The Truth About Using Filtered Water in Your CPAP Machine
An Opinion Piece by Sebastian Cardenas, Founder of CSpring
As someone who has been using a CPAP machine for over a decade, I've had ample time to reflect on the recommendations surrounding CPAP maintenance—particularly the use of distilled water in humidifier chambers. Official guidelines from manufacturers and medical professionals universally advocate for distilled water, emphasizing its purity and the protection it offers against mineral buildup. While I acknowledge that distilled water is undoubtedly the best option, I want to share my personal experience and observations that suggest filtered water—both bottled and home-filtered—can also be a safe and practical alternative for many users.
The Curious Case of Missing Articles
In my quest to understand more about this topic, I noticed an odd coincidence: several previously published articles that supported the use of filtered water in CPAP machines have seemingly vanished. Links that once led to informative pieces now result in 404 error pages. It's as if the information has been quietly removed from the public domain.
This observation leads me to hypothesize that corporations, organizations, and even medical professionals find it simpler and safer to strictly endorse distilled water. From a liability and consistency standpoint, advising the use of distilled water eliminates uncertainties and aligns with the highest safety standards. However, this leaves little room for discussing viable alternatives that many users, including myself, have found to be effective.
Discovering ResMed's Guidance on Water Usage
After carefully reading the ResMed instructions for the AirSense 11, I found a section that states: "If using the HumidAir 11 Cleanable water tub, use drinking quality water (potable)." Although there is a dishwasher-safe version of the water chamber—which likely uses a different kind of plastic—the standard chamber is also labeled as "cleanable." This suggests that even the manufacturer acknowledges that potable (drinking quality) water can be used in certain circumstances. This discovery further supports the idea that filtered water can be a feasible option for CPAP users.
My Personal Journey with Filtered Water
Over the past decade, I've used a ResMed AirSense 10 and more recently transitioned to the AirSense 11. Throughout this time, I've exclusively used filtered water in my CPAP humidifier chamber, including both bottled filtered water and water filtered through my refrigerator's filtration system.
Living in Roanoke, Virginia, I've noticed that the local water seems to have higher amounts of calcium. When I use my refrigerator's filtered water, I do observe a light mineral deposit on my humidifier chamber's heat plate. This deposit is a minor inconvenience that I manage with regular cleaning using citric acid and baking soda. This experience highlights that while filtered water is a practical alternative, it does require a bit more vigilance in maintenance compared to distilled water.
Despite these minor maintenance tasks, I've experienced absolutely zero issues—no machine malfunctions and, most importantly, no health complications. This personal success has reinforced my belief that filtered water can be a viable option for CPAP users who are diligent about upkeep.
Anecdotal Evidence from the CPAP Community
I'm not alone in this practice. A substantial number of CPAP users on various forums and social media groups have shared their experiences using filtered water—both bottled and home-filtered. These anecdotal accounts often mirror my own—users report minimal adverse effects on their health or equipment when using filtered water responsibly. Many also note the importance of regular maintenance to prevent mineral buildup.
While anecdotal evidence isn't a substitute for scientific research, it does highlight a gap between official recommendations and real-world practices. Many users find distilled water inconvenient to obtain, especially when traveling or living in areas where it's not readily available. Filtered water offers a practical alternative that, when coupled with proper machine maintenance, can be effective for daily therapy.
Important Considerations When Using Bottled Filtered Water
When opting for bottled filtered water, it's crucial to be selective about the products you choose:
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Avoid Added Minerals: Refrain from purchasing bottled water that has added minerals, electrolytes, or other advertised additives. These minerals can accumulate in your humidifier chamber and lead to increased maintenance needs.
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Choose Purified or Distilled Labels: Look for bottled water labeled as "purified" through processes like reverse osmosis, or better yet, "distilled" if available.
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Read the Labels Carefully: Marketing terms can be misleading. Ensure that the water doesn't contain enhancements that could introduce unwanted minerals into your CPAP machine.
Why the Emphasis on Distilled Water?
It's important to understand why distilled water is the gold standard:
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Purity: Distilled water is free from minerals, bacteria, and other contaminants.
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Machine Longevity: It prevents mineral deposits that can damage the humidifier chamber and internal components.
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Health Safety: Eliminates the risk of inhaling harmful substances that could affect respiratory health.
Given these advantages, it's logical for manufacturers and healthcare providers to recommend distilled water. It ensures the highest level of safety and minimizes liability.
Considering Filtered Water as a Viable Option
Based on my experience and the shared experiences of others, I believe that filtered water—both bottled and home-filtered—can be a viable option for CPAP users who are diligent about machine maintenance. Here are some considerations:
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Quality of Filtration: Not all filtered water is equal. Using high-quality filters, such as those in modern refrigerators or dedicated filtration systems, can significantly reduce impurities. However, in areas with hard water, like Roanoke, Virginia, even filtered water may contain higher levels of minerals like calcium.
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Regular Cleaning: If you opt for filtered water, cleaning your humidifier chamber regularly becomes even more important to prevent mineral deposits. I've found that a mixture of citric acid and baking soda effectively removes any buildup on the heat plate.
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Awareness of Local Water Quality: Understanding the mineral content of your local water supply can help you anticipate maintenance needs. In areas with higher mineral content, more frequent cleaning may be necessary.
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Careful Selection of Bottled Water: When using bottled filtered water, avoid brands that add minerals or other substances for taste or health benefits. These additives can contribute to mineral buildup in your machine.
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Awareness of Risks: Understand that deviating from manufacturer recommendations may have implications for your machine's warranty and potential risks, albeit minimal based on anecdotal evidence.
A Call for Open Dialogue and Research
The disappearance of articles discussing the safe use of filtered water in CPAP machines suggests a reluctance to explore alternatives to distilled water. I believe there is value in having an open dialogue about this topic. More research and official guidance could provide clarity and potentially offer practical solutions for users who find distilled water inaccessible.
Conclusion
While I recognize that distilled water remains the best option for CPAP humidifiers, my personal experience over the past decade leads me to advocate for the careful use of filtered water—both bottled and home-filtered—as a practical alternative. It's essential for users to make informed decisions based on their circumstances, prioritizing both their health and the longevity of their equipment.
If you're considering using filtered water, I encourage you to:
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Consult with a Healthcare Professional: Discuss your specific situation with your doctor or a respiratory therapist.
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Ensure High-Quality Filtration: Use the best filtration methods available to you, and be mindful of your local water quality.
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Select Bottled Water Wisely: When choosing bottled water, opt for brands that do not add minerals or other additives. This reduces the risk of mineral buildup in your CPAP machine.
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Maintain Your Equipment: Commit to a regular cleaning schedule to keep your machine in optimal condition. Be prepared to address any mineral deposits promptly.
By sharing my perspective, I hope to contribute to a broader conversation about CPAP maintenance and the practical realities many users face. Let's continue to share our experiences and support one another in our journey toward better sleep and health.
Disclaimer: And for good measure, so I don't get sued, I must plainly state that I am not a doctor or qualified in a professional manner to advise anyone to use or not use filtered water. To be completely clear, distilled water is the best water to use.
Sebastian Cardenas is the founder of CSpring and a long-term CPAP user committed to improving sleep health through open dialogue and shared experiences.
References - Curious Case of Missing Articles:
the following links and article summaries were found repeatedly by "ChatGPT o1" however after many attempts to find working links or manually searching. I was not able to access them.
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1. American Sleep Apnea Association
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Title: CPAP Machine Use and Maintenance
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Link: https://www.sleepapnea.org/treat/cpap-machine-use-and-maintenance/
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Detailed Summary:
This article from the American Sleep Apnea Association provides comprehensive guidelines on the proper use and maintenance of CPAP machines. Key points include:
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Importance of Regular Cleaning: Emphasizes cleaning the CPAP mask, tubing, and humidifier chamber daily to prevent bacterial growth and infections.
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Use of Distilled Water: Recommends using distilled water in the humidifier to prevent mineral deposits and ensure the machine's longevity.
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Alternatives to Distilled Water: Acknowledges that if distilled water is not available, purified or filtered water can be used temporarily, but users should return to distilled water as soon as possible.
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Health Risks of Tap Water: Warns against using tap water due to potential contaminants and minerals that can harm the user and damage the machine.
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Maintenance Tips: Provides advice on replacing filters, inspecting equipment for wear and tear, and scheduling regular check-ups with healthcare providers.
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2. Sleep Foundation
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Title: CPAP Cleaning Tips
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Link: https://www.sleepfoundation.org/cpap/cleaning-and-maintenance
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Detailed Summary:
The Sleep Foundation's article focuses on best practices for cleaning and maintaining CPAP equipment to ensure effective therapy and prolong the device's lifespan. Highlights include:
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Daily Cleaning Routine: Recommends washing the mask, cushion, and tubing daily with warm, soapy water and allowing them to air dry.
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Weekly Deep Cleaning: Suggests disinfecting the equipment weekly using a solution of vinegar and water to eliminate any lingering bacteria or mold.
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Use of Distilled Water: Advises using distilled water in the humidifier to prevent mineral buildup, which can harbor bacteria and affect air quality.
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Alternative Water Options: Notes that if distilled water is not available, bottled water is preferable to tap water, but users should return to distilled water when possible.
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Avoiding Harmful Cleaning Products: Cautions against using harsh chemicals or antibacterial soaps that can leave residues and cause skin irritation.
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3. ResMed
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Title: What Kind of Water Should I Use in My Humidifier?
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Detailed Summary:
In this article, ResMed addresses common questions about the type of water to use in CPAP humidifiers. Key takeaways include:
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Recommendation for Distilled Water: Strongly recommends using distilled water to prevent mineral deposits and ensure optimal humidifier performance.
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Risks of Tap and Bottled Water: Explains that tap water and some bottled waters contain minerals and contaminants that can lead to residue buildup and bacterial growth.
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Temporary Use of Purified Water: Acknowledges that if distilled water is not available, using purified or filtered water is acceptable for short periods, but users should switch back to distilled water as soon as possible.
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Cleaning and Maintenance: Stresses the importance of regular cleaning, especially when using water other than distilled, to prevent scaling and prolong the life of the humidifier chamber.
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Health Considerations: Highlights that using the proper water type contributes to the overall effectiveness of CPAP therapy and the user's health.
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4. CPAP.com Blog:
Title: Is Distilled Water Necessary for CPAP?
Link: https://www.cpap.com/blog/is-distilled-water-necessary-for-cpap/
Summary:This article discusses the importance of using distilled water and explores alternatives, including the use of purified and filtered water.
5. Sleep Advisor:
Title: Can I Use Tap Water in My CPAP Machine?
Link: https://www.sleepadvisor.org/can-i-use-tap-water-in-my-cpap-machine/
Summary: The article examines the risks associated with using tap water and offers guidance on safe water options for CPAP users.
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