Is this microwavable for disinfection?

No, it is just a soft squeeze plastic bottle so I wouldn't. Just warm water and dish soap. I use mine in the shower. The lid could be put in the dishwasher since it is a harder plastic and is the main part that could get germs.

can I make my own solution with neti salt.

I am not familiar with Neti salt and though the manufacturer will say that they use a pure grade of salt, I have been using it for years with Himilayan Sea Salt-- adding 1/4 -1/2 tsp for the bottle.

How do you all heat the distilled water? The room temperature water is still a little cold for me.

I have a small hot pot in my bathroom that is only used for heating distilled water for nasal lavage. I put 4oz in the hot pot and 4 oz in a Pyrex measuring cup, plug in the hot pot, and wait about 18-20 seconds for the water to warm. When I hear it starting to boil I unplug the hot pot and dump the heated water into the room-temperature water in the Pyrex, and test it with my fingertip. I have been doing this for a long time and it is easier than having to go out to the kitchen to the microwave.

do we just need to fill the bottle with warm water? is it full of germs

You need to use distilled or previously boiled water...NEVER just tap water!!! If you're worried about germs in the bottle itself just rinse it out with some dish washing soap.

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