One of the key reasons why a person using CPAP may not be as compliant with their therapy is travel.
Whether it's for vacation, work, or other reasons, there are many who think they can just leave their CPAP machine at home for a few days because they mistakenly believe they can go without using positive airway pressure during their time away. The idea of packing and bringing their equipment with them.
However, sleep apnea occurs whether or not you use your therapy. Without CPAP, you run the risk of experiencing all the unwanted, sometimes even dangerous, affects of untreated sleep apnea that CPAP is there to mitigate.
The good news is, traveling with CPAP equipment is much easier to do than you might imagine. In some cases, you don't even need electricity in order to use your therapy.
Traveling with a CPAP Machine: Getting there
Here are some tips and tricks for packing your CPAP, getting through security lines, following airline regulations, and using your device while on board.
Keep it together. If you don't already have one, consider buying the carrying case that goes with your CPAP machine. These are designed for convenience while traveling as well as to protect your gear and keep it all in one place.
Remember, CPAP is an approved medical device. The Americans with Disabilities Act (ADA) defines CPAP machines as medical devices; as such, they do not count as carry-on items when boarding a plane, train, ferry, cruise ship, or any other form of commercial transportation where luggage must be accounted for. You will not have to sacrifice your normal carry-on item in order to bring your CPAP.
Prepare to board with CPAP. Most users bring their equipment onboard to protect it from damage, to ensure it doesn't get lost, and to use it on long or overnight flights.
Mark your gear and include pertinent information. When traveling with CPAP, consider marking your equipment with a medical device luggage tag. Also, stash a copy of your prescription, complete with your doctor's name and information, pressure settings, preferred mask type and size, health insurance information, and any travel letters required by your airlines or the FAA.
While on the road, you could misplace, break, or lose your CPAP machine to theft; having this information will make it easier to replace all or part of your equipment in these situations.
Don't forget the spares. Bring extra mask cushions; you never know when they might fail.
Drain the chamber. Empty your humidifier of water before you leave for the airport, otherwise you will have to do so during security check in.
Pack water, when possible. If you will be camping, bring enough distilled or deionized water to adequately fill your humidifier.
Be hidden in plain sight. If you feel self conscious about using CPAP in public, you can look into wearing a special travel hoodie to remain inconspicuous while using your therapy. Other users find that wearing an eye mask and ear plugs or ear buds while using CPAP in transit sufficiently blocks unwanted attention from others.
Getting through security
Transportation Security Administration (TSA) agents are trained to recognize CPAP as a medical device and take special care when examining it or running it through the X-ray. What you can expect:
You'll need to take your machine out of its case and place it in its own screening bin like you would your laptop, leaving accessories in the case.
Some travelers place the entire machine in a large, clear plastic bag to keep it protected from microorganisms left behind on the screening belt.
Those eligible for TSA PreCheck won't need to remove their machines from their cases.
Occasionally, a TSA agents may pull your CPAP machine aside to swab it; this is normal. While they are trained to use fresh gloves and sterile swabs, they get busy and may forget.
Your medical equipment needs to be hygienic, so it's never out of line to ask for your device to be treated with utmost care. If you're concerned about its cleanliness, you may wish to wipe it down once you arrive at your destination.
Most airlines have policies about using CPAP while in flight; you'll want to check with your airline carrier at least 2 weeks prior to your trip if you think you will need to use yours. This way you can be sure FAA standards are met, you'll have access to the outlets necessary to plug in, and you can take care of additional paperwork your airline may require.
You may also need to request a letter from the airline confirming your plan to use your CPAP while in flight.
While on board
Yes, it's okay to use your CPAP on planes. For transcontinental and transoceanic flights, it's an absolute necessity. However:
Be sure your CPAP manufacturer recommends using the humidifier while in flight. You may need to turn off this feature. The reason? Turbulence can force water into your CPAP hose which could be aspirated into the lungs.
It is perfectly safe to use your CPAP machine without the humidifier; it will feel slightly different and may be less comfortable, but your safety is more important at this time.
That said, some humidification features may be okay to use while in flight. However, you won't be able to use distilled water in it unless you can find some in the concourse prior to boarding. Don't worry; you can use bottled water from the plane for temporary situations (but do avoid less hygienic tap water from airport or plane lavatories).
Traveling with a CPAP Machine: Once you’ve arrived
Here are the most likely scenarios you'll face while traveling with CPAP.
Electricity available (domestic location)
In this most common situation, there are a few hazards to anticipate:
Sometimes, hotels and motels do not have electrical outlets close enough to the bed for plugging in your machine. Packing an extension cord (rated for the appropriate voltage) can easily fix this problem.
If you are sleeping in unusual conditions (indoors or out), make sure your CPAP humidifier chamber is below the level of your head. This prevents any rare chance that water from the reservoir can enter the tubing in large quantities and be blown into the lungs. This can happen due to a tipped or falling machine or to unstable movement in the sleeping space. Tugging on the hose may also cause this to happen.
Make sure your machine, tubing, and mask are placed out of reach while not in use so that they do not become damaged by curious pets or small children.
Electricity available (foreign country)
The same hazards apply in foreign countries. In addition, you may need to make sure you pack the appropriate adapters and cables for hooking up your machine where electrical voltage is metered differently.
You are encouraged to research what kind of electrical connection you will be using. It is critical that you connect your CPAP machine to the correct voltage; otherwise, you risk damaging your machine and voiding its warranty.
Contact your DME provider if you have any questions or concerns about allocating and using the right adapters, cables, batteries, and inverters with your CPAP while out of the country.
Electricity available (but unreliable)
Sometimes you travel where inclement weather or remote surroundings can lead to problems with utility reliability. Power outages and rolling brown-outs can make using CPAP problematic.
One option is to anticipate poor access to electricity and "go unplugged" by renting or buying a back-up battery pack for your CPAP machine. A back-up battery pack ensures your machine will run regardless of access to electricity.
These packs can be expensive and mean you'll have more to pack, but for frequent travelers to remote areas or where power outages are the norm, the convenience may be worth it.
Electricity unavailable (camping)
Packing a smaller portable machine (sometimes called a "mini CPAP") with a battery back-up can make it much easier to remain on your therapy while camping.
Two popular portable CPAP machines used during recreational trips are the Transcend Travel CPAP Machine and the Z1 Travel CPAP Machine:
The Transcend operates uses a lightweight battery which lasts several nights; it includes a compact solar charger for battery recharging during the day when the machine is not in use.
The ultralight, very compact Z1 has data recording capability, low noise, and an optional integrated battery.
If you are "car camping," you can also power your CPAP using a long cable hooked to the standard lighter socket found in most vehicles (not only automobiles, but boats and RVs). You'll need to check into DC connectivity requirements and bring the appropriate cables and adapters to match the voltage of the power source most available to you. You will also need some way to charge your machine during the day when not in use.
When camping at higher altitudes: If your CPAP does not already include automatic altitude adjustment settings, have your DME provider show you how to manually adjust your settings for altitude.
Sometimes, CPAP running on batteries may not offer maximized pressure; if this is the case, you can turn off the humidifier, which consumes much of the energy used to power the machine.
Ambient air temperature is of special consideration when using CPAP in the outdoors. Air temperatures of less than 55°F or in very hot conditions can make using CPAP unsafe. Why? Your machine draws from the air in your sleeping space; at extreme temperatures, that air, as it enters your lungs, can bring your body core temperature too low (resulting in CPAP-related hypothermia) or too high (resulting in heat stroke).
Thousands of people travel all the time with their CPAPs
Remember, though it may seem that CPAP is inconvenient, the greater reality is that not using CPAP will be much more problematic. Not only are you not receiving necessary therapy, which leads to the return of the symptoms of sleep apnea, but your compliance numbers will go down and put you at risk for losing your therapy or being otherwise penalized by your insurer for not using it consistently.
At any rate, with some planning and patience, traveling with CPAP can be simplified thanks to improved technology. Today's machines default to smaller, more portable sizes; there are more and better battery back-up options than ever; and most security agents are seasoned when it comes to identifying CPAP as the medically necessary device it is, meaning fewer roadblocks for you while you're en route.