Sorry for my delayed response.
I am a bit paranoid as well about introducing more germs, bacteria, etc. in to my lungs. I hear so many things as far as how we’re supposed to clean this stuff. What I do may not be correct, but I think it’s probably pretty good.
With the acapella (green part and clear mouthpiece), I try to clean it regularly in hot, soapy water – I use anti-bacterial dish soap (most isn’t), just to make myself feel safer. Then, I periodically soak it in 91% alcohol for about 10 minutes. I’m pretty sure the alcohol kills just about everything!
I don’t have any kind of tubing with my acapella, but I know you are absolutely not supposed to clean your tubing (I’m assuming you’re talking about the long tube that goes from your compressor). It is impossible for it to dry out, and it will become a bacteria haven!
I use nebulizers as well, and the tubing I use with them I never clean. I just replace it periodically. For my nebulizers, I wash them in the dishwasher, and periodically soak them in alcohol as well.
One thing I’ve wondered – are we supposed to wash these medical things in the dishwasher by themselves, or can they go in with dishes, pans, etc? I usually don’t wash them by themselves, and once in a while they’ve had bits of old food on them, which grossed me out. So, I always inspect them pretty closely, and if there are any signs of food or something I put them right back in.