My wife and I recently represented CPAP.com at the Montana Regional Sleep Seminar. We decided the best way to show people what we were about was to bring as many comfort and travel items with us as possible, and pile them on the table, so people could try them out and answer questions. Respiratory therapists and sleep technologists seemed to really key off the battery packs. When we asked why, we learned that hunting season would soon be under way. As the demand for ammo increases, compliance rates can plummet as hunters leave their CPAP machines behind. When it comes time for your patients to pack their bags, how can you ensure they will arm themselves with their CPAP machines? The following travel tips can help encourage patients to continue their treatment when away from home.
Pack the CPAP machine
The first and most important thing a sleep apnea patient can do is to bring their CPAP with them! The goal is to stay rested by recreating one’s usual nightly CPAP setup to the extent possible. Patients would not leave heart medication behind. Why would they leave their CPAP?
Empty the humidifier chamber
Patients should be sure to drain and dry their heated humidifier before packing it away. A humidifier containing water can be jostled during travel, causing leaks into the CPAP machine. While heated humidifier backflow prevention designs are much improved in recent years, water-logged CPAP machines will still short out and few warranties cover water damage.
Take an extension cord
Power outlet locations in hotel rooms, camp sites, and cruise ships are quite nonstandard. This can cause problems when the nearest power outlet is more than 6 feet away from the patient’s bed. Packing an extra extension cord will prevent such issues.
Pack all CPAP equipment at one time
Patients should “break down” their CPAP and gather all components together. CPAP travel bags tend to have a compartment for each part. Start with an open CPAP travel bag and pack each part in turn until there are no more empty compartments. At minimum, patients should pack their machine, mask (with headgear, frame, and cushion or nasal pillows), hose, and power cord.
Keep the CPAP bag as a carry-on item
It is a good idea to pack a CPAP as a carry-on and not place it in a larger suitcase. Most airlines will not count a CPAP bag as a carry-on. By carrying on, patients can prevent CPAPs from being damaged during transit and lost in checked luggage.
AIRPORT, HOTEL, AND CRUISE LINE TIPS
Identify CPAP as medical equipment
Patients should display medical equipment identification tags on their CPAP bags. Most Transportation Security Administration (TSA) agents will ask permission to take it out of the bag and examine it. If possible, patients should walk with them to the area where they are performing the inspections. A CPAP bag contains many parts. When the agent takes out the machine, a power cord or mask cushion can fall out and be missed. By watching the inspection, patients can help make sure their complete CPAP rig makes it to their destination.
Check power options
Some international flights include power boxes under the seat, which can be used by patients to plug in CPAPs during long flights. Each airline has their own policy on in-air CPAP use and power requirements. Patients should call their carrier in advance to learn about their options.
Check distilled water options
Many cruise lines ask on their reservation forms if the customer will need arrangements for CPAP equipment. In fact, many hotels and cruise lines now stock distilled water and will often provide it for free to their guests on request. This is one less thing to remember to pack and less weight to carry.
The battery trend
Patients are increasingly seeking out CPAP comfort and mobility items. Battery basics aren’t always easy to understand and actual setup gets complex fast. How can you help a patient who is heading into the great outdoors?
Know the types of power
There are two basic types of power delivery, AC and DC. Alternating current or “AC” is what flows from the power outlets in your home. Direct current or “DC” is what flows from batteries.
Understand inverters and converters
Inverters and converters can be used to adjust AC and DC power. An inverter is a device that will convert DC into AC power. This is useful if a CPAP user has an AC-only device and wants to power it with a battery. A converter is a unit that will step up or step down DC power. This is useful if the CPAP user has a machine that will only take 24V DC and the power source is 12V DC.
Consider battery options
A deep cycle marine battery offers the longest available battery life. A CPAP set at 10 cm/H2O without a humidifier will usually run for about 3 nights before having to recharge. Unfortunately, these batteries do not travel well due to their size and weight. If a patient is headed out on a road trip or camping, let them know that a car battery will usually run a machine without a humidifier for 8 hours while still being able to start the car. The Philips Respironics Battery Pack is a 13-pound, sealed, lead acid battery pack that will run a typical CPAP set at 10 cm/H2O for 2 nights or a CPAP with humidifier for 1 night. The CPAP.com Battery Pack is a 2.5 pound lithium ion battery pack that will run a typical CPAP set at 10 cm/H2O for 1 night but will likely not run a CPAP with humidifier for a full night. CPAP.com provides a power calculator tool on each machine and battery product page that allows you or your patients to input a given machine and pressure and get back estimated battery lifetimes in hours for the Philips Respironics and CPAP.com battery packs.
Get the right DC cable
Not all DC cables work with all machines. Make sure your patient purchases a DC cable that is approved for use on their specific machine. In extreme cases, using the wrong DC cable can damage the machine and void the warranty.
Determine if adapter plugs are needed
Patients traveling internationally will need a set of World Traveler Power Adapters. To use, plug the power cable into the power adapters and the power adapters into the socket in a foreign country. This will allow any CPAP rated to accept domestic and international power (110/220) to work nearly anywhere in the world.
Know a machine’s power requirements
Depending on the patient’s machine, they may need additional parts to power their machine. For example, not all machines can be run on DC power, and they require an inverter as a result. Others need 24V DC and need a converter to step up a 12V DC battery. If the proper power requirements are not followed, damage to the CPAP machine can result. You can refer to the manual or call CPAP.com for help with detailed power questions.
TIPS FOR HELPING “ROAD WARRIOR” PATIENTS
Keep the weight down
CPAPs are getting smaller with each new product line’s release. The machines all have smaller profiles and good to great sound levels in terms of pitch and total volume. As a result, when deciding between nightstand units for travel, the most useful metric is the “entire weight,” which is the combined weight of the machine, heated humidifier, power cables, bag, and hose. Some manufacturers will publish and advertise only the weight of the machine itself. This allows the weight advertised to be low but can gloss over a heavy power brick or heated humidifier. A lightweight CPAP unit in terms of entire weight is the Probasics Zzz-PAP at 5.3 pounds. The IntelliPAP Auto merits an honorable mention, packing auto adjust technology into a travel-friendly 6.1 pounds.
Find power-friendly machines
Other than weight, the second most important factor to consider when suggesting a travel machine is power flexibility. Some machines require a complex, multiple part setup to be able to run on alternative power. Although the Zzz-PAP is light, it cannot be run on DC power without an inverter. DeVilbiss and Philips Respironics are two manufacturers whose machines tend to be battery friendly. ResMed just released their DC converter for their S9 machines, allowing their machines to use battery power. Humidifier power requirements should also be considered when deciding which travel CPAP is best for a patient. Ideally, running a machine with a humidifier should require no additional parts or adapters. The more power-friendly the machine, the less worry the patient will have about getting the power setup correct.
The cutting edge of travel friendly
Somnetics has recently introduced the Transcend CPAP machine. It is a battery powered CPAP machine roughly half the size of the smallest nightstand unit and is worn on the head. The CPAP is held in place by extensions to traditional nasal mask headgear, and a short tube routes air from the unit overhead down to the mask below. It comes with click-in cushion adapters for the most popular nasal CPAP masks, so patients can wear their tried and true mask. Humidification is provided with a heat moisture exchanger most commonly used in hospital applications but cleverly adapted to CPAP. There are several areas where this machine comes out even with or behind traditional units. Being designed for battery power, the Transcend operates from 4 to 16 cm/H2O. This covers the vast majority of patients but not all. The Transcend is rated at 31.4 dB, which is on par with the last generation of nightstand units but louder than the 24-26 dB new generation nightstand units.
TRAVEL ACCESSORIES TIPS
Keep light and leak out
Not only does the soft and flexible Onyix eye shield help prevent mask leaks from irritating the eyes, it also is a great accessory for blocking out light while traveling or when adjusting to a new time zone. This is always a favorite of night-shift workers.
Bring along hose management
Traditional hose management systems do a great job of keeping the hose up and away as a patient sleeps but are heavy and bulky. Recently, a new Travel Hose Buddy system was released that is built of the same materials as collapsible tent poles. These lightweight poles fold easily and perform very well.
Block out the noise
Many times new sounds or lack of noise can make getting a good night’s sleep difficult. SleepPhones can be described as a soft fleece headband that contains headphones. Patients can wear the SleepPhones under a CPAP mask and connect to any music player, enabling users to select the sounds to fall asleep to.
Johnny Goodman is general manager at CPAP.com. The author can be reached at firstname.lastname@example.org.