When you are not at home travelling with CPAP

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1 When you are not at home travelling with CPAP SAANZ collects information about experiences with CPAP when away from home. The notes are grouped in sections and each paragraph represents a comment from a different individuals this is why comments may offer different opinions. It is helpful if you are aware of possible situations before you set out. Feel free to add your experiences contact details at the bottom. It is worth mentioning that the occasional night without using a CPAP should not cause you more problem than tiredness the following day. If then you are able to have an easy day, this may be an easier option than setting up a CPAP when conditions (power supply, etc) might make it seem more trouble than it is worth. People with sleep apnoea can experience problems because they are a little older and because they are a little less fit than they think they are, and there we are! The fact that they have a CPAP is coincidental. Sections 1. Before you leave home 2. Air Travel 3. Cruise Ships 4. Camping, tramping and boating 5. Customs 6. At The Other End 1. Before you leave home Checklist: CPAP machine Air hose Head straps Adams circuit T piece Nasal pillow and spares Fuses Extension lead Surge protector 12 volt battery connector Insulating tape (for hose repairs) Covering letter from clinic, for Customs Solar panel charger for battery CPAP on Wheels I went to a suitcase repair company and asked if they could make some wheels and an extension handle for me. The prototype after 14 months of travel is still working well. It wheels around and frees you up from carrying it on your shoulder. This works well when you are in transit overseas and have to walk a fair distance to the next gate. In Hong Kong I once walked from gate 68 to gate 2 and the wheelie CPAP worked a treat. 2. Air Travel One traveler generally travels Qantas and has been with many airlines including Garuda, Cathay Pacific, Singapore Airlines, China Air, Dragon Air, Air New Zealand, American Airlines, United etc - all have been OK.

2 We fly Qantas as hubby can use his CPAP on board with no fuss. Another commented: Cathay Pacific were excellent. Cathay Pacific wrote to say they accept passengers with Sleep Apnoea on their flights and require 72 hours notice of this, but suggest 2 weeks notice to review the specifications if the equipment is not one of their pre-approved devices. Electrical power of 115 volts, 400 HZ, is available on board, but an adaptor is required (eg Teleadapt or Targus, available for sale in in-flight duty free). A manually operated breatherinhaler is also recommended as they are unable to guarantee a constant source of power. There is no reason why a person who requires a CPAP machine should be inhibited from travelling. However in the same breath, if you are going to fly you do need to be careful. The power supply in aircraft, ie Air New Zealand Business Premier, is designed to support computers not CPAP machines, so don t even ask unless you want to make the cabin crew flip out. If you have a battery powered CPAP that you intend to use in the aircraft you will need your specialist to give you a prescription saying you must use it. You run the risk that the airline might refuse to carry you. Getting it through security could also be a mission. (Oxygen is available on aircraft, but if you have a pre-existing condition you are expected to get medical clearance from the airline in advance, and pay for the oxygen you consume. Several airlines charge for oxygen, but not all, so check!) People with sleep apnoea tend to be a bit overweight and have a prevalence to oxygen deprivation and these two conditions can increase the effect of altitude on your body and the risk of thrombosis. If you feel this might be you, your doctor could consider giving you blood thinning medication and do not sleep on aircraft. A lot of people travel with a CPAP. Security at Los Angeles International Airport reckon they see two or three a day. It is a different story in Asia, they think you have just landed from space and act a bit like it. Coming home from Hong Kong a group of us all with mild medical problems found ourselves grouped together in Air NZ Premium Economy and were then treated like lepers. The treatment would put anyone off flying. The answer is that they need to have medical seats, with easy access, but a request for that sort of thing needs to be suggested by organizations with a bit of clout. It is also worth remembering that if for some reason you are unable to use your CPAP on a long distance flight and you can t get a decent sleep you are not alone! Many people without OSA also experience problems getting a reasonable sleep in these circumstances. There is a requirement by some airlines - especially those going to or through the USA - for the CPAP machine to be registered on the flight. We found out that mine wasn't when we were in London at the time of the foiled terrorist attack the they told air travellers that the only cabin baggage allowed was a small sealed see-through plastic bag containing very small amounts of essential liquids to be used on the flights. We had to see Air New Zealand; they managed to get my CPAP registered for the Los Angeles flight. When we arrived at Heathrow they were still telling all the passengers they were only allowed this little plastic bag and we were really worried - there was no way I was allowing them to put the CPAP with the luggage in the hold. Check-in, Baggage and Suitcases Do not check through the baggage with the CPAP machine. Checked baggage goes into the hold of the aircraft and lower air pressure there (in some aircraft types) may affect the sensitivity of the instruments. Take it as cabin baggage.

3 If on a long haul trip, chat to the airline staff to see if they will upgrade you to a seat with a power point so you can use your CPAP machine. It depends on the airline and seat availability, but is worth trying. I generally always take the CPAP with me as cabin luggage. It fits in fine above me in the locker. Recently I have placed the CPAP bag and all into a larger suitcase and it has travelled well. F&P Healthcare leave it up to us and how we feel about carrying it or packing it safely away as luggage. I have found that the CPAP bag sits great on top of my suitcase and leans onto my extension handle. A mistake I made when I bought one of my bags: do not buy one with a single extension handle as the CPAP seems to twist around when wheeling. Far better to have a twin extension handle which supports it well. CPAP machines need to be part of your carry-on luggage. I keep mine in an aluminium instrument case which provides excellent protection for the CPAP and is just large enough for my extra bits and pieces. You will usually have to open it up at security and expect to have it swabbed for explosives at US airports. In Asia show them the power cord and tell them it has no battery. 3. Cruise Ships On cruise ships use a surge protector because the power is not always well regulated. While the following comments come from the operators of Pacific Sun, Pacific Star and Pacific Princess, they suggest some of the questions you should ask before booking your cruise. Cabins on Pacific Sun and Pacific Princess are supplied with 110v and v. Cabins on Pacific Star are supplied with 220v only. The standard electricity frequency in Australia is 50HZ (Hertz), however the ships can only deliver electricity at 60HZ and they cannot change the frequency of the power supply. A transformer only converts electricity to different voltages and will not alter the frequency (hertz) of the supply. Most equipment designed to work at 50HZ will either not work on board or will be damaged if used. Ensure written details about your electrical equipment are forwarded to the cruise company prior to travel. On the day of sailing before the ship departs, the passenger is required to get their electrical equipment checked by an Electro-Technical Officer on board to ensure the equipment is compatible with the ship s supply and is electrically safe to use. Pacific Sun has two types of socket in every room (Australian v and American 110v). Pacific Start was European style sockets (220v) only. All cabins are supplied with one Australian adaptor. Pacific Princess has the American socket (110v). An adaptor is available on request from the cabin steward. Sleep Apnoea machines are not available for hire. 4. Camping, tramping and boating When I tramped the Heaphy Track I arranged for the CPAP to meet me at the other end. In a camping ground make sure you use a RCD isolator so that you can t electrocute yourself. Do not even contemplate using a petrol generator to run a CPAP. The fumes under pressure are absolutely lethal.

4 When boating, you may be able to use the on-board electrical supply with an inverter which will give the right voltage. However, you must check with the Skipper. Boats can have a house battery (for lights, music etc) which is quite different from the engine battery, different in design, construction and electrical use. Not all boats do have a two-battery system. You do not want to be responsible for causing a flat battery which means the engine can t be started. Check the power consumption of your CPAP before going on board. The Skipper will want to know how much power your CPAP will draw. 5. Customs When the CPAP is packed away in its travel case it could look suspiciously like something else, so simple preparations before you encounter Customs in a foreign airport do make sense. I think we all worry about it looking like a bomb. Never joke with Customs using this word. They take it seriously. Contact your Sleep Lab who will have a file on you stating that you suffer from Sleep Apnoea and require the assistance of a CPAP machine to assist your breathing. Take a copy of your doctor s letter which confirms this. I carry a medical paper stating that I am a CPAP User. It was given to me by the Greenlane Respiratory unit some years ago. To date I have never had to show it to Customs and never asked once to have a look in the CPAP bag. 6. At The Other End Power: Always check on what country you are going to ensure that you have a correct power adaptor. I generally take an assortment, and most hotels have a spare. Power points: In your room are not always located beside your bed. A lot of the power and lights are all fixed into the sockets. This can cause some problems but I have found there are ways around it. Always check first where the nearest one is - pull the bed out to check. The room service must have access to a plug for cleaning. I have on one occasion turned the bed around to reach a power point - but it works. Generally with the cord and hose you will reach one. An extension cord can be very useful because not all accommodation has a power socket by the bed. Do not forget adaptor plugs if you are going anywhere other than Australia. I take some string, tacks and paper clips so that I can have the hose coming in on the angle that I prefer. If I am forced, the CPAP machine works happily sitting on its aluminium box. We have stayed in places where all the gadgets were wired in and there were no power outlets to plug into except in the bathroom or on a stove. We always found a way though - even if we had to move the bed as close as we could. It helps that we always carry a 1 metre long extension lead. It has a place on it where we can recharge video camera batteries while using the CPAP overnight. Spares: Always carry some electrical tape just in case your hose has a split. Carry spare filters and silicone mask. Generators: In Sierra Leone the hotel s generator went off at midnight, and the CPAP stopped until 6.30am. The solution was to buy a 12 volt battery to run the CPAP overnight, and charge it during the daytime. Intermittent supply was another problem; if power comes from hydro

5 lakes they may be near empty at the end of the dry season and power was rationed, and diesel for generators was in short supply. You are not allowed to fly on a helicopter with a battery. Conclusion Have confidence with your CPAP when travelling and as soon as you get booked in, and before you see the sights, get the CPAP sorted out first. It s a good investment. You will hit the bed at night you have the trusty CPAP working away for you ensuring a good night s rest. My CPAP has been round the world twice, it has been to the Arctic, operated at high altitude in America and coped with desert and tropical heat. With a bit of care there is no reason why you can t go where ever you want. ******************************************************** Contents Sleep Apnoea Association of New Zealand Inc. Information is provided in good faith by SAANZ. No liability is accepted in the event that any information proves incorrect. Improvements are welcome and can either be sent to: SAANZ Booklets, P O Box , Papakura 2244, New Zealand or using the Your Message option on the Contact page of the website.