Airport hand baggage allowance and CPAP

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Permalink Reply by Jonathan on September 15, 2012 at 0:27

Hi, this is my first post to this forum. I have a Respironics M Series with humidifier (untreated AHI = 86, treated = 0).  I need the humidifier or I awake with a sore throat. After diagnosis I put off travelling for a couple of years, as I was worried about airports.  When I did fly, it was a complete non-event.  I have flown from LHR to Cork, Berlin and Verona, and no-one was interested.  The CPAP machine is scanned on the X-ray machine, and no-one questions why I am carrying two pieces of hand baggage.  I just have to remember to buy some bottled water once we're air-side, as a starter kit for when we arrive at the hotel.  However, I have just returned from a trip LHR-Singapore-Perth-SIN-LHR.  That did not go so well.  I checked with Singapore Airlines whether I could use the machine in-flight, giving them exact details of the machine, and a copy of my NHS consultant's letter stating I was fit to fly, but would need to use CPAP.  They replied:

"Singapore Airlines does permit you to use a CPAP (Continuous Positive Airway Pressure) for Sleep Apnea on-board.

"We do recommend that you use a battery operate machine although we do have in-seat power supply but this is subject to availability and compatibility, and we are not able to guarantee the continuous power supply throughout the flight as the power can be interrupted or turned off depending on the needs of the aircraft.

"If you still wish to go ahead and use the in-seat power we will require you to complete a disclaimer on departure and you will have to bring your own power supply adaptor.The batteries for battery operated machines have to be either gel or dry cell batteries and you must carry enough battery supply for the entire journey (that is not only the duration of the flight but also any unexpected delays.)

"Please note that for safety reasons, the use of a CPAP is restricted to the cruise phase of the flight only you are not allowed to use it during take off and landing. Please check with crew when you are permitted to use your machine.

"We request you to confirm your medical condition requiring you to use the CPAP machine during the flight.

"Please note you will need to carry a doctors letter confirming you are fit to fly, and your need to use the CPAP during the flight also listing any medication you may require during your trip.

"We hope this information helps with your query. "

At check-in at Heathrow, the check-in staff paged a Singapore Airlines employee, who told me there had been a mistake, the machine was not approved, and could not be used on the flight.  This was a 13 hour flight leaving at 6:30pm.  There was no point in getting upset with the poor soul who had to break the news to me.  But staying awake all night wasn't the best start to a holiday!  Instead, at every stage of the journey I was dutifully asked whether I would need assistance getting on/off the plane -- normally by some hapless Singapore Airlines employee who was confused at why they were asking a healthy individual this question!  I have written a formal letter of complaint to Singapore Airlines, and will follow-up when/if they reply.

Just to cover off a few other comments I have read in this thread.  I do consider OSA a disability, as I need to use a machine to sleep safely.  Like many people with a disability, with the correct support (in my case a machine) I am no longer disabled.  When I forgot to take a super-long mains cable with me on a UK break, and the hotel had to put me in the disabled suite, as that was the only room with a socket by the bed, I felt quite guilty (but kudos to Sleeperz hotel, Newcastle for finding a solution!).

As for buying a second machine, I e-mailed a copy of my diagnosis from my NHS hospital to cpap.com and they were happy to supply a machine to that prescription.  (I commute between two homes, so I bought a "twin" for my NHS-issued machine, and I bought the optional extra humidifier for both machines.)  The NHS check my machine annually, and they are very happy to check both.  As far as I know, they concentrate to checking the pressure delivered by the machine is accurate. I have purchased a USB oximeter, and I therefore do my own sleep studies, which the consultant checks.  They don't look at the compliance data from the machine.

Jonathan.

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Permalink Reply by Kath Hope on September 16, 2012 at 23:55

Thanks for that update Jonathan.  I've personally never had a problem myself when flying to Europe and have always took it as extra hand luggage.  My laptop always comes with me though, so for my next trip I'm investing in one of those extra light cabin bags on wheels to put everything in.  Sorry to hear of your bad experience, and not a good start to your holiday with no treatment.  If you're like me, one bad night and those symptoms are back again :(

I got an email earlier from one of my Australian customers who gave me some news which might help others....... she usually flies with Singapore Airlines, but someone she knows always flies with Qantas as apparently they are the only airlines who accommodate you easily to use a machine. You have to sit in the back row but they have plugs to plug in the machine whereas other airlines you have to rely on battery power.

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Permalink Reply by Jonathan on September 18, 2012 at 1:24

Hi.  I was sitting in an aircraft seat with a power outlet in the chair arm.  Apparently it is limited to 75 watts.  I don't know what my machine draws.  If you overload the socket, it cuts out, and can only be reset once the plane is on the ground. I guess this was the issue at hand.  Let's see if Singapore Airlines reply to my complaint.  I will bear Qantas in mind!!  Thanks for the tip.

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Permalink Reply by Tigers Fan on September 18, 2012 at 11:04

All power to those who are stirring about using and carrying CPAP on planes! I wish you success.

I still take a pragmatic approach considering the current rules, regs and prejudices and continue to travel hassle free. I wouldn't dream of using my machine on a plane other than in a 1st Class bed - not likely to happen now I'm retired!

When I was at sea and pre-OSA, we would sometimes have to work two or three days straight through, without sleep. When I flew on business non-stop to Japan and Korea (the longest flights I can remember off the top of my head) I doubt I ever got more than a brief doze because I am too long to fit airplane seats - 1st or Business. Because of these experiences, I am left wondering why people think they must use CPAP during an over-night flight.

I put 'must' in bold because Jonathan says that " I do consider OSA a disability, as I need to use a machine to sleep safely." That assertion shocked me! Are folk being told that their lives are at risk without CPAP for a night? Do folk believe that they may die in their sleep in a single night without CPAP?

For people who hold such beliefs, I have some very good news! You won't! Not unless the plane crashes whilst you sleep or your house falls on your head - or other catastrophes. Think of the years you had OSA before you were diagnosed - you didn't die, all that happened was that you got fed up with being tired and went to your GP. Maybe you were chased there for snoring so badly!

Long term un-treated OSA is very definitely a huge health risk. But over-night? You'd do better to worry about your heart and cholesterol levels than about dying from OSA.

Do you have a back-up battery supply at home for your CPAP in case of power cuts? I suggest the answer to that question indicates your real attitude to a night without CPAP.

In the meantime, good luck with your efforts to change airline and airport policy to us. It would be a proud achievement!

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Permalink Reply by Kath Hope on September 18, 2012 at 11:57

I personally would never ever sleep for even one night without my treatment TF.  That's such a bold statement you've made, stating that people won't die in their sleep!   Whilst I agree in 99.9% of cases this is true (possibly the same odds as getting run over whilst crossing the road), as our bodies are very clever at rescuing us from these apnoeas.  However, there are instances (most of which haven't reached the headlines) of people who've not used their equipment and have died in their sleep - and I personally know of 3 people this has happened to.  Lots of research is going on at the moment re the link with cot deaths too, along with people who have gone to bed drunk where their brains have been incapable of sending the right messages to the heart.  Going for long periods without sleep is certainly not going to kill anyone, but sleeping without treatment for apnoeas is a far greater risk!

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Permalink Reply by Jonathan on September 19, 2012 at 0:32

Hi Tigers Fan

I think you are conflating a couple of issues.

1. Do I need a CPAP machine to sleep safely?  You've already answered that: "Long term un-treated OSA is very definitely a huge health risk."

2. Is an airline obliged to facilitate in-flight CPAP treatment?  No.  But they should not say that they will, and then at check-in say they made a mistake.  If I had known in advance, I would have had the option of a daytime flight, choosing a different airline, or buying batteries.

To answer a few specifics:

Should airlines allow you to carry on CPAP equipment?  Yes.  It's too important and too delicate to put in hold baggage.  It weighs the same whether it goes in the hold, or in carry-on baggage.  As I said previously, I have travelled within Europe, and to Asia and Australia without any problem.

Can I "pull an all-nighter"?  Yes, and I did on the flight.  Not the best start to a holiday, but I didn't need to drive, or attend a business meeting, or "hit-the-ground-running" as an engineer, on landing in Singapore.

What happens if I "sleep" without CPAP?  I stop breathing.  86 times an hour.  That's once every 42 seconds.  And that's my brain delivering a little dose of adrenaline every 42 seconds.  It's not "being tired" the following day, it's being unable to function.

Do I have a back-up battery for my home CPAP?  No, I live in a city where the last time we had an overnight power outage was the "great storm" of October 1987. And I was definitely awake during that!!  If I don't have power, I have to sit up in a chair, and try to keep awake.

I don't doubt that everyone's experience of OSA is different.  To me, it's just a pesky box of tricks I have to cart around with me.

Jonathan

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Permalink Reply by Tigers Fan on September 19, 2012 at 9:47

I have never said that people don't die in their sleep - of course they do! I've booked a slot to exit that way myself - still awaiting confirmation, mind.

Simple question, Kath - how many of your three people died in their sleep because of OSA, pure and simple, no other medical conditions, sober?

You say, very scarily, "....not used their equipment and have died in their sleep" but neglect to inform us for how long they didn't use their equipment, let alone what they died of!

We are talking in this thread of people fit and well enough to fly and travel, are we not? I think Jonathan almost sums it up nicely, "....it's just a pesky box of tricks I have to cart around with me." I would add to that, "so I can sleep restfully." Peace, calm, no thought of dying.

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Permalink Reply by Kath Hope on September 20, 2012 at 22:54

Sorry for the delayed response, but I've had no time these past few days to spend long on here.

In answer to your question TF, all 3 cases were 'scary' news to me, as the first very young person was awaiting treatment and sadly never got to try any.  The other 2 were CPAP users - one of them I'm not exactly sure as to how often the person used it (and I don't feel it's my place to quiz their spouse) or why the mask wasn't on them the night the heart attack happened, but the other had only taken a night's break due to a cold and it was a stroke that killed them.  None of them had any other health issues they were aware of either.  I do know that the 2 adults had not had alcohol.

I am not trying to scare-monger anyone, and as most people on here know I work hard to raise awareness and help people cope with their therapy to enable them to reap the benefits, both for health reasons and so they don't have to live a life like I used to with no energy etc.   I was merely pointing out that I, personally, would never sleep without mine and take any risks.  Even bearing in mind the 3 people I personally knew, I still agree that the odds of taking an occasional night off therapy would be fine.  However, I'm taking no chances!  Just in the same way that my daughter never goes out of the house without her inhaler.  The chances of her dying from an asthma attack are fairly slim, even though this did happen to one of our family members several years ago,  but she still wouldn't risk it.  Interestingly, there was a discussion on our SleepGuide Sister Site on this.  Thankfully, most people on here are CPAP-compliant so we don't have this worry, but I was concerned with your statement of "I have some very good news! You won't!" as I would hate anyone to read this on our forum, take it literally and think it's ok to miss an occasional night, just in case your opinion is wrong!  I'm sure you understand where I'm coming from.

I hope this subject can now be dropped and we can all remain positive that we have been diagnosed and are fortunate enough to have our CPAPs to give us a better quality and longer life.

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Permalink Reply by Terry Vella on September 21, 2012 at 0:09

Well said Kath and I think we pretty much all agree on the same thing, it is giving people on here support and advice that is the most important thing.

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Permalink Reply by Tigers Fan on September 21, 2012 at 11:13

I know where you are coming from, Kath, and applaud you and your efforts. Whilst you are trying to encourage the 'don't take a risk' mind set, I am also saying that if you can't use your CPAP one night (and assuming compliance as a norm) then don't fret  - you won't die (of OSA though heart attacks and strokes and other conditions may get you). You'll wake up feeling like rubbish but you will wake up. A night off will do no harm except to your tiredness level. No need to panic or be fearful. It's alright, dear! Trains, planes, blown fuses, black outs, hotels, foreign holidays, flat batteries etc may conspire to deprive us of the use of CPAP for a night - forgetting to take a hose, in my case - buy it isn't life threatening, you'll be alright, get as much sleep as you can (hah!)

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Permalink Reply by Kath Hope on September 21, 2012 at 18:35

Pleased you understand my concern.  I have had a night where I couldn't use mine and made sure I had no alcohol, my nasal airways were clear and I slept a little elevated on my side.  No way did I go to sleep thinking I might not wake up, and yes I did feel rather lousy the next day, along with the fact it took me ages to get to sleep as I felt naked and vulnerable without the mask on (no I wasn't naked by the way lol).  It's amazing how you get used to sleeping with the dreaded mask.  Rather like women feel when they go out and forget their handbag :D

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Permalink Reply by Rosemary Kemp on September 21, 2012 at 19:10

Thought I'd put my spoke into the wheel over this as there is confusion now that Tigers Fan has made it seem less than urgent that we comply religiously with our cpap equipment.

It isn't just about feeling better because we aren't tired after a night on the machine and the odd night off of the treatment isn't really even the issue here. (I know you aren't dismissing the risks Tigers Fan - I did hear what you said). It is however about attitudes towards our treatment. Once we allow ourselves to get into a mindset that allows us to not use the cpap because we really won't die .... we start to use it less and many may get complacent. This is dangerous. Bad advice to follow!  

Perhaps this is why the hospitals don't encourage us to control our condition and perhaps we deserve to be treated this way by hospitals when complaincy suddenly becomes an option!?

People who can be compliant whatever and not allow themselves the undisciplined attitude that says it is ok to be non compliant when the going gets tough are resposnible. I have no problem with these people preferring to control their own conditions (when hospitals in the UK make it so hard for us to do this, often). Those who are permissive over the treatment perhaps should at least not be encouraging others to follow their ways. It is fine to be permissive for yourself but don't proclaim this to be helpful to others.

I am quite certain that you will reply to me strongly Tigers Fan. I'm ready for it! A lot of people on treatment read this stuff and their futures probably depend on compliancy. We don't know otherwise for sure, most certainly. Some people have died when not using their equipment and there is evidence that it is dangerous for some users of cpap to not use the equipment especially when they have had alchohol.  

Rosemary

   

   

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