Using cpap on-board flight

Reply

Old Apr 10, 10, 1:10 pm
  #31  
 
Join Date: Dec 2005
Location: PDX...most of the time.
Programs: F9 Ascent, UA, AA, AS, ICH PA, Hertz PC.....
Posts: 190
What I mean is that, according to my doctor, my sleep issues are fairly moderate, and that the setting of 10 in H2O was fairly conservative. And, I've had friends much higher... However, since you posted I've done a bit of web searching and see that at least one website describes the average pressure for CPAP therapy as 10 cm, or around 4 inches. Guess it's time to chat with my doctor again. Weird thing is, although the CPAP does test as accurate, 10" feels really low to me...not like when I started therapy, when 10 felt like it was popping my ears etc when it came on. As mentioned above, I've actually had it in to confirm the setting.

I use a full face mask, as I tend to have a lot of sinus issues. I might be able to use a nasal mask now, but when I started, I was having a lot of problems with open-mouth...

RFT
RFTraveler is offline  
Reply With Quote
Old Apr 10, 10, 1:13 pm
  #32  
 
Join Date: Dec 2005
Location: PDX...most of the time.
Programs: F9 Ascent, UA, AA, AS, ICH PA, Hertz PC.....
Posts: 190
Boy, do I feel like an idiot...

I looked really close at the display, and it's 10.5 cm H2O, not inches...

Sorry...

RFT
RFTraveler is offline  
Reply With Quote
Old Apr 10, 10, 3:38 pm
  #33  
Suspended
 
Join Date: Jan 2002
Posts: 22,791
Originally Posted by RFTraveler View Post
Boy, do I feel like an idiot...

I looked really close at the display, and it's 10.5 cm H2O, not inches...

Sorry...

RFT
Don't feel bad. Anyone can make a mistake. NASA lost a $125 million mars orbiter due to the same issue of conversion between metric and English units. Traditionally scientists, especially physicists, use metric units while engineers, structural, mechanical etc. are more at home with feet pounds and seconds, along with BTu's. Lockheed provided data in English units, which NASA assumed was in metric units.

Originally Posted by RFTraveler View Post
What I mean is that, according to my doctor, my sleep issues are fairly moderate, and that the setting of 10 in H2O was fairly conservative. And, I've had friends much higher... However, since you posted I've done a bit of web searching and see that at least one website describes the average pressure for CPAP therapy as 10 cm, or around 4 inches. Guess it's time to chat with my doctor again. Weird thing is, although the CPAP does test as accurate, 10" feels really low to me...not like when I started therapy, when 10 felt like it was popping my ears etc when it came on. As mentioned above, I've actually had it in to confirm the setting.

I use a full face mask, as I tend to have a lot of sinus issues. I might be able to use a nasal mask now, but when I started, I was having a lot of problems with open-mouth...

RFT
I chose a full face mask also primarily because even if my sinuses had some issue, I would still get appropriate therapy. My respiratory therapist had set my CPAP unit to not sound an alarm if it detected a leak. I found out after a week, that my usage was skewed with 50 hours of CPAP usage, I had received only 4.5 hours of therapy, which meant the mask was leaking 90% of the time.
I then set the unit to sound an alarm if it detected a (steady) leak. I was able to find ways to adjust the mask so that there was no leak. After a few months the straps had been tightened so much that the mask left a mark on face that lasted most of the day, my neck started to hurt and the mask would still leak. My beard did not help either. The mask had to be adjusted almost every day as the beard grew. I tried nasal pillow, I guess that's what you call nasal mask. I did not like that at all. I felt that the air was rushing too fast through my nostrils. I then found a mask made by Resmed, called Activa. The air pressure inside the mask creates a seal between the face and the mask. It worked perfectly, until I got the bipap/vpap. The two nights that I have used it so far there have been many leak alerts, on an average of about 3 per hour. Changing the orientation of the face usually eliminates the leak.
I take it we are in agreement that a pressure of 16 cm of water is not light?
So the question becomes, "who is a candidate for a BiPAP machine?". In general anyone with a relatively high CPAP pressure setting is a candidate for bilevel therapy. For example, if a CPAP user is prescribed a CPAP pressure setting of 16 cm H2O, then the maximum pressure support (or pressure relief) you could expect to experience with a technology like C-Flex is a drop of approximately 3 cm H2O, leaving you with the task of exhaling against a pressure of 13 cm H2O. For some CPAP users, an exhalation pressure of 13 cm H2O is uncomfortable. For others, it's simply just not possible.
A closer look at bipaps.
When I was first diagnosed with OSA, my biggest concern was whether I would be able to tolerate the pressure during exhalation. I asked the person who gave me the CPAP if I needed a bipap. She told me that the unit they gave me is what the doctor prescribed. I thought she, as well my doctor, both were a part of the sleep lab. This past week, I found out it wasn't so. The person, who I thought was my respiratory therapist, actually worked for a vendor that the sleep lap works with, and is an approved vendor for many insurance companies. The vendor sells a limited variety CPAP units. By limiting the number of types and manufacturers, the vendor presumptively gets a better deal and is also able to, at least, claim, that they can provided a better service at a lower cost. Having a vendor rep on site in the sleep lap helps patients as they get the therapy unit and service from the same place. I wanted to get a unit that has an integrated battery with the CPAP unit but I couldn't because the vendor did not supply or stock them.
On the other hand, whenever I have an issue with the mask, I go to the sleep lab and see the therapist/vendor rep. I get to try different masks without having to buy one.
I have not found a bipap/vpap that has an integrated battery. There is a cpap with a battery though. AEIOmed makes a CPAP Unit, Integrated Humidifier, Battery Pack and DC Power Adapter for just over $500, which would be ideal for travellers as some airlines allow you to use a CPAP with a battery only.

I have noticed that swallow some air during the night. Most mornings, I announce my arousal a big burp..
Yaatri is offline  
Reply With Quote
Old Apr 10, 10, 9:56 pm
  #34  
 
Join Date: May 2003
Location: Virginia
Posts: 1,549
Originally Posted by RFTraveler View Post
What I mean is that, according to my doctor, my sleep issues are fairly moderate, and that the setting of 10 in H2O was fairly conservative. And, I've had friends much higher... However, since you posted I've done a bit of web searching and see that at least one website describes the average pressure for CPAP therapy as 10 cm, or around 4 inches. Guess it's time to chat with my doctor again. Weird thing is, although the CPAP does test as accurate, 10" feels really low to me...not like when I started therapy, when 10 felt like it was popping my ears etc when it came on. As mentioned above, I've actually had it in to confirm the setting.

I use a full face mask, as I tend to have a lot of sinus issues. I might be able to use a nasal mask now, but when I started, I was having a lot of problems with open-mouth...

RFT
You can always try a chin strap with a nasal mask, or some people even use Poligrip tape to tape their lips together. Opening your mouth when using a CPAP is the worst type of cotton mouth you can have. LOL!
I love my little Resmed machine. Even though my pressure is pretty high I don't have any problems exhaling against it, it's got the EPR feather that lowers the pressure automatically when you're exhaling so you're not trying to fight a tornado when you're breathing out. I only used the ramp feature for a couple of nights, now I just start out at full throttle and fall asleep within minutes.
I have tried a variety of masks and the one I love the best is the Ultra Mirage II. I have an Activa and really love it, except that it kills the bridge of my nose and I can only stand to wear it a couple of nights before my nose is almost blistered. I want to try one of the gel masks, those look pretty comfy.
There are several sleep forums on line, but the best one I've found so far is on www.cpap.com They sell everything from machines to masks to accessories and have a great forum where you can get answers about anything related to OSA and equipment.
GalleyWench is offline  
Reply With Quote
Old Apr 10, 10, 9:59 pm
  #35  
 
Join Date: May 2003
Location: Virginia
Posts: 1,549
Originally Posted by Yaatri View Post
Don't feel bad. Anyone can make a mistake. NASA lost a $125 million mars orbiter due to the same issue of conversion between metric and English units. Traditionally scientists, especially physicists, use metric units while engineers, structural, mechanical etc. are more at home with feet pounds and seconds, along with BTu's. Lockheed provided data in English units, which NASA assumed was in metric units.


I chose a full face mask also primarily because even if my sinuses had some issue, I would still get appropriate therapy. My respiratory therapist had set my CPAP unit to not sound an alarm if it detected a leak. I found out after a week, that my usage was skewed with 50 hours of CPAP usage, I had received only 4.5 hours of therapy, which meant the mask was leaking 90% of the time.
I then set the unit to sound an alarm if it detected a (steady) leak. I was able to find ways to adjust the mask so that there was no leak. After a few months the straps had been tightened so much that the mask left a mark on face that lasted most of the day, my neck started to hurt and the mask would still leak. My beard did not help either. The mask had to be adjusted almost every day as the beard grew. I tried nasal pillow, I guess that's what you call nasal mask. I did not like that at all. I felt that the air was rushing too fast through my nostrils. I then found a mask made by Resmed, called Activa. The air pressure inside the mask creates a seal between the face and the mask. It worked perfectly, until I got the bipap/vpap. The two nights that I have used it so far there have been many leak alerts, on an average of about 3 per hour. Changing the orientation of the face usually eliminates the leak.
I take it we are in agreement that a pressure of 16 cm of water is not light?

A closer look at bipaps.
When I was first diagnosed with OSA, my biggest concern was whether I would be able to tolerate the pressure during exhalation. I asked the person who gave me the CPAP if I needed a bipap. She told me that the unit they gave me is what the doctor prescribed. I thought she, as well my doctor, both were a part of the sleep lab. This past week, I found out it wasn't so. The person, who I thought was my respiratory therapist, actually worked for a vendor that the sleep lap works with, and is an approved vendor for many insurance companies. The vendor sells a limited variety CPAP units. By limiting the number of types and manufacturers, the vendor presumptively gets a better deal and is also able to, at least, claim, that they can provided a better service at a lower cost. Having a vendor rep on site in the sleep lap helps patients as they get the therapy unit and service from the same place. I wanted to get a unit that has an integrated battery with the CPAP unit but I couldn't because the vendor did not supply or stock them.
On the other hand, whenever I have an issue with the mask, I go to the sleep lab and see the therapist/vendor rep. I get to try different masks without having to buy one.
I have not found a bipap/vpap that has an integrated battery. There is a cpap with a battery though. AEIOmed makes a CPAP Unit, Integrated Humidifier, Battery Pack and DC Power Adapter for just over $500, which would be ideal for travellers as some airlines allow you to use a CPAP with a battery only.

I have noticed that swallow some air during the night. Most mornings, I announce my arousal a big burp..


I can so relate to that! Being that this is mostly a flying forum, you can compare it to a rapid decompression on an airplane! LOL
GalleyWench is offline  
Reply With Quote
Old Apr 11, 10, 12:00 am
  #36  
 
Join Date: Dec 2005
Location: PDX...most of the time.
Programs: F9 Ascent, UA, AA, AS, ICH PA, Hertz PC.....
Posts: 190
Tried the chin strap with the nasal mask (the one that uses air pressure to make the seal. Never could get it right, and with my sinus issues, sometimes end up breathing through my mouth anyway... You're right: the pressure-driven open mouth dryness is unbelievable. I felt like if I held my breath with my mouth open, the air ran in my nose, turned around and went right back out my mouth.

Like I described, I kicked up the low pressure on the ramp by a few cm and shortened the ramp time way up. And at that, I often just start on full.

It's also pretty crazy - I had felt for weeks that the pressure was too low, even had it calibrated at the place I got it (was like 0.1 cm low). When I figured out how to kick it up just 1/2 cm, I actually slept better...and that experiment was a whole lot cheaper than another study! I may try a little more experimentation...

I use an Ultra Mirage also and am pretty happy with it. Awkward to travel with the whole mess, but I've got it pretty much down now. The one trip where I forgot the power adapter was kinda uncomfortable, though.

RFTraveler
RFTraveler is offline  
Reply With Quote
Old Apr 11, 10, 8:30 am
  #37  
iff
 
Join Date: Jan 2002
Posts: 2,335
Originally Posted by GalleyWench View Post
some people even use Poligrip tape to tape their lips together.
<raising hand> Count me among them! It works well for me, but my pressure isn't all that high. My Ultra Mirage II wasn't working for me anymore, and I was happy to switch to nasal pillows but needed to make sure my mouth stayed closed.

I second the recommendation of cpap.com and their forum cpaptalk.com.
iff is offline  
Reply With Quote
Old Apr 11, 10, 2:54 pm
  #38  
 
Join Date: Jun 2008
Posts: 934
And might I draw your attention to the excellent British Snoring and Sleep Apnoea Association who have an excellent website and forums http://www.britishsnoring.co.uk
Alsacienne is offline  
Reply With Quote
Old Apr 11, 10, 6:39 pm
  #39  
 
Join Date: Apr 2005
Location: san jose,calif
Programs: AA explat,Adm Club,Priority Club, and all nonsense in my comic book mind.
Posts: 555
I'm so happy to have found this thread. I've just been diagnosed with sleep apnea and planning a 3 wk trip to europe this summer mostly getting around by train...which means i'm limited as far as luggage etc. the unit i have takes up almost 1/3 of my luggage. So the information about the smaller /lighter unit sounds great..I'm going to run it by my doc. I do have another question..I was thinking about bringing some sort of power strip...which would be equivalent to an extension cord.. i have converter of course..would this overstress a converter..especially if i was charging something (computer whatever) while i was sleeping. (I am from US).

Has anyone had experience with carrying on/ using on AA flight??

And the next biggie: Canada. I'm going to Canada in 2 months...They apparently have some draconian security measures and restrictions in place...anyone have experience with Canada-Us travel?? Thanks in advance.

Pat
retirementdreams is offline  
Reply With Quote
Old Apr 11, 10, 7:57 pm
  #40  
Suspended
 
Join Date: Jan 2002
Posts: 22,791
Originally Posted by GalleyWench View Post
[/I][/B]

I can so relate to that! Being that this is mostly a flying forum, you can compare it to a rapid decompression on an airplane! LOL
Similar, but not quite. Difference is that between $10k and a million $. Both sums represent large amount of money.
In an aircraft decompression at 30,000 ft, pressure drops by 400 cm, hundred times the difference in a bipap, Decompression from 20 cm of pressure is 20 times less than that in an aircraft decompression.
Yaatri is offline  
Reply With Quote
Old Apr 11, 10, 9:50 pm
  #41  
Suspended
 
Join Date: Jan 2002
Posts: 22,791
Originally Posted by GalleyWench View Post
You can always try a chin strap with a nasal mask, or some people even use Poligrip tape to tape their lips together. Opening your mouth when using a CPAP is the worst type of cotton mouth you can have. LOL!
I love my little Resmed machine. Even though my pressure is pretty high I don't have any problems exhaling against it, it's got the EPR feather that lowers the pressure automatically when you're exhaling so you're not trying to fight a tornado when you're breathing out. I only used the ramp feature for a couple of nights, now I just start out at full throttle and fall asleep within minutes.
I have tried a variety of masks and the one I love the best is the Ultra Mirage II. I have an Activa and really love it, except that it kills the bridge of my nose and I can only stand to wear it a couple of nights before my nose is almost blistered. I want to try one of the gel masks, those look pretty comfy.
There are several sleep forums on line, but the best one I've found so far is on www.cpap.com They sell everything from machines to masks to accessories and have a great forum where you can get answers about anything related to OSA and equipment.
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.
Originally Posted by iff View Post
<raising hand> Count me among them! It works well for me, but my pressure isn't all that high. My Ultra Mirage II wasn't working for me anymore, and I was happy to switch to nasal pillows but needed to make sure my mouth stayed closed.

I second the recommendation of cpap.com and their forum cpaptalk.com.
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.

Originally Posted by Alsacienne View Post
And might I draw your attention to the excellent British Snoring and Sleep Apnoea Association who have an excellent website and forums http://www.britishsnoring.co.uk
Thanks Alsaciene. British masks have to have a different design to make accommodations for their accent in snoring.
Yaatri is offline  
Reply With Quote
Old Apr 13, 10, 12:29 am
  #42  
 
Join Date: Jun 2008
Posts: 934
To Yaatri ...
Alsacienne is offline  
Reply With Quote
Old Apr 17, 10, 2:40 am
  #43  
 
Join Date: Sep 2003
Location: LAX, PSP
Programs: SPG & CO Plat.
Posts: 3,139
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.

Carriers, except for on-demand air taxi operators, who conduct passenger services must allow, on all aircraft with a capacity of more than 19 seats, any passenger with a disability to use a ventilator, respirator, CPAP machine, or an FAA-approved POC, unless either the device does not meet FAA requirements for medical portable electronic devices and does not display a manufacturer’s label that indicates the device meets those FAA requirements or the device cannot be stowed and used in the passenger cabin consistent with TSA, FAA, and PHMSA regulations.
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?
FatManInNYC is offline  
Reply With Quote
Old Apr 17, 10, 5:32 am
  #44  
Suspended
 
Join Date: Jan 2002
Posts: 22,791
Originally Posted by FatManInNYC View Post
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.
Yaatri is offline  
Reply With Quote
Old Apr 17, 10, 5:58 am
  #45  
FlyerTalk Evangelist
 
Join Date: Sep 2003
Location: Location: Hyatt "Giggity-Giggity", UA Silver, HH Diamond, IHG Plat, BW Diamond
Posts: 23,315
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.
Jaimito Cartero is offline  
Reply With Quote

Thread Tools
Search this Thread