Using cpap on-board flight

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Old Apr 17, 10, 7:30 am
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Originally Posted by FatManInNYC View Post
RE: Delta. I witnessed a man using a Everest 3 on a fairly recent NRT-JFK, so perhaps there is some leeway?
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.
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Old Apr 17, 10, 8:32 am
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Originally Posted by Yaatri View Post
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.

Last edited by FatManInNYC; Apr 17, 10 at 8:37 am
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Old Apr 17, 10, 9:21 am
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Originally Posted by FatManInNYC View Post
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.
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Old Apr 17, 10, 9:31 am
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Originally Posted by Jaimito Cartero View Post
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.
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

Originally Posted by Jaimito Cartero View Post
Still, better than falling asleep driving which led to my first and only sleep study.
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
Originally Posted by Jaimito Cartero View Post
My machine alarmed 'red' the last I returned from Asia. It's done this before as well as a few yellow alarms.
What does alarm "red" or yellow alarm mean?
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Old Apr 17, 10, 11:31 am
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Originally Posted by Yaatri View Post
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 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!

Last edited by FatManInNYC; Apr 17, 10 at 12:19 pm Reason: TMI
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Old Apr 17, 10, 11:47 am
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Originally Posted by FatManInNYC View Post
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.
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.

Originally Posted by Yaatri View Post
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.
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.
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Old Apr 17, 10, 9:03 pm
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Originally Posted by FatManInNYC View Post

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

Safe Travels!
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.
A. Portable Oxygen Concentrators.
(1) Until all FAA-approved POCs have labeling that confirms to air carriers that “This
device does not exceed the maximum level of radiated radio frequency interference as described in
the current edition of Radio Technical Commission for Aeronautics (RTCA) Document (DO) 160,
section 21, Category M”, air carriers are reminded that if a manufacturer tests its POC and it meets
the RTCA standard, the aircraft operator is not required to perform additional tests. However, the
aircraft operator must be able to show that the device has been tested and meets the applicable
standard, regardless of the test method used. For more information see the current edition of
Advisory Circular (AC) 91.21-1, Use of Portable Electronic Devices Aboard Aircraft at
http://rgl.faa.gov/.
Approved by: AFS-200 OPR: AFS-220
Approved by: AFS-200 OPR: AFS-220
(2) To facilitate air carriers in obtaining testing results for FAA-approved POCs, the FAA
has made available, via Web-site, the test results provided by manufacturers. This Web-site is
updated as the documents are received and may be viewed at
http://www.faa.gov/about/initiatives/c
abin_safety/portable_oxygen/.
(3) In order for a POC to be approved for use on aircraft by the FAA, it must be determined
that it does not contain hazardous materials (hazmat) and that it meets FAA safety requirements.
Therefore, only FAA-approved POCs, as listed in Special Federal Air Regulation (SFAR)-106, Use
of Certain Portable Oxygen Concentrator Devices on Aircraft, may be used onboard aircraft. In
addition, air carriers must meet the other requirements of SFAR 106 when FAA-approved POCs are
used on their aircraft. For more information, see SFAR-106, at 14 CFR part 121, Appendix and the
current edition of AC 120-95, Portable Oxygen Concentrators at http://rgl.faa.gov.
B. Other Respiratory Devices. All POC manufacturers are knowledgeable regarding aviation
requirements for POCs. POCs are in common use on air carriers. All currently FAA-approved
POCs meet FAA requirements for M-PEDs. However, this is not the case for other respiratory
assistive devices (ventilators, respirators and CPAP machines)
. For other devices that have not been
tested by the manufacturer to meet the emission levels in the RTCA standard, air carriers can
continue to use the current guidance in AC 91.21-1. In many situations, this requires case-by-case
testing of a particular device and a determination by the air carrier that the device can be operated
safely on their aircraft.

Recommended Action: Directors of safety, directors of operations, directors of training and
compliance resolution officials (CRO) for part 121 and 135 operators should be aware that they are
responsible for meeting applicable FAA safety requirements regarding the use of M-PEDs, while
complying with the provisions of DOT’s final rule.
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.
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Old Apr 17, 10, 11:03 pm
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Originally Posted by Yaatri View Post
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,
I was just making a bad attempt at humor, comparing that first burp in the morning to a decompression.
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Old Apr 17, 10, 11:11 pm
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Originally Posted by retirementdreams View Post
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
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!
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Old Apr 17, 10, 11:37 pm
  #55  
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Originally Posted by Yaatri View Post
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?
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.
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Old Apr 17, 10, 11:40 pm
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Originally Posted by Yaatri View Post
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.
The sticker rule is a final rule.

As the airlines were advised by the FAA, here, that we have both cited:
DOT final rule, section 382.133 requires that air carriers conducting passenger service (on aircraft originally designed to have a passenger capacity of 19 or more seats) must permit someone with a disability, to use a ... (CPAP) machine, ... unless the device fails to meet applicable FAA requirements for Medical Portable Electronic Devices (M-PED) and does not display a manufacturer’s label that indicates the device meets those FAA requirements.
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.
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Old Apr 18, 10, 8:48 am
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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
Originally Posted by GalleyWench View Post
Yaatri,
I was just making a bad attempt at humor, comparing that first burp in the morning to a decompression.
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.
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Old Apr 18, 10, 9:19 am
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Originally Posted by FatManInNYC View Post
The sticker rule is a final rule.

As the airlines were advised by the FAA, here, that we have both cited:
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.
DOT final rule, section 382.133 requires that air carriers conducting passenger service (on aircraft originally designed to have a passenger capacity of 19 or more seats) must permit someone with a disability, to use a ... (CPAP) machine, ... unless the device fails to meet applicable FAA requirements for Medical Portable Electronic Devices (M-PED) and does not display a manufacturer’s label that indicates the device meets those FAA requirements.
Originally Posted by FatManInNYC View Post
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.
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.
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Old Apr 18, 10, 9:59 am
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Originally Posted by GalleyWench View Post
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!
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.
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Old Apr 18, 10, 10:51 am
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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.
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