silicone and possibly interrupt the seal needed to keep your pressure uniform). That's it! Once weekly, sanitize the mask using 1 part white vinegar to 3 parts water and rinse in distilled water.

Headgear and chinstraps 
Wash by hand using warm soapy water, rinse well and air dry. Try not to stretch the material out of shape. Do not use a washer/dryer for this process.

Tubing/hosing
Clean this once weekly by soaking in a basin of warm soapy water. Rinse well and hang-dry away from direct sunlight.

Humidifiers
If your machine does not have a humidifier, it is likely time to get a machine upgrade! Humidifiers help reduce morning dry mouth and stuffy nasal passages while in use.

The water reservoir must be cleaned daily to eliminate both bacteria and mineral buildup along its sides. Wash with warm, soapy water, then rinse well and dry on a clean towel away from direct sunlight. Always fill with distilled or sterile water; tap water contains minerals and chemicals that can damage the mask or tubing. Note: Water filters for tap water do not remove these substances.

Once weekly, sanitize the reservoir using 1 part white vinegar to 3 parts water for 20 minutes, then rinse in distilled water.You may have the option of cleaning your humidifier reservoir in the dishwasher; check your PAP machine manual to confirm.

Air Filters
PAP machines draw air from the room to filter and pressurize before they deliver it as therapy. They require filters to remove typical household debris from the air such as allergens like dust, smoke or pet dander. Filters are generally disposable and require regular replacement. Fortunately, filters for PAP devices are cheap, costing maybe $2 a month. It's recommended that you change them at this interval as well. Filters allowed to become dirty for a long time will have a negative impact on your PAP machine's effectiveness and could fail to remove particulate matter from the air coming to you through the hose.

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Unless otherwise indicated, the products discussed below can be used for nearly all kinds of PAP gear regardless of therapy (CPAP, BiPAP, AutoPAP, etc.). They can help you establish better cleaning and maintenance practices with your gear. Not only will keeping your equipment clean keep you healthier, but it will also help you keep your gear in better shape, which means less frequency in making replacement purchases down the line.

It's always recommended that you consult your PAP machine manual for advice about cleaning and sanitizing your gear, as it will have the most accurate information available for your particular gear.

SHC cannot be held liable for any damage to any PAP devices caused by using the products listed below.

HOME PAP DEVICE SANITIZER
SoClean may be expensive at $300 a pop, but the time-pressed PAP user may find this to be the perfect solution for keeping up with a daily cleaning schedule.

This home PAP device sanitizing appliance is advertised as "a faster, easier, more effective way to clean your CPAP equipment. SoClean kills 99.9% of CPAP germs and bacteria in your mask, hose and reservoir with no disassembly, no water, and no chemicals."

It really is simple: just place your mask with the tubing still connected into both the SoClean unit and your humidifier, then turn it on and leave for the day. When you get home, your mask, humidifier and hose will be clean and sanitized.

The appliance makers claim it uses the same sanitizing process as used for water purification, produce handling, hotel housekeeping and hospital sanitizing; SoClean is FDA approved and their website at Better Rest Solutions offers laboratory evidence of these claims.

As of the timing of this post, there are no other cleaning machines available to do this kind of work. You can also purchase travel versions and spare parts from the SoClean website.

MASK WIPES & CLEANERS
If buying a sanitizing machine for your system is out of the question, you can certainly simplify the daily task of cleaning your mask by using any one of a number of mask wipes or cleaners made specifically for this task. Mask wipes are generally made of natural products that are biodegradable, alcohol and latex free and with a choice of fragrance or unscented products. Their chief use is to remove dirt, facial oils and other residues from your mask and other PAP gear and they are considered safe and gentle.

Some brands of wipes to look for: Beaumont Citrus II, Contour, Reliable Respiratory

In the same vein, there are spray cleaners that can also be used to clean PAP gear from the same manufacturers listed above (see also: Respiclean). Simply spray onto a lint-free towel and wipe down your mask.

TUBING CLEANER
The trick to cleaning the tubing is to effectively remove the bacteria from the hose, but this can be difficult without the right tools. A good cleaning kit will allow you to gently run a cleaning brush or pads through your tubing in one pull as well as flush out the tubing easily and with little mess. A tube cleaning kit should not damage your tubing and insertion tools should be long enough to do the job. Some brands to consider: AG Industries, Beaumont Citrus II, Clair Devices

MACHINE AIR FILTERS
PAP machine manufacturers have filter recommendations included in their manual as well as instructions for how to install, remove and replace them (plus a recommended filter replacement schedule). Your best bet is to find the filters best suited to your particular machine.

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SleepyHeadCENTRAL strongly encourages people with ongoing sleep health problems to approach a medical professional to determine appropriate differential diagnoses and treatment. This post, like all other posts on SHC, is not intended to substitute for medical advice.

See SLEEP STUFF series main disclosure notifications here regarding any products discussed on this blog. 

Guest Post || CPAP Care and Maintenance with Rui de Sousa, RPSGT, RST, B.Sc

CPAP therapy typically includes a unit with
a humidity chamber, tubing, a CPAP mask
and its headgear, all which need regular
cleaning and maintenance in order to
preserve function, hygiene and value

So you have been diagnosed with sleep apnea. And now you have this monstrosity at your bedside that is supposed to help you sleep. You know you have to use it every night, it is essential to keeping you healthy. But did you know you have to clean it every morning too? 

Cleaning and maintaining your CPAP and accessories properly not only makes it work better, but it helps it lasts longer, and also keeps you healthier.

Morning maintenance

MASK

After using the CPAP all night, you have to clean the mask every morning. The mask is made with very delicate silicon material that must be cleaned every morning to prevent decay and breakdown of the material. Masks typically last six months to a year with proper maintenance. Cleaning the mask removes the oils that your skin released as well as germs and dirt and dead skin cells that were picked up during the night. This is especially important if you are fighting a cold or otherwise sick. If you fail to properly wash your mask in the morning, the cold may last much longer than it would have normally.

In the morning, fill the sink with warm water. Add some mild dish washing soap (like a Palmolive for example) or a mild antibacterial hand washing soap. Let the mask soak in this solution for a few minutes. You can also gently rub the delicate membrane to help clean it. After 5-10 minutes, rinse it with clean water and let it air dry.

There are also one-time-use disposable wipes specifically made for CPAP masks. You just clean the mask with these wipes and let it air dry. Dispose of the wipe in the garbage.

I will also add that, before you put on the mask at night, wash your face well--remove dirt, sweat, oil from your face. If you moisturize, avoid the areas of the mask. This will limit the accumulation of dirt and oil throughout the night. 

Also, check your mask for tears in the silicon or broken plastic parts. If the mask is defective, replace it immediately. A tear can result in excessive air leakage, reducing the pressure required to keep your airway open throughout the night.

HEADGEAR

Depending on how dirty the headgear gets, it can be washed weekly, in the same manner as the mask, using a mild soap and letting it soak. You can wash it more often if needed.

Weekly maintenance

TUBING

Some people will suggest washing the tubing every morning or once a week. I would say that once a week is enough, unless you are feeling under the weather. Then you might want to wash it out every morning until you feel better.

Fill the tubing about a quarter full of soapy water, then pick it up from both ends, blocking both ends with your thumbs, and rock the tubing up and down, swishing the water inside. Then just immerse the tubing in the soapy water for the same 5-10 minutes. Drape the tubing over the top of the door or on the towel rack to drain and dry throughout the day.

Check your tubing for slight tears and leaks. It will sometimes tear at the neck, near the ends. If you find a tear, replace it immediately, since the loss of air pressure can affect the minimal effective pressure needed to keep your airway open.

CPAP UNIT 

Wipe down the actual CPAP unit weekly. Avoid using any hard cleaning chemicals on the CPAP unit itself. You can easily wipe it down with a moist cloth to remove dust and dirt.

CPAP units also often have filters that need cleaning. Some filters are disposable (usually white), which you can replace. Depending on how much dirt and dust is in the air, these filters can last anywhere from a month to several months. If you live in the country, you can expect a dirtier filter and you may need to replace it more often. Please note that not all CPAPs have a disposable filter. Check the owner's manual or call the CPAP representative to double check if your unit has such a filter.

Some filters are re-usable (usually look like a sponge). These should be rinsed with cool water once a week or so. Just rinse the filter until the water runs clear. You can gently squeeze the filter to help eliminate the water. Let air dry and replace in the CPAP unit once it is completely dry.

Caution: There is no reason to open the CPAP unit. There is nothing inside the CPAP that needs to be maintained on a regular basis. If the CPAP seems to be malfunctioning, please have a professional look at it. Not only can tinkering with it void the warranty, but you can do more damage to the unit; or worse, you can get hurt.

HUMIDIFIER CHAMBER

The humidifier can be cleaned weekly with warm soapy water. Swish the solution in the chamber, then rinse it with clean water. You can also disinfect it with a vinegar/water solution (1 part vinegar to 4 parts water) and let soak for about 30 minutes. Then rinse and let air dry.  

Some chambers can be disassembled. If you have one that can, you can open it and place it on the top rack of your dishwasher. Most humidifiers are dishwasher safe, just check the owner's manual.

Annual Maintenance

It is a good idea to have the CPAP unit looked at once a year by qualified personnel. Take the CPAP unit in to be checked annually to the same people you purchased it from. The will have specialized equipment to make sure the CPAP unit is working optimally.

A short comment on traveling with CPAP

Never travel with water in the humidifier chamber. Depending on the model, water from the humidifier chamber can splash back into the actual CPAP unit, either rendering it useless, or shortening its lifespan. If this happens, it is important to immediately dry the unit as quickly as possible. Turn the unit over until the last drops have dripped out, then run the CPAP for 10-15 minutes without the tubing, just blowing off excess moisture that may have entered inside.

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Rui de Sousa,
RPSGT, RST, B.Sc

Rui de Sousa is a Canadian sleep technologist with over 20 years experience helping patients sleep better in and around the greater Toronto area. Rui is also heavily involved in educating new sleep technologists and the population at large. He has presented education forums for the interested public. He has published several chapters in a medical textbook and articles in local newspapers, and has been interviewed on TV and on the radio. He also keeps abreast of the latest knowledge, techniques and technologies attending local and international conferences.