This article on CPAP disinfection methods originally was featured on Sleep Review and was written by Dillon Stickle. It has been edited slightly.
With the launch of a new ultraviolet light-based CPAP disinfectant, Sleep Review takes a look at the pros and cons of ozone versus UV light, as opposed to plain water and soap. In addition to the impact of travel CPAPs on the device cleaners market.
As CPAP technology continues to advance, so does accessories like CPAP cleaners. Cleaners help patients keep their devices free of bacteria and other buildups. Some people find the convenience of cleaner devices to be an integral part of their therapy experience. This article discusses the advantages and disadvantages of ozone versus ultraviolet (UV) light, as opposed to warm soapy water, to clean CPAPs, as well as the impact of the increase of travel CPAPs on the CPAP cleaners market.
UV Light, Ozone, or Soap & Water? Which CPAP Disinfection Methods Work?
Incorporating UV is a new technology in the CPAP cleaners market. However, it has been previously utilized for other types of medical disinfection. Alex Lucio, CEO of 3B Medical, says, “We planned a 90-day initial production run and went on backorder within the first week of sales. We raised production levels and still went on back order.”
Lucio thinks the higher-than-3B-anticipated order volume is due to pulmonary physician concerns over respiratory patients using CPAP cleaners that rely on ozone. This is traditionally the disinfecting mechanism employed in CPAP cleaning products.
Though using ozone does have its own advantages, which are discussed later in this article, Lucio says there are concerns.
“When ozone is handled correctly (ie, not vented into a room with humans or pets and a 2- to-3-hour waiting period before use), it is an effective disinfectant. But if used incorrectly, or with products that don’t have safety warnings or labeling, it can result in pulmonary edema and lung irritation. For that reason, I think the market was primed for an ozone-free alternative to disinfection.”
Ozone (O3) is the disinfectant that most sleep clinicians think of when it comes to CPAP cleaners. SoClean uses ozone for its devices for several reasons, according to Jess Cormier, director of marketing at SoClean.
“Ozone has the ability to permeate into areas that are difficult to reach by other processes, such as the inside of a CPAP hose, water in the reservoir, and crevices of the reservoir and mask,” she says. “CPAP hoses, for instance, are a breeding ground for germs and bacteria and are often constructed with ridges throughout, making it very difficult to thoroughly disinfect a hose.”
SoClean’s technology floods the inside of the hose with ozone, cleaning the interior and its crevices.
“SoClean connects directly to a CPAP device via adapter to automatically sanitize the CPAP reservoir, hose, and mask between uses without any additional work on behalf of the user,” Cormier says, adding that it’s an automated and fully closed system that will even sanitize residual water left in the humidifier chamber.
The downside with UV light is that it’s “only effective on the surface that it touches,” Cormier says. “Any shadows cast on any piece of equipment can impede the effectiveness of the UV light process. For example, a mask in a compartment will not be completely sanitized by UV light if the surfaces are pressed against a wall of a compartment.”
Lucio, however, counters by saying the Lumin solves this potential problem of light-based disinfection. He says the Lumin chamber is constructed of highly polished aluminum that reflects UVC light 360 degrees.
“Additionally,” he says, “most thin polymers and silicones are semi-transparent to UVC, allowing UVC to penetrate sufficiently for additional coverage into crevices of soft plastic or silicone. For example, with a CPAP hose, sufficient UVC penetrates the interior of the hose to disinfect and stop the growth of a biofilm. 3B Medical does not make a marketing claim on disinfecting the interior of the hose because the wide variety of hoses on the market makes it difficult to design a study to support the claim, but the company does advise using Lumin twice a week on a CPAP hose for general sanitization.”
Lucio adds that in a few months, 3B will launch a companion accessory called the Lumin Bullet. This is specifically designed to disinfect the interior of a CPAP hose.
So what about regular soap and water? This is the most accessible and affordable CPAP cleaner available. Many CPAP device and mask makers recommend it as the default choice.
CPAP cleaner companies concede that soap and water are effective, but say there are downsides. Particularly related to the amount of time needed and the lack of convenience.
SoClean’s Cormier says soap and water can be an effective sanitization method if done correctly.
“However, it is nearly impossible to reach the inside of a hose and the crevices in a hose, the inside of a reservoir, and the crevices of a mask with soap and water alone,” she says. “This method of cleaning is a time-consuming process for users that requires taking apart CPAP machines and a scrubbing process.”
Daniel Labi is the vice president of product sales at VirtuOx, maker of the VirtuClean CPAP cleaner, which uses ozone. She says, “Cleaning with soap and water is a very time-consuming, tedious process that cannot ensure all of the necessary germs and bacteria are sanitized at the same rate that you can with ozone.”
Lucio says, “Soap is a surfactant, which means it can loosen bacteria. But when hands are rubbed together or fingers rub a surface, bacteria are typically just moved and relocated,” he says. “We generally recommend use of a CPAP wipe to remove oil and residue (or soap and water) followed by disinfection or sanitization.”
The Impact of Travel CPAPs on the CPAP Cleaners Market
Consumers have more awareness today ever than before about the need to travel with their sleep apnea therapy. In part due to the launches of the Philips DreamStation Go and ResMed’s AirMini in 2017.
Soap and water remain accessible while traveling. But the drying time for this cleaning method may not be available. Especially when hotel checkout times are 11 a.m. or noon.
CPAP cleaner companies weigh in. Has the increased awareness of traveling with CPAP has made an impact on their business?
3B’s Lucio says there hasn’t been much of an impact. He believes that users will make their own decisions when it comes to how to clean their CPAP devices.
“Our view of this is that disinfection is education and awareness,” he says. “A patient with a travel PAP is either going to respond—or not—based on their own awareness, but not because of owning a travel device.”
SoClean sees it differently. “The increase of travel CPAPs has been beneficial for the CPAP cleaners market. A CPAP user’s investment in travel devices confirms the importance of adhering to daily CPAP therapy,” says Cormier. He then added that the company markets its SoClean 2 Go as a lightweight wireless device for travel CPAPs.
VirtuOx’s Labi says travel CPAPs have given VirtuOx an opportunity to meet demand.
“We see it as a large opportunity for our specific device, which can easily be used for at home or traveling use,” he says. “With the growth of travel CPAPs in the market, typically this same market will grow hand-in-hand with a portable CPAP sanitizer.”
CPAP cleaners are one tool for patients to keep their device clean and free of potentially harmful bacteria. When deciding what option is best, clinicians and patients must weigh the pros and cons. Once they do that you need to figure out which option would work best for them.
If you’re interested in the Lumin, be sure to check out the Lumin Bullet the latest disinfecting method for CPAP hoses that uses UVC light which destroys germs and pathogens in under 60 seconds.