Using cpap on-board flight
 

I searched the forum and there are a few threads, primarily concerning carrying on cpap units as carry-on luggage. But the threads are very skimpy re actual usage, so a 'duplicate' post here.

I just started cpap for less than 1 month and will eventually be flying to Asia. Depending on my destinations, I could be in CX's non-stop from JFK to HK, or SQ on the non-stop to Singapore, or less appealing, JFK to Seoul on KAL. Since all are at least 15 hrs or longer, I would like to use cpap in-flight.

CX has a website page re using medical devices and I've spoken with the manufacturer of my cpap unit, Resmed. I am curious how many folks have actually used their cpap machine on board - more and more J and F class has direct AC power. On CX, they carry 115V, 400H AC which is ok for my Resmed machine (accordingly to Resmed).

And what procedure did you follow to get approval to use it on-board - advance notification, paperwork, etc.?

First of all, it's great that you found out you needed it. I had to fight with my doctor here to even order a sleep study. I had had already done in India on a suggestion of a doctor in Delhi, but I couldn't use results of that to get a CPAP.
Some units are certified for use on aircraft. If your unit is certified for use on the aircraft you will be on, the airline should alow you to use it on board. The reality is quite different. The response you get from the airline depends on who answers your phone and how diligent they are in digging up information. Some airlines would allow you to use CPAP only if it runs on a battery (quite expensive at $400 or more). You can also attack the problem from Resmed end. Have them produce documentation to you as to which aircraft teir unit has been certified for. Requiring battery use makes no sense as seats with power points provide enough power from a CPAP (other than empower ones) nor is the EM radiation from a CPAP is not likey to be much more than that from a DVD drive on a laptop. After spending hours with the airline and the manufacturer, the best I could get was "You can use it on the aircraft if you run it on a battery, and NOT use aircraft power).
That said, you will not die if you don;t use CPAP for one night. I had an AHI of 93 with a pressure setting of 16 mm of water. DO you mind sharing what your numbers were. It does make a big difference once you start using it. My BP numbers became normal only after a week's use.

Virgin Atlantic: A major CPAP pain in the ***.
 

Three years ago I had a sleep study and started CPAP the day before a Virgin Atlantic flight LAX-LHR-CPT in PE. I called VA to ask if I could bring my machine with me in the cabin without it being counted as an extra carry-on. I was nervous putting it in my checked luggage. I DIDN'T ASK TO USE THE MACHINE DURING THE FLIGHT. They said no problem. I got to the check-in counter and the drama started. They said that they weren't sure I could fly because I had "Apneoa Syndrome" (their spelling) and I could stop breathing during the flight. I ended-up talking with some nurse from VA and I had to agree to keep my seat vertical for both flight segments from LAX-LHR-CPT. I also had to get a 'fit to fly" statement faxed by my EENT to VA. I was livid, but I agreed so that I could board my flight. I thought that was the end of it, but no. The same thing happened to me me in London when I was boarding my flight to Capetown, AND Capetown to London AND London to Los Angeles. I fly VA a lot; I just returned from South Africa three weeks ago and you can bet that I never mentioned CPAP. VA hasn't changed their policy as far as I know. They do not allow the use of CPAP with or without battery power. I would sure like to be able to use the machine when I fly UC, if not for me for my fellow passengers with my intense snoring.

I'm planning a trip to Chennai, India in April and I'm considering flying Singapore Air if they would let me use my machine instead of flying LAX-LHR-DEL and then taking a domestic carrier to Chennai (MAA).

Never put it in your checked baggage. There are plenty of Youtube videos about what baggage handlers do with the bags for you to put an expensive piece of medical equipment -- but of course I am preaching to the choir.

You can bring a CPAP onboard as a 3rd piece of carry-on. I've never had to argue the point but it is in the airline regulations. I find of course that it is logistically problematic with the overcrowding of flights these days and have a carry-on that will hold the CPAP safely plus my clothes and then bring the laptop bag and I am good to go.

If you haven't already done so, I suggest you check out cpaptalk.com as well. Very helpful site for new hoseheads. :)

Good luck with your trip, and please report back afterwards how it went.

True, but your seatmate and anyone else near you might not get much sleep. ;)

Thanks iff, I actually do read the cpaptalk.com forum. I just finished doing a search there and found lots of great information there. This is what I learned so far:

1. You are permitted to carry-on your cpap unit and it does not count toward the maximum 2 bag allowance (at least on domestic flights). Best to carry a couple of the TSA ruling letter, copy of your doctor's script as backup in case you run into an uneducated airline person.

2. CX (I'm still checking on Singapore Airlines and KAL) runs 115v, 400H AC power and my Resmed S8 autoelite II will operate properly. CX requires advance notice by phone (24 hrs). Others have successfully operated their cpap unit on Eva Air and Qantas.

3. If you can use a battery pack, that's preferred way...according to some but that adds weight.

4. You have less 'problems' if sitting in J or F class but it can be done in economy...

Look forward to hearing how your trip went. And I will post my experiences on this thread after my next trip.


Slightly OT but my brother checked his cpap in when flying JFK/HK, then China, etc., even though I told him not to. Fortunately nothing happened

Print out this page from the TSA site. ;) Also be sure to insist that the screener clean the table, use fresh sampling media, and put on a pair of new gloves (from the box, not pulled out of their back pocket).

I think you mean the pdf file that can be downloaded from this page:
http://www.tsa.gov/travelers/airtrav...eds/index.shtm - dated 2006 but still valid. ;)

Having a medical ID tag for your carry-on also helps. It can be downloaded here:
1. Heroic Red Star version http://www.mindspring.com/~jimw203@m.../PAP-Tag_1.pdf

2. Authentic True-Believer Blue Star version http://www.mindspring.com/~jimw203@m.../PAP-Tag_2.pdf

Print them and bring to Staples to get laminated tags made for $0.99 each!

Or you can purchase them on-line for about $10 each.

Right. But the good news is that they won't die either. :)
If your machine is not certified for use on aircraft, you can't use it anyway.

Amen, brother. Of all the flights I took in 2009, I did this maybe five times. I just wanted to get through the security check without having to unload countless items into the plastic bins. Then on one flight out of ORD, I got a random call from an unknown number. I was already in my seat and let the call go voicemail. Bad move on my part. It was American baggage claim at O'Hare telling me they had my bag. Ummm...do you think you can send it with me to DFW? When I got to DFW I told them to send that bag forward and it never came until the following morning. What a night. I will NEVER do that again.

Keep in mind that even though the USA allows a third carryon bag for your CPAP machine, other countries may not have such an allowance. I keep a copy of my prescription, and all the DOT and TSA paperwork with me just in case I need it. I also carry a 10 ft AC extension cord, too often I end up in a hotel room where the AC outlet is too far away to be of any good.

I've come to the point where I don't bother taking my CPAP machine out of it's case anymore at the security checkpoint. If they want to swab it down, let the TSA open the case! No complaints so far.

Just curious what machines fellow cpap users have here for travel? I'm looking for something very compact and portable that can fit in my roll aboard for those occasions that a third carryon is not permitted. Been thinking of getting myself this one:
http://www.cpap.com/cpap-machine/aei...p-machine.html
or this one:
http://www.cpap.com/cpap-machine/pro...p-machine.html

Re the first unit - check this review: http://www.cpaptalk.com/viewtopic.ph...z+PAP+#p438093

I'd be curious re which you ultimately get. I use a S8 AutoElite II - not too large to carry but anything smaller is always better.

My partner has used his CPAP machine several times on BA, but always in F or J - there are some good seats in J on the upper deck of 747s that are perfect for resting the machine. He used the inseat power, always asks the crew before using it, and has never had a problem.

BA's website is very clear and in stark contrast to backdoc's shocking Virgin experience states: "Medical clearance is not required for the carriage or use of CPAP machines (used in the treatment of sleep apnoea) as fitness to travel will not be in doubt." Laptop power is rated at 75w and as long as your device needs less than that you are fine, although BA do not guarantee that they will be in service and suggest you use a battery-powered machine if necessary.

I have been flying with a BiPap for a little more than a year now. Last year 7 international r/t flights on UA, mostly in C with two legs Y. UA has an AeroMedical Desk staffed with terrific agents. They require a minimum of 48 hours notice to set up electrical for the flight. They will tell you if you have an approved machine. On planes without in-seat power UA will bring power to your seat, but you must have an original manufacturer cigarette lighter adapter for your equipment. Mine cost about $30 for my $5000 machine.

When UA came out with their new seats in F & C that had the in-seat power (currently the 747 and 767) initially they still brought power to the seat because their engineering department had not yet approved the in-seat power for medical equipment use. They subsequently approved it, however. This has made travelling overseas very easy for me. I just wish I had a humidifier option on my machine.

The best part, however, is when you are stuck in Y on a 14 hour transpac and are the only one with power! I have an adapter for my laptop and iPhone as well and when I wasn't using my machine I was able to charge my other equipment (and that of my friends who were along on the trip). On UA, mechanics board the plane first and plug a long extension cord into the outlet by the door that the cleaners use for their vacuum cleaners, run an extension cord to an inverter box, which they place under the seat in front of you or under your seat. The cord is taped down with FAA approved airplane tape (kind of a duct tape on steriods). For the return portion of your international flight they fly the box over to your departure airport on the plane that you return on and mechanics at that airport install it for the return flight. They always let you board before the engineers leave to test the equipment. There has been one or two occasions where the inverter box didn't work and required some tinkering.

One of the reasons I did not go on the *A Mega DO was the different airline rules for medical equipment use on board. With all the different carriers involved, it would have been a nightmare to deal with. That is one reason I am very happy to stay with UA on overnight international flights. They have made flying with medical issues very easy.

While CPaps and BiPaps are prescribed for similar illnesses, equipment varies. My BiPap is more like a mini-respirator, which explains the cost. While some may not die from not using their CPaps, I can die from not using my BiPap. So I would not necessary heed the medical advice tossed around in this thread and would instead ask my treating physician how harmful it would be to you if you went without the CPap for a night while flying.

I don't understand that. I'm quite certain none of my laptop, Zune, DVD player, GameBoy, hairdryer, cellphone charger, or any one of hundreds of other "portable electronic devices" have been "certified for use on aircraft". What's special about a CPAP machine that differentiates it from from any other portable electronic device and requires certification?

That's a very good question. I also don't understand why TSA thinks they need to swab a CPAP machine but not a laptop or other electronic equipment. But I have found they are at least generally pleasant about it.

I haven't tried to use my machine on-board. i can't sleep well on planes anyway, even with a lie-flat seat. I can nap a bit but don't ever really sleep.

Thanks for UA info
 

Interesting thread.

I've been using CPAP since 2004 and have literally flown around the world with it and generally my only issue is dealing the CO Red Coats whilst standing in line at security. At least a few of those trips were on Virgin, without issue, but that would have been when I was working in London some 3 years or so ago.

I'm tired (in many ways) of paying for a nice seat in Business and still not being able to sleep very well, so I'm in the market for a new CPAP just for in-flight use.

I just got off the phone with CO and was told that no CPAPs had been FAA approved and no CPAP usage is permitted without said approval.

However, now that I see UA has some flexibility, and now that CO and UA have an alliance, I'm going to throw business in UA's direction.

Of note: I second the extension cord recommendation. I've had to move the bed and place the CPAP on the floor to reach the plug in more than one hotel.

I just flew ATL to LHR BE in one of the new 764 planes which I figured would be ideal for trying CPAP use on board. However, after much consultation, the onboard flight leader found a section in their manual which said that CPAP could not be used on board.

From a similar Cathay Pacific Airlines thread on FT as well as cpaptalk.com, it's hit and miss with airlines. Some extremely helpful, other's don't give a darn.

This might help:

http://www.cpaptalk.com/viewtopic/t4...nd-Travel.html

http://www.cpaptalk.com/viewtopic/t4...NG-flight.html

http://www.cpaptalk.com/viewtopic/t4...with-cpap.html

http://www.cpaptalk.com/viewtopic/t4...l-flights.html

I have been using a CPAP for the last 10 years or so and find that it is becoming more and more complicated to use a CPAP on longhaul thanks to the rise in would-be air terrorist technology. The following pointers may help.

1. ALWAYS carry your machine in your handbaggage ...... even if you then need to put other things in the hold. That way you are never separated from your machine - even if your luggage goes on a voyage of its own - and do not risk your machine being thrown by baggage handlers (sorry baggage handlers but it does happen and I've actually seen this myself) or falling off the loading ramp between the plane and the truck (again I've seen this for myself).

2. Read up on the rules for your airline or ask. At the time of writing,

BA didn't allow the use of CPAPs in WT+ using their mains power points because the machines supposedly draw more than computer laptops from the power supply available (so it's no use paying extra for the privilege of a plug!). They have no objection to you using them in any class as long as you are using an independent battery.

AF allow their use, but solely on battery and the make and model of your CPAP has to be declared at the time of ticket purchase and then agreed as being suitable for use inflight (YES even with a battery power source).

AC seem relatively clued up on their website, and it would seem that you can use mains power ............... but, once you get on board, you may need a battery pack anyway because they start to use the argument above, as exemplified by BA.

Note that some BA planes still use EMPOWER sockets which need a special plug. It's worth looking at www.seatguru.com in my experience to see if your plane has a plug at your seat and what type of power is supplied.

I have found that using a laptop battery gives me 5.5 hours charge for using a CPAP at 13 mB pressure - sufficient for a short transatlantic flight plus meals. Recharge time is 3 hours.

Incidentally BA in SFO were the most paranoid ground staff I've ever met (2007) and whose flapping resulted in great personal distress and 19 days of lost baggage, because of their insistence that my CPAP was not allowed as hand baggage as they said it would explode inflight (!!!!), and my insistance (backed by the Homeland Security team THANKS FOLKS!!!) that it was in no way dangerous and that I would not be separated from it. It travelled with me, I used it in flight and I and the other members of the public and crew using that service are still alive to tell the tale.

Please make sure that you check with your airline before you travel.

So in short:

Take enough battery power to last you in case of lack of power (because your seat power point is never guaranteed to be in service ... little catch-all clause in the T&C ...) and the right adapter for your flight and your destination.

Take an extension lead, because invariably the plugs in your hotel room are on the wall opposite the bed, and I can't be bothered every time to change the layout of the room and move the bed to get to the power point ........ plus you get to see what's never been vacuumed from underneath the bed and that isn't a pretty sight.

Take a letter from your doctor (on headed paper) stating that you have been medically prescribed CPAP treatment and for health reasons, you need to have it available at all times.

I often explain to those sharing a row with me about my CPAP before I use it, so that noone panics when they see me using a mask. I also inform the cabin crew member serving my part of the cabin out of courtesy, and found that they appreciate it ... and can wake me if I don't hear landing announcements etc because once I've got the gear on, I usually sleep very well!

Good luck, sleep well and happy landings!

I too don't understand the reason why CPAP has to be certified for use on aircraft, but that's the line taken by the airlines, possibly due to ignorance. Surely, electromagnetic signature of a laptop, Gameboy, DS or PSP will be different from that of CPAP, ( CPAP might have a peak in a different region of the spectrum), but total energy in the siignature cannot exceed the power drawn by the unit. One difference between a CPAP and other gadgets you mentioned is that some of the energy of those devices goes in display while for a CPAP,. all of the energy goes into driving the motor (pump). Whether peak of the electromagnetic signature of a CPAP lies in an objectionable part of the spectrum or exceeds a set limit, I cannot say.

Yesterday morning (Sunday) I transited through JFK as I had to spend the night in a hotel at JFK due to bad weather at DCA. I arrived at the airport around 10:30 a.m. to find, to my pleasant surprise a deserted security checkpoint. As usual, I took out my laptop and my CPAP and put them in separate bins. For the first time, they did not take a swab off my CPAP to test it for explosives.

Tnanks for your detailed input with lots of good advice.
I don't see how they can say that a CPAP draws more power than a laptop. My CPAP's power adapter has an input of 1.2 Amp max at 100-240 V (A.C.) with an output of 4.16 Amps at 12 V (D.C.), while my netbook's power adapter has the same input as the CPAP and output of 2 Amp at 20V. Bigger laptops with an optical drive will consume more power. My Toshiba power adapter has an input of 100-240 V at 1,8 Amp and an output of 3.42 Amp at 19 V. I have tried to reason this point with NW people without any success. I don't think laptops use any shielding or more shielding than CPAP. I am inclined to think it's just because no one has produced documentation to the airlines about power usage of CPAP, they are skeptical and can get away with disallowing powering CPAP from aircraft power as the number of people wanting to use their laptop far exceeds those wanting to use CPAP on aircraft.

I use similar pressure as yours 14 cm of water (14 mb). How do you draw power from your laptop battery? is there an adapter you use? I have a laptop battery from an expired (dead) laptop. How would I charge it without the laptop?

Neither can I! It's probably just their 'get-out' clause!

I went to a specialist battery shop and asked for a supplemental lbattery suitable for a laptop. It came with a charger lead to attach it to the mains supply and a separate lead to connect the charged battery to the cpap. It is about the size of a small paperback book and is light. It cost me about 170€ (I live in France) but Maplins in the UK sell one about the size of an A4 sheet of paper for about £80.

Make sure you take your cpap technical manual to the battery shop to check the voltage required. The consumption of your CPAP and the pressure you use it at plus the capacity of the battery can give you some idea of how long the charged battery can run your cpap. Make sure you know how long the battery needs to be recharged.

I hope that this helps. I sit my battery on top of my CPAP on the dropdown table and there are no trailing leads .......... just my hose!!

Happy landings!

Continental and Delta: no thank you
 

Bad news from another forum:


Don't bother trying to fly overseas on Continental Airlines using your CPAP machine on board. Their customer service informed me that my AEIOMed Everest 3 CPAP machine with integrated battery cannot be used on the plane, since the machine "has not undergone RTCA Document (DO)-160 testing. This test would be performed by the manufacturer and would report if a device has
or has not been found to exceed the maximum level of radiated radio frequency interference in all modes of operation." Upon contacting AEIOMed, I was informed that they would not conduct such a test due to the expense. Additionally, you are not allowed to plug any CPAP machine into the on board AC power even in Business/First class...so if you fly Continental on long business flights like me, you are out of luck in the sleep department. It looks like Delta Airlines has the same policy.

This is really stupid. I ran into something similar too, with a different flavour. The manufacturer calimed that their unit met the emission standards while NW claimed they had nothing on file for that unit. Further digging revealed that an earlier version of basically the same unit met the standards, because of which the manufacturer claimed that the new and improved unit would too. It is indeed expensive to perform a laboratory tests and compile results of the tests. Manufacturers are willing to go through the expense of testing if the payback is big, for example equipment that goes on military platforms such as ships submarines and aircraft. I don't know what the emission limits are. But we do know that these units consume power in the range of hundred watts. As I said, I don;t know what the standards are, and how they are specified. Typically radiated power at one meter from the source is used in many applications. Two motors consuming the similar power will have similar total radiated power. But you cannot make them understand. I have tried. If Model A meets the standards and model B is similar, model B should be OK too. But no luck.


I see only three possible solutions: Making the Govt to recognise the need for allowing use of CPAP on board so that

• The Government forces the manufacturer to provide some models that have undergone tested and that all models be clearly labelled if they meet emission standards
• Govt bearing the cost of testing.
• Forcing the airlines to maintain a list of units that meet emission standards. If a manufacturer provides test results, the airline should either accept them or condcut its own tests to confirm or disprove manufacturer's claims.

I have a few thoughts and a question or two about CPAP and aircraft.
Does anyone here use a bipap or a vpap?

I had my annual sleep study a few weeks ago. I had been using CPAP for about 18 months. The good news is that my AHI index was halved from mid 90's per hour to mid 40's per hour. I have lost about 45 lbs during that period.
Despite my AHI index going down, the pressure setting had to be increased. Prior setting of pressure I was using did not eliminate all obstructive events, but the doctor had recommended that pressure since I was new to CPAP and the pressure setting of 16cm was high enough that a new user might not be able to tolerate the pressure. Now my pressure setting is 20 cm of water column. I was unable to tolerate it during exhalation. So within three weeks of the last sleep study, I was sent in for another titration using a bibap.
I was curious about the significance of the pressure. What does a pressure of 20 cm of water column in access of the atmospheric pressure mean?

I have two practical answers.

1. My brother, who was a chief engineer on oil tankers told me, they used a pressure of 20 cm in piping for air supply, on the ships to keep the pipes clean, i.e. to keep corrosion from building up on the inside walls of the pipes.
   
2. For Flyertalk, a better analogy would be in terms of aircraft. I did a simple calculation and the result was quite impressive. I had an inkling the pressure would be within an order of magnitude of that required to lift an aircraft off the ground. If the pressure of 20 cm of water column (2% of the atmospheric pressure) was uniformly applied to the underside of the wings of a Boeing 747-400 ER, i.e., the pressure difference between the upper and the lower surface of the wings was 20 cm of water column, it would be sufficient to lift an aircraft the size of a Boeing 747-400 ER that weighed 26% of the maximum take off weight of the aircraft. Quite a daunting thought.
3. Even an empty Boeing 747-400 ER weigh more than the weight that could could be lifted by a pressure of 20 cm of water column. The pressure is enough to lift a weight more than twice the number of passengers and their luggage of a fully loaded Boeing 747-400-ER

I was using a Respirnoics CPAP, but now I am using a Resmed Vpap Auto25, that the vendor has loaned me pending results of the second titration.

20 cm of H2O is about 0.28 PSI...pretty light. About 7.75 inches H2O, in the terms that I think in. My Respironics has a ramp feature, and I've played with the settings. Originally it was set to start at 5 in and ramp to 10 over 45 minutes. Over a few years I've gotten really used to it, and now start at 7 and do a 20 min ramp to 10.5 inches (about 26.6 cm). I know people that are a lot higher...

But yeah, a little force applied in a lot of places can move a heck of a lot. My 10.5 inches/0.36 PSI over 1 square foot (144 sq inches) is about 52 pounds of force...

RFTraveler

I am not sure what you meant by "20 cm of water pressure is pretty light". An excess pressure of 20 cm of water column will feel pretty light on the your palm, the force of about 2 pound force. A little pressure applied over a large area, can produce a large force, which is not the same thing as applying a little force in lots of places. Little forces applied in lots of places can produce no net force. Intra-molecular forces, or electrostatic forces between electrons, for example, produces no net force. ;)
My Respironics had a ramp feature also. It ramped up from 4 cm to 16 cm over a course of 45 minutes or so. After a few months of use, I stopped using the ramp feature, since I didn't want to weight for 45 minutes to find out my mask was leaking. I was able to tolerate 16 cm pf pressure without ramping it up from 4 cm.
water pressure of 10 in is pretty high. I have not come across anyone with a pressure that high. When I was at 16cm, I had the highest pressure among those in a support group for people with OSA.
Have you got any problems with your mask? You need a very good mask at a pressure like yours.

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

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. ;)

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..

You can always try a chin strap with a nasal mask, or some people even use Poligrip tape to tape their lips together. :p 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.

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

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

<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.

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

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

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.