That is certainly the case on U.S. airlines. FAA regulations (and certifications), however, are not generally compulsory outside the U.S. on non-U.S. airlines.

Just as pseudoephedrine (Sudafed) is an over-the-counter drug and possession is legal in the U.S., yet possession is a crime in Dubai, each country is free to set its own laws. It is simply one of the things you need to deal with when traveling internationally.

While I appreciate that you want to be able to use your CPAP without restriction worldwide on every airline you might fly, just as I would like to be able to carry pseudoephedrine when I travel to Dubai, that is not how the world works.

Your analogy breaks down and completely do not apply in this situation because neither CX nor HK law bans CPAP on planes, CX just made it very hard to use them on the air craft. The argument is not wether CPAP should be legal by HK or CX or not, approved models are legal, period.

There should be no reason why CX couldn't just have something on the web, for example, for customers to key in their CPAP information (brand, model number, etc.) and CX instantaneously know their CPAP is air-worthy or not.

By the way, I'm told by Resmed (most popular CPAP maker) all CPAP machines (Resmed or other brands) are air-worthy and approved by FAA or EU-equivalent. This is why Resmed was kind of shock when I asked them about the hassle and wonder if this is air industry wide. There are no models out there that aren't approved. Interesting....

You're still looking at it backward. CPAPs are not permitted unless and until they are approved by CX or HK regulatory authorities. Certification elsewhere is meaningless. It's not a matter of what is banned. It is a matter of what has been approved.

Can't disagree with that, but perhaps the reason is that CPAPs are so seldom used in-flight. With about 4-million miles under my belt, I have seen one used on an international flight. One.

Are they approved by CX or HKG regulatory authorities? That's all that matters when you fly CX.

Can't disagree with that, but perhaps the reason is that CPAPs are so seldom used in-flight. With about 4-million miles under my belt, I have seen one used on an international flight. One.


The fact that CX and most other airlines have adopted policies regarding the inflight use of CPAP machines would suggest there is more demand than your observations would indicate.

CX would know better than I, and I can't affirm that I have seen every CPAP in use on every flight, but I don't think it is legitimately debatable that CPAPs are not in wide-spread use on flights. It's a niche issue

For those who need them, however, it is obviously a significant issue to them.

I find it funny that is the author actually trying to tell us everytime he flies he goes up and down checking everyone making sure if someone is using CPAP or not? Planes head to tail? Heh heh.

So let me get this straight, we've know now that Lithium battery when not store property is a definite fire hazard and has already caused a few on-board fires, is still not regulated less than a "warning". But CPAP, which to date has not caused any problems on-board, and the technology is exponentially safer than a lithium battery, gets all kinds of grief? Talk about twisted priorities.

Care to point to where I said any such thing? Heh, heh indeed.

Perhaps you need to learn a little more about aviation safety before you rant.

CX gives you a procedure to use your CPAP. You apparently don't want to be bothered to follow that procedure. Maybe you should fly an airline other than CX in that case.

I am not sure you meant on CX only or all other airlines too. I guess the reason why there are so few passengers using CPAP on board of CX flights is because it is really tedious. I have applied before, it was usually a 3 days job. I have to call reservation first and then send in the manual at least twice and explain to at least 2 different departments. I have not bothered to use the machine on board any more. It's not worth the time being wasted.

BA treats cpap as a notebook, no need to apply at all. On the last flight I took to LHR, there were 3 pax (including me) using CPAP on board. So go figure.

That's good information on BA. I'll start using them for my London flights. I could not agree more with your comments regarding the tedious and unnecessary arrangements CX requires for inflight CPAP use.

Have you looked into obtaining a FREMEC? I'm curious to know if this would remove the need to call CX before every flight.

I'll just call that "incredible".

Couple of data points:

I have flown JFK to Taipei/hk/Bkk via Eva air for last few yrs, always use Cpap inflight without issue. Once in a while on ANA, which does require a 24 hr notice.

Last month Eva flight delayed so switched to. CX flying Hk/JFK, dreaded sleeping without my hose, guess what - plugged it in, put on my mask and slept 7 hrs without incident!:)

On recent UA flight to Tokyo, FA came over after I slept and we traded info re Cpap models and masks. He flies with one for past 15 yrs.

I am in business class, Ymmv.

A few years ago there was no problem using a CPAP on-board, then they insisted on contacting the airline and using a battery, now its possible to just plug in again. I am thinking that F.A. comments might be a function of which class one is flying. I have flown six flights in F without a battery with no problems or comments whatsoever. I just plug in and pull the duvet over my head.

Total ignorance, battery is MORE POTENTIAL FOR FIRE than just plug it in the power outlet. What's wrong with them? Don't they at least do some research before making dumb rules?

Lugging that battery and charger around was a PITA. It also wasn´t cheap to purchase.

I tried the "call for pre-clearance" policy on a recent flight in first class from London to Hong Kong.

The good:
I used my CPAP machine inflight without being accosted by the flight crew. I plugged in and had a great snooze without incident.

The bad:
Getting clearance was a painful ordeal.
My journey to on-board sleep started when I called CX reservations and spent close to 30 min on hold. The agent who eventually answered had absolutely no idea what I was talking about and had to speak to a supervisor. Another 10 minutes on hold. Then the agent came back asking me to spell out CPAP in long form. He then disappeared for another 10 minutes and the call dropped. 50 minutes on the bloody phone and still no further along. I thought they may call me back or send me an email, but nothing.

I called again and waited 20 minutes before giving up.

The next morning I called in again and waited 15 minutes before getting an agent. Again, no idea what I was talking about and no record of my call the day before. Better prepared this time, I helped the agent navigate to the spot on the CX website where they publish CPAP information. Back on hold for 10 minutes, agent back on the line to ask more questions, back on hold for 10 more minutes, more questions. Finally the agent came on and asked if I could use a battery of if I had to plug in to the aircraft power. I don't have a battery, so I said power. He replied that if I told him I would use a battery, he could approve. So I did. (very Hong Kong way of approaching the rules).

Update: I called CX reservations for cpap clearance on my next flight and was told that it is no longer necessary to get permission as long as the Cpap unit does not use the aircraft's power supply. Happy days. Let's see what happens onboard!

My 'hope' is the left hand doesn't know what the right hand is doing. Plug it in and see what happens. Good luck!

July Update
 

Interesting call with USA toll free customer service number. She was extremely knowledgable, professional and cleared me for upcoming trip with approval to use power source. She did ask if I had battery backup in case power plug not working; I said yes, LOL :)

Took 5 minutes. Will report back if I encounter any problems.

CX 841 on Thursday went smoothly. Plugged in my S8 and slept a few hours without any problems. Chief Purser actually woke me up to 'ask if the power' outlet was working properly????

Interesting
 

I was on a long haul CX flight this week and saw three biz class passengers using CPAP (including me). And two were plugged in to the aircraft power supply. I bought an expensive battery powered unit to comply with the ever-changing rules, which appear to have either changed again or at least are not uniformly applied.

Not CX specific, I bring my battery pack with my travel Trenscend CPAP. If there is power, I use that. If no inflight power is available for use then I am still covered.

Be Prepared!

CX changed [yes, apparently flip/flops back and forth -- again] policy and now permits using on-board power. To be on the safe side, call ahead to advise them and go to their website and print out the relevant information as backup.

Using CPAP on board
 

For those with mild sleep apnea, talk to your doctor about an oral appliance. Can be an effective way to treat without CPAP, and much more portable (and comfortable).

More portable yes, more effective no. Sleep Apnea is the constant shut down of air flow, any good doctor will tell you oral appliance will only help, but not eliminate the problems of sleep apnea brings (lack of enough oxygen intake during sleep.) CPAP is the way to go if you don't want to have brain and heart damages caused by sleep apnea, even for mild.

Depends on your situation-- if you have a mild case, the oral appliance can be perfectly effective for keeping your airway open without the need for CPAP. It's a potential option, and of course I'm not a doctor, but to say that an oral appliance can't be enough to treat sleep apnea is misleading.

FAA & CPAP
 

Does anyone have any links to online FAA documents allowing passengers to use CPAP machines on board flights and particularly, use them with the aircraft's AC power supply?

Also, does anyone have any experience on using CPAP machines on JAL (in Business Class)? I used mine several times without incident, but on my last JL flights (NRT-SAN), the FA threw a fit when she saw me plugged in.

I believe cpap usage stateside is associated with disability act and not FAA per se. I don't believe CX has to abide with either the DA or the FAA as not a US carrier.

I used on JAL flight several years ago and had to call ahead to register the model of my device.

IIRC

You are allow to use a FAA approved CPAP by the DA. This include all US flagged carriers. I carried a copy of my Resmed 9's FAA certificate and bring my own power. The airline is not obligated to provide power.

JAL and CX are not covered by FAA nor DA unless the origin and destination are US airports.

Have you ever gone 24hrs without sleep? While sleep apnea may not be life threatening all the time it would certainly be a quick way to ruin the first few days of a vacation.

Sleep Apnea is actually life threatening. The patient can go without breathing (for anytime to 15s - 60s) when asleep and then subsequently brain damage (due to insufficient Oxygen to brain) or RIP eternally.

Which is why I'm shock some airlines actually bans CPAP use. I think USA it's mandatory airlines have to provide means for people with Sleep Apnea ability to use CPAP, and carrying a CPAP case up to the airplane is NOT consider extra baggage.

People do not realize the severity of Sleep Apnea and the damages that it causes to the person's brain, and in some cases, death. It is said most historical peoples that "died in their sleep" (not at really old age, but relatively younger age) were probably people with Sleep Apnea.

Sleep Apnea is not just the fact that you can't get quality sleep, but the fact that you stop breathing and your body don't get oxygen (hence lack of quality sleep), and especially causes brain damage and heart damage (lack of oxygen also damages the heart)

A reminder - their are two types of sleep apnea - obstructive and central.

A CPAP machine does work for obstructive apnea. Its effectiveness against central apnea is less clear, though additional oxygen through higher air flow is always a plus.

IANAD, but the arguments I have had with my GP have been instructional for both positions.

Happy wandering

Fred

Warning...
 

I was shaken out of a sound sleep and ordered to stop using my CPAP machine onboard a flight today. I was surprised to say the least as I've been using this same machine on my 15+ annual flights for many years without incident. I was told several years ago that I no longer needed to do pre-registration as CX had noted CPAP use in my profile.

However, I was curtly informed by the flight purser that CX once again requires pre-registration 48 hours before flying to use a CPAP machine onboard.

Back on land, it took me four calls and more than an hour on the phone with clueless people at CX to conclude that the only way around the requirement to pre-register is to see a doctor, complete a MEDA form and then obtain a FREMEC card.

I don't know what's more frustrating: 1. Cathay's ever-changing policies on CPAP use; 2. The universal ignorance of CX staff in regards to the ever changing policies and the resulting haphazard application; 3. The ridiculous level of medical clearance required to get a FREMEC for sleep apnea.

If you use CPAP and fly CX, forewarned is forearmed. Or, you can also move to airlines with less idiotic policies towards CPAP machines (i.e. any other carrier). It will be the latter move for me.

However in general most countries aviation bodies recognize FAA/EASA certification for purposes of allowing equipment to be used. For example most seat belts are simply certified to meet FAA standard, regardless of the country/airline. However it's still legal to use them since the countries recognize the FAA standard.

Then don't take a 24hrs flight with it? Problem solved.

I have flown hundreds of long (10-16 hour) flights without using my cpap machine.

Most of my US-Asia trips have me awake from 30-38 hours depending on routing and layovers. I've only used my CPAP on two flights. Not really comfortable using it, even in F. I don't think I slept more than 3-4 hours on a flight with it.

Yes, and if flying to Asia means you're at constant risk of death should a machine not work or the battery runs out I would argue that doing so may be a bad idea.

On board WiFi
 

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Good news, CPAP users. I complained to CX and asked them to revise their CPAP policies. I was shocked to receive a call from the airline agreeing with me. Lo and behold, the policies have, in fact, been changed!

First, you no longer need to call 48 hours in advance to clear CPAP use if you have a FREMEC card.

"If you are a regular traveller onboard Cathay Pacific or Cathay Dragon, you can apply for a Frequent Travellers Medical Card (FREMEC). If you hold a FREMEC card, you no longer have to submit the details of your device each time you fly with us, provided there has been no change in your condition or the assistance required."

Second, they now clearly state CPAP users do not require medical clearance.

" Passengers who only require the use of a CPAP or BIPAP machine inflight do not need medical clearance."

Third, and this is really good, you can use in-seat power for your device:

"For non-critical medical portable electronic devices (e.g. CPAP or BIPAP machines, nebulisers, neurostimulators, HR/BP monitors, syringe/feeding pumps, suction devices and aspirators, external or transcutaneous nerve stimulators e.g. TENS machine), please note the following:
All non-critical medical portable electronic devices can either be connected to the inflight laptop power 110VAC outlets (where available) or be self-powered using approved dry-cell or gel-type battery packs in accordance with all applicable regulations."

On this last point, your device may draw more power than the laptop outlet can manage, but it's worth a try. I used to make use of the seat power back in the days before it was outlawed.

Happy days.