Mine uses water in small tubes in the mattress pad and a heating/cooling box that brings the water to your desired temperature and has a reservoir with a pump in it to move the heat into or out of the mattress pad via the water. It’s not a sealed system so I need to fill it regularly.
I haven’t taken my box apart but I’ve guessed it’s using a thermoelectric (aka peltier) heat pump to heat and cool the water. There’s no compressor for a full refrigeration unit, just a fan and the pump.
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