Oh tell me about the cottonmouth. My new bipap, which I have used for only two nights has been beeping a lot due to air leaks. I have also been having really bad cotton mouth. I need to start using the chin strap that I bought a few months ago. I never had a problem of opening mouth until my pressure was raised. Thanks for the link. I used to sleep with the full face Mirage Quatro. I prefer a full face mask as it works even when you have a cold and you have to breath through the mouth. It leaked a lot.
Thanks for the link. I tried nasal pillows, but I couldn't tolerate it as my pressure was quite high and now it's higher.

Thanks Alsaciene. British masks have to have a different design to make accommodations for their accent in snoring. ;)

To Yaatri ...;)^

Certified machines
 

Technically, there are no "certified" CPAP machines, at least as that term is defined at law.

The Air Carrier Access Act does give you the right to use your CPAP, but only if that CPAP has undergone rigorous testing approved by the FAA.

emphasis mine.

The testing is cost prohibitive, hence none are certified and none bear the required label.

Read more about the ACAA here.

Some airlines maintain their own list, but that list is not ubiquitous across all carriers.

RE: Delta. I witnessed a man using a Everest 3 on a fairly recent NRT-JFK, so perhaps there is some leeway?

I agree with most of your thread except the testing part.
The word "certified" is used loosely. You are right, testing costs money, but Resmed has tested quite a few of its units for EMC (ElectroMagnetic compliance) under DoT rules and are now considered FAA compliant. Think FAA compliant when you read "certified." See the sticky for details. We shouldn;t be arguing about semantics here.

I've had a cpap for 11 or 12 years. I've never used it on a plane, though. I saw one used on a CX flight a couple of weeks ago, as well as a KLM flight the week before.

I usually just stay mostly awake for the 30+ hour trips I seem to take. Needless to say it takes a few days to get back to normal.

Still, better than falling asleep driving which led to my first and only sleep study. My machine alarmed 'red' the last I returned from Asia. It's done this before as well as a few yellow alarms.

I was considering that as my travel unit, but I have now been put on a bipap. The battery won't last long with the humidfier. As it is cabin air is so dry that using a cpap without the humidifier will dry yiour throat and sinuses. One might be better off not using a cpap on an aircraft.

Or, you can use saline gel or saline spray before dozing off. @:-)

My DME provider suggested "Ayr" brand and it has worked fine. I haven't used on a flight yet, but have travelled without the humidifier with no issues.

http://www.amazon.com/Ayr-Saline-Nas.../dp/B000052X6G

Thanks for pointing me to the sticky (in a separate response) about certified machines - I literally bought my new machine last month and every manufacturer and every DME provider I called told me there were none that carried the label.

Thanks for the idea about the saline gel or saline spray. What about the throat. MY throat becomes very dry too and hurts from dryness.
How many different brands/models does your DME provider carry? Are you tied to selecting only those brands/models your DME carries? My provider has been reluctant to supply anth unit other than those that they carry.

I too mostly stay awake. I have a great deal of difficulty falling asleep in BIz seats. I doze off for longer periods sitting up in coach as well as biz than I do lying down in biz seats

I have had 5 sleep studies since July 2007. I paid for the first one in India, but didn't get a CPAP in India as I didn't want to buy a CPAP in India to bring it here because of service issues. Moreover, I had crappy insurance that that time, which would not have paid for a CPAP. Finally when I did have good insurance, I talked to my doctor about a sleep study. He did not sound very enthusiastic about it. I showed him my sleep study from India. He agreed to order one since a year had passed since then. Since that study in Sept 2008, I had one done in April 2009 and another one in March 2009, which indicated that my pressure had gone up. Since I could not tolerate the high pressure, the highest setting on most CPAPs, I had to have another one done for a bipap. Eleven years is way too long to go without a sleep study. Your AHI, AI pr pressure could have changed
What does alarm "red" or yellow alarm mean?

I recently changed jobs and insurance, so I was permitted to shop for a new DME. All only played with the big brands, as that is with whom they had the negotiated deals. ResMed, Respironics, Paykel (sp?) were on all. I looked hard at the S8, but didn't like how it would look on my nightstand and I was told it did not have c-flex. In retrospect, it is how I should have gone.

Do those on the list you found now carry the FAA sticker?

I have no problem with my throat. I snort a blast of saline in each nostril and wipe on a not-too-large amount of gel and am good to go. If your current machine allows you to bypass the humidifier, give a try some afternoon for a nap, and then perhaps for a night.

I'm lucky in that I sleep well in a plane from a seated upright position. When I lean forward (think resting head on window or chest) I don't snore and get restful sleep. Indeed, for years before I got tested my best sleep came in planes and taxis.

BTW: I strongly recommend getting the routine sleep studies. I kept ramping up a .5 for several years until losing weight recently. The metric from my Dr. is once-a-year or every 50 lbs of loss or 25 lbs of gain. YMMV. Besides, Jaimito Cartero is known for providing some of the best deals and insight on this board, we all want him to stay around for a long time.

Safe Travels!

I can vouch for Ayr. I started using it when I was on O2 24/7 and was especially important when flying with O2. I use it in conjunction with my BiPap when in dry air situations (airplanes, LAS or other desert locations, heated rooms in the winter). I also recommend it to total strangers on airplanes when I see they are on O2.

My BiPap does not have a humidifier. When I fly, I try to hydrate as much as possible before going to sleep and ask the FAs to make sure there is water in my glass at all times. I have found I can get a solid 4 hours sleep if I do before my nasal passages and throat becomes totally dry. I rehydrate and go back to sleep.

My DME provider didn't carry the machine my pulmonary doc prescribed and there was a bit of a battle with the HMO to get the prescribed machine covered. I had to remain in the hospital 4 extra days until they were able to resolve the issue and get the machine. So they ended up paying an extra 40K+ on that battle they lost in the end.

Sorry to have truncated your post. I wanted to respond to the legal issue you raised before I forget what I researched. The sickr requirement is proposed but it's not been implemented yet. In my research I have found lots of information about POC's (portable oxygen concentrators). I have actually seen a document that lists e few POC's that have been approved by the FAA. It appears that the situation with other M PED's (medical portable electronic devices) is a in flux. It's also confusing as it states that once the manufacturer conducts a test to determine emission levels, in compliance with the RTCA document I have mentioned earlier, the carrier doesn't have to do any further testing. But., the carrier is still held accountable to ensure that any equipment operating on the aircraft is in compliance with the FAA EMC requirements as defined by RTCA. Kind of a catch 22. I plan to write to Resmed asking them what they plan to do with the compliance letter they published on the internet. It doesn't do us any good, unless the agencies involved, FAA and the air carriers are brought up to date. If the airline is to be held accountable, the airline needs at least a letter from the manufacturer, preferably backed by FAA.
Department of Transportation (DOT) Final Rule “Nondiscrimination on the Basis of
Disability in Air Travel” and the Use of Respiratory Assistive Devices on Aircraft The first part of this document is what you had reproduced.

Yaatri,
I was just making a bad attempt at humor, comparing that first burp in the morning to a decompression. :D

My Resmed S8 Elite's carrying case is about the size of a laptop case. When carried in that case, that bag doesn't count towards the 1 carry-on 1 personal item limit.
I travelled a lot through Europe with mine and never had a problem getting an extension cord from the hotels. You'll need one, outlets in the hotel rooms over there are very limited!

Well, I had insurance when the first study was done, but they wouldn't pay for the machine. I ended up buying a new one online, although it was pricey for me at the time.

A few years later my mediocre group insurance was gone, so I'm self insured from there. I guess I've got a bit of disdain for the US medical situation, so try to get anything done in Costa Rica or Thailand. I'm actually in Bangkok now recovering from a minor surgery I had done at Bumrungrad.

I think I was originally set at a 8.5 or 9, and had adjusted another used machine I had to about 10.5 as I got heavier.

If I don't use my humidifier (non-electric), then I am so dry, that I might as well not use the machine. I tried saline spray early on but it never seemed to do much for me.

I'm sure I also have a deviated septum of some sort, so that if I sleep on my right side, I don't do well. Unless I'm 100% exhausted, it's hard to sleep more than 10 minutes in coach. I have slept as much as an hour or two if I'm in a nice biz or fc seat. As I said, I've never used a cpap on a flight.

As for the yellow and red alarms, these are when the TSA swabs your cpap. Yellow is suspicious, red is for bomblike materials.

The sticker rule is a final rule.

As the airlines were advised by the FAA, here, that we have both cited:
What this means is that the only time an airline must, upon demand of the passenger, allow the passenger to use CPAP during a flight is when, among other things, it has a manufacturer's label (or sticker) indicating its compliance.

Of course the airlines can allow a passenger to use CPAP, but is not required to under the relevant law and regulations absent the label. This is why getting a device with a label is so important: it changes the passenger from a beggar to a boss.

Good luck with the ResMed letter, please keep us informed.

Of course, you did. But my brain played games with me. I read "Being" as "Boeing". Since I was talking about the pressure drop in a bipap, I thought you were comparing that pressure drop with decompression.

Isn't it funny how people, without any attempt at distortion, can give a completely different dimension to words they hear or read? It's almost like the game of "telephone".
We used to play that game as a kid, in another world. We called it "whisper".

Any way, I apologise. It wasn't a bad attempt at humour. I did not get it.

Yes, the rule is final. But what I meant is that the iimplimentation is in flux as the airlines have been given guidance until the "sticker" becomes a common practice.
I have read this rule again and again. The words , specifically the two condtiions, make no sense at all. I differ with your interpretation of the intent of the rule. What the rule does is place a limit on the airline as to what it may disallow. It does not put a limit on a passenger with a CPAP.
The airline must have adequate reason for denying a passenger who wants to use a CPAP. The device not meeting two conditions, conjuncted with "and" must be met before an airline can deny.
The conjunction "and" means that both conditions must be met before an airline can turn down the use of CPAP on board. the two conditions are

1. The device fails to meet the FAA requirements.
2. The device fails to display a manufacturer's label that it meets the requirements.

There are four sets of possible events:

1. The device meets the FAA requirements but does not have the label.
2. The device does not meet the FAA requirements but has a label--- an impossibility.
3. The device meets FAA requirements and has the label.
4. The device neither meets the FAA requirements, nor has the label

Both rcondtions aree met only in 4. #. is not a problem for the passenger.
2 describes a fraudulent claim by the manufacturer of a malfunctioning unit. What if the device meets only one condition, events 1 or 2?
Event 2 is a fraud and no manufacturer is going to put a label if the device does not meet the requirements. So 2 is unlikley to take place unless the unit is malfunctioning.
According to the rule, if the first event occurs, the airline cannot deny the passenger.

Oh I love the bag for Resmed S8 series bag. You can use it as a laptop bag for a mid size screen. I think, I can put the hose, the mask, the cpap, without the humidifier in the main compartment, and my netbook, the power adapter, the mouse and all its little gadgets in the front pocket.
My DME provider's rep was telling me that some people were complaining about the bag size when Resmed changed the size of the bag. I think, he was talking about the bag for the S9 series. It's much smaller.

I second the need for an extension cord, as many European hotels have their sockets, kettle (what's that do I hear you ask?) and TV on the wall opposite the bed! And take an adapter, or better one with more than one outlet socket so you can charge your mobile phone at the same time.

I am with you 100%. There is great technology here, and we spend so much, but we don;t see the benefit in terms of overall better health care. I have been diabetic, hypertensive, and had started gaining weight. I was suspected of having a heart attack. The cardiologist told me to watch what I put in my mouth. :mad: No one, NOT one doctor in the U.S. suggested that I have a sleep study. The first time I saw a physician in India, he sent me for a sleep study. He was not even my doctor. He was the the M.D. who was consulted by my surgeon. The surgeon told me that the M.D. had recommended not to perform the surgery, unless I have a sleep study done.

All the technology, the premiums I paid, the primary care doctors I had, the dictates of HMOs and MCO's. Not one had the sense to send me for a sleep study.@:-)

Don't get me started on the state of health care in the U.S. It's shameful. for 7 years in a row, I worked away from home. So either, I , or my family had to depend on out of area physicians. One plan, paid very little for out of area medical visits. This when the corporation did offer plans both areas, but I could only choose one.
This is common mis-perception and "common medical knowledge" propagated through internet. There is some corrrelation between weight and the pressure. But it's not 1. It's just like diabetes and weight. There is a correlation between diabetes and weight. Some people, think being fat causes diabetes. If you watch what you put in your mouth, you won;t "get" diabetes. :rolleyes:
Warning: I want to warn every one that please, please do not assume that your pressure has gone up as you gained weight or that it has gone down as you lost weight. I lost 45-50 pounds since last year, about 18-20% of my body weight at my highest. But guess what! My pressure went up by 25%.
Please do not change your pressure without a sleep study. There are risks of too much pressure.

People think an electric humidifier is better but non electric humidifier has many advantages.
Consumes less power, which is especially handy when you run it on battery power.
A heated humidifer puts more moisture in the air than the ambient air is capable of carrying. That increases the likelihood of rain out, which creates the need of a sock or a mitten for the hose, or of a heated hose, as Resmed has done for some of its S9 units. I have used my CPAP without a humidifier on two trips. One was to an island off the east coast of Malaysia. I figured that with monsoon around the corner, the air was humid enough. I did not miss my humidifier. On a trip to Moldova in November, I did not take my humidifier. I stayed in an apartment that had hot water radiator heat. The outside air was dry to begin with, the heat was making it even drier. Fortunately, I had plenty of towels. I soaked them all and stacked them on top of the radiator. I had no problem.

I think I too have a deviated septum. As soon as I turn on my right, I feel something shift in my nostrils and my right nostril closes. I don't enjoy the thought of having a surgery. So I will live with it.
Oh. I thought it was some sort of a warning/alarm on your CPAP. What happens when it sets of a red alarm? Test it again? I don't know if any of my stuff has alarmed. Once a screener said he was going to take my CPAP to check it out. I said, "I can tell you it works". LOL

I have seen that too. I was able to manage sleeping wioth my feet poiting towards the headboard. Now, if you forget your power chord, nothong can help you. I can't believe a person asking a speaker about it in an OSA support group meeting. :D
"My husband and I went on a cruise and forgot to take the power chord. How should we handle a situation like that?" :D
I thought ti myself, ask the steward, and if does not oblige, go over his head to the Captain, ask for an extension chord and then strangle yourself until you can sleep without a CPAP.

I know, my thoughts were harsh. But how do you help someone like that.

I understand your point, here's a clearer statement, from http://airconsumer.ost.dot.gov/rules...20382-2008.pdf

emphasis and enumeration mine.

Yes, there is some flux around how far to take the labeling requirement, as noted in document cited supra:

That debate is about whether to mandate testing, but separate from that debate is the present rule that with a manufacturer label, which by definition means that all other conditions are satisfied, a carrier must permit the use of the CPAP.

The label is the pass-card to empowerment.

Okay, I'll fess up. I once left my power cord at home and discovered it when I unpacked in the room. Rookie error and I was just crushed. Now I don't know what your power cords look like, but mine looks exactly like the power cord for a desktop computer. I asked the front office if they had a spare laying about as most offices I've been in it seems there is a whole box of them. After several hours of looking they didn't find a single cord. Crushed and devastated that the trip had been ruined by my stupidity I went back to the room to pack. A lightening bolt of inspiration hit me and I checked the power cord on the small digital TV in the room and lo and behold it was a perfect match. Crisis averted. Needless to say I now leave an extra power cord in the bag at all times.

I have also had to sleep with my feet pointing toward the headboard. I am not allowed to use my machine on any kind of power strip or extension cord, so I am always having to make accomodations for that.

I was going to post about this. I travel about 6 months of the year, and on 2-3 occasions <head hung in shame> have forgot to bring my power cord. Luckily, as you discovered, most use the same plug as a computer.

I recall one time when in South Africa, they didn't have any kind of adapter or anything, and after flying for a LONG time I really needed sleep. They ended up taking a cord off an old computer and splicing it a plug they had.

One other time in Argentina, I went the rounds to internet cafes offering to buy old computer power cords. It was pretty funny trying to explain it to them.

I've gotten a bit wiser now, and double check the cord.

How did you find out you needed a cpap?
 

There seems to be a lot of misdiagnosis mentioned on this thread. I guess I'm lucky that I had another relative who had been diagnosed with needing a cpap, and had a decent idea what needed to get done. He had to sleep sitting up, or he couldn't function.

Since then a number of relatives including one stubborn uncle, have gotten them.

I got very concerned after starting to fall asleep during the day, after getting 7 or 8 hours of sleep. As bad as drunk driving, I think. When I was younger I could stay up all night, and just get a few hours of sleep. Now, that won't work at all! 6 hours minimum if I'm going to be driving or working where I need to think. Obviously I can post on FT with no sleep. ;)

I was diagnosed with SOSA (among other pulmonary problems) when I ended up in the hospital near death. Not only was I falling asleep at my desk, I was also getting carbon dioxyde poisoning nearly every night and I lost about 2 years of memory due to that. I had my sleep study done after I was discharged from the hospital to confirm the diagnosis.

I guess it shouldn't have been that much of a surprise since my father, mother, and brother all had/have SOSA.

I assume SOSA is Severe Obstructive Sleep Apnoea. Severe is broad range as AHI>30 is rated severe. I fell asleep at my desk a few times, but I attributed it to other causes. I wonder if it was OSA. I was homeless during those days after Katrina. I had a job but no place to live. I slept in my car, my office, or in a bed when some acquaintance was generous enough to invote me into their house from a day to a few days. I was diagnosed with OSA after that. I had become used to living sleep deprived.

It's great that UA delivers power for CPAP/BiPap. Many airlines that allow use of the device on board say it has to be used on battery power. I don't understand that becuase power draw, of a CPAP/BiPAP is about the same as a laptop. What kind of BiPap do you use? I use ResMed VPAP Auto25.
This maybe the reason for me to switch to Star Alliance from SkyTeam. It would be a big move as I am a million miler with them.

I use the Respironics Synchrony ST BiPap. The ST version is more sophisticated (and $$$) than the standard BiPap as it serves as a mini-respirator.

I feel very fortunate that UA was my preferred carrier at the time I was diagnosed. When I read about other airlines and their rules and restrictions I am so very happy to have the UA AeroMedical Desk to take care of me. Granted the extra steps of having to get on board early, educate the flight crew, and check to make sure the power is operating properly while the mechanics are still there is a pain, but in the end it's all worth it.

Continental movement?
 

Continental seems to be moving towards Yaatri's interpritation of the Carrier Access rules.

Formerly, the website was very clear that the manufacturer's label certifying compliance was required. Now, it shows some flexibility.

However, the "Ask Alex" feature still uses the old language.

Flying JAL for first time in almost 25yrs, this weekend on JAL 005 JFK/Narita, then connecting on to Saigon. Talked with their CS and confirmed that for Narita sector,can use on-board power for my cpap machine.

They asked for my specific brand, model number before confirming above. Excellent, considering they didn't have anything listed on their website re disability travel!

Some CPAPS/BiPaps raise the pressure incrementally to the level necessary to keep your airway open. If your airway opens at a pressure lower than your prescribed pressure, it stays there until it's necessary to increase it. That ensures that you don't get too much pressure, as there are disadvantages of using respiratory devices. Some also sense if you forget to breathe (central apnoea) and forces you to breath. Does your SOSA have significant CSA also? I don't think my insurance company will approve an expensive machine like yours unless I were being treated for CSA. But I might be wrong. I had seen $5000 machines but I never thought to ask for them.

Sorry, I wasn't making any judgment about people who forget to take their CPAP chord with them. This couple raised this issue 4 times over the course if 4 different meetings. It just irritated me.

You are right about misdiagnoses. One cause is that insurance companies spend more time and energy on forcing doctors to save the former money rather than allowing them to treat patients. My internist in MS did no more than blood tests, as they were done the lab in-house. He made enough money through lab tests and did not worry about anything else.
This is how I was diagnosed.
I am the only one in my family to have been diagnosed with OSA. I was forced to undergo a sleep study on insistence of an MD who was consulted by my surgeon in India, as I was diabetic, hypertensive, had enlarged heart, was on medication to control my lipids and was obese, with a BMI of 41. That sleep study diagnosed me to be suffering from severe OSA. A couple of years earlier, had had a minor surgery in the U.S. to remove a kidney stone when my medical history circumstances were essentially the same, but I was not recommended to have a sleep study.

I think you're right about your insurance company. My doc explained to me that my brain would stop sending the signal for me to breathe and that is why I had repeated episodes of CO2 poisoning. I would wake up with raging headaches but could breathe it out. I was just forcing in O2 to clear the CO2 out of my blood. These repeated episodes caused me to lose about 2 years of my memory, unfortunately. (Boy is it embarrassing to run into people I met during that period. They are total strangers to me and are somewhat confused when I don't have any memory of them at all. I had one of those re-meetings at an FT DO this weekend).

Yes my machine is also set to start inhaling for me if I fail to inhale within a set time (determined by my doc). When the machine starts inhalation, it controls the time of inhalation and automatically decreases the pressure for exhalation within a set time. As I mentioned previously my doc had to fight for my insurance company to cover the machine and I was stuck in the hospital for several days while they argued and then the DME provider had to find one and get it shipped here.

Oh I didn't take it that way. I'm just saying that I had it happen to me. I guess it can happen to anyone. But I promise you that I check and recheck my bag before I leave the house with it. I also carry an extra oxygen bleed connector after a hotel maid broke mine and tried to hide it while on vacation in Australia last year and an extra nasal pillow (separate from the BiPap bag) after the TSA yanked out my tubing and mask from the bag and swabbed it all on a "random bag check" (that really ticked me off). I also carry a roll of medical tape in case I get a crack in the hoses or tubing.

Does anybody know what BA's policy is when people in WT require CPAP? Only WT+ and above have in seat power, is your only option to use a battery powered machine?

I have used BA in the past once for CPAP use in WT+ and all went well - 2006, but when I went to look for a journey in 2009 their T&C say that CPAP use is not allowed from the WT+ socket because the power drain is too great ... or words to that effect. I used a laptop supplementary battery in WT, and slept fine and the difference in the cost of the seats more than paid for my battery outlay. I got 5.5 hours use at 13 mB pressure.

I don't think that their power drain argument is actually valid but the fact that they state it in their T&C probably protect them if something happens when you use it for CPAP and can empower the cabin crew to stop you from doing so ....

From the BA website:

So it looks like it might be worth knowing the wattage of your machine (and having documentation to prove it), and a copy of this policy. Sounds also like if the draw is more than 75w the outlet will shut down, so there wouldn't be a lot the cabin crew could do about it.

But to the original question, in WT you'll certainly need a battery.

Finally, DElta gets it. By God Delta gets it.
 

This is in continuation of the discussion FatManInNYC
have had earlier in the thread.
On my trip to Sydney, I was able to use my CPAP on board. No one at Delta had a clue. Even a supervisor in Delta interpretd the Final FAA letter to mean that if there is no sticker it will not be allowed. I told her that no CPAPs have any stickers although I do have a letter from the manufacturer that it hyas tested the device in compliance with FAA requirements and that it c0omplies with all FAA requirements and by law, Delta must allow me to use it on board. But she kep on singing the same song like a parrot. Finally she said I would have to have it aporoved by the ticket agent at the beginning of my trip as they were the onlt ones with the discretion to allow it on board. I reminded her "Madam, it's not at anyone's discretion to allow me my right. Delta must comply with thew law or face penalties. The suggestion to show it to the agent made no sense as I was going to Sydney from DCA via DTW-JFK-LAX. The ticket agent in DCA had no control over what the gate agent in in LAX would do. Then she made another stupid suggestion. "When you get to Los Angeles, you out of the secure area to see the ticket agent". I can't believe how stupoid she was and she was a supervisor.
I had called 2 days before my flight. She was supposed to call me back the enxt day. But I never got a call back.

At LAX, I asked a lady in the sku club. She called around and then told me that I need to speak to the gate agent, named Miss XXX./ Now, MS XXX was just as bright as the supervisor. She went to another guy at the next gate. He looked through the rules on his computer and acted confused. Due to heihgtened security, he announced, it would not be allowed. I showed him the Final letter from FAA. He homed in on the sticker clause. No sticker, no go. I didn;t give up. The CRO/Station manger was called, and another lady, I don;t know who joined in to sing the chorus of "no sticker, no go. I told the CRO to read the letter very careful, before saying "NO:, because if tyhey said "NO", they would be in violation of FEDERAL LAW, that allows me to use CPAP. It's for the airline to prove that it had a valid reason to deny it to me. Then they walked away from me and huddled together to discuss. I followed them. They told me I could not be with them.
I also told them that BA, Qantas, Continetal and United are the ones I know that allow a CPAP on board. I didn;t see why Delta was so ignorant.
They then talked to the crew and then asked me. "Do you have sleep apnoea?" Duuh. I just like to carry around m,y CPAP. So, I was allowed to use it on board.