Many patients who regularly use CPAP at home do not take it when they travel. This is a very dangerous decision due to increased risk of cardiac and stroke problems. People with untreated apnea are more likely to die in sleep than when exercising. When patients do take their CPAP they may have problems with current or compatible plugs, access to clean water for humidifiers or facilities to properly clean machines on a daily basis. I recently saw a patient who inadvertently used raspberry flavored Dasani water in her humidifier instead of plain and ended up hospitalized with a severe pulmonary edema. Unfortunately, clean water may not always be available in foreign travel.
China is becoming a common business destination as is the entire Asian continent, and long travel times usually mean sleeping on the plane. CPAP machines are now available with batteries but these increase weight dramatically and you may not be allowed to use them. In addition, it is problematic using them if you are not flying first or business class. I recently saw a patient who flew to China for a business trip; however, his snoring was so loud that the stewardess woke him continually throughout the trip. He was embarrassed when he realized that not only did he disturb the passengers in first class but it was a major topic of discussion throughout the plane. Worst of all he arrived in China so exhausted he was unable to function well in his executive capacity. An oral appliance saved his next trip, but he almost missed his plane home when he realized he left his appliance on the bed stand and had to return to retrieve it. He never had this problem with his CPAP machine because of the size and packing issues.
Sharing rooms with spouses and friends can be a major issue if the CPAP machine is not brought along. Many patients book two hotel rooms at great expense or stay at less posh resorts to get inexpensive rooms. Snoring often leads to tense situations on what was supposed to be pleasurable vacation. Patients who go on camping and hunting trips with friends may find that they are not invited on the next trip due to their snoring disturbing the sleep of others. As it can be difficult to find a 200-mile extension cord, one patient who used an adapter to run his CPAP off the auto battery found himself stranded in the morning with a dead battery.
The Academy of Sleep Medicine approves oral appliances to treat mild and moderate apnea as a choice of treatment. They are also used for severe apnea in patients who do not tolerate CPAP. They are not for everyone, but the majority of patients prefer them to CPAP and compliance rates are higher. Oral appliances are easy to travel with fitting unobtrusively in shirt pockets and purses. They can be worn while sleeping on a plane, as the patient cited earlier did on his next China flight. Unfortunately, because they are small they are sometimes forgotten in hotel rooms. They are easy to use and care for while traveling. Many patients who like their CPAP machines get oral appliances to travel with and often switch full time to appliances.
Dr. Shapira has been treating patients utilizing oral appliances for 25 years and is a pioneer in the field. More information can be obtained at www.ihatecpap.com.