About Our Expert: Dr. Carleara Weiss, Ph.D., MSN, RN is a clinician scientist in behavioral sleep medicine and circadian rhythms with over 15 years of experience as an adult-geriatric nurse.
Millions of Americans are living with obstructive sleep apnea (OSA), and if you are among them, you should know that you deserve to fly and go on road trips without stress. If you’re afraid that traveling with a C-PAP machine will be a logistical nightmare, don’t worry. It’s easier than you might think to take it through the TSA line. In fact, traveling when you have sleep apnea can be seamless with the right preparation. I asked sleep scientist Dr. Carleara Weiss about everything travelers with sleep apnea need to know before they hit the road or the runway.
The real risk of skipping your CPAP on a trip
The biggest risk for a traveler with sleep apnea is arriving at their destination without a working CPAP. Dr. Weiss cautioned, “Those traveling with untreated OSA may experience symptoms such as extreme daytime fatigue and, in extreme cases, a risk for cardiovascular events, such as heart attacks and strokes,”
The effects go beyond physical health. Untreated or mismanaged OSA negatively impacts oxygen levels to the brain. According to Dr. Weiss, the fallout includes “headache, daytime sleepiness, brain fog, fatigue, and high blood pressure.” Mentally, she noted, “it can cause mood swings, irritability, anxiety, or depression.”
Skipping your CPAP can mean a ruined trip, so plan ahead and double-check you have it before you leave your home.
Is it actually safe to travel with sleep apnea?
“It is safe to travel with sleep apnea and bring the CPAP device,” advised Dr. Weiss. The only patients she’d advise to hold off are those with unstable medical conditions such as “a recent stroke or heart attack, those experiencing severe and untreated OSA symptoms with a severe apnea-hypopnea index.” (A severe apnea-hypopnea index (AHI) means you have 30 or more breathing disruptions per hour of sleep.)
For everyone else? “OSA should not limit your travel plans,” she said. “Instead, make sure to follow the proper treatment prescribed by your provider and follow the advice to bring your CPAP on your trip.”
What flying actually does to sleep apnea
Here’s something many travelers don’t realize: the airplane cabin itself can make sleep apnea temporarily worse. “Cabin pressure, reduced oxygen levels, and dry airplane air can exacerbate sleep apnea symptoms, primarily by reducing oxygen levels and triggering more frequent breathing disturbances for people with OSA,” Dr. Weiss explained.
However, as for sleeping upright in your seat, that can be a good thing. “Typically, sleeping in an upright seat does not make OSA worse, because this position keeps the upper airways open, as long as the neck does not bend forward while sitting.”
Your complete CPAP packing list
Dr. Weiss recommended treating your CPAP like the essential medical equipment it is.. The Air Carrier Access Act classifies CPAP as a medical device, allowing it to be carried on, and it does not count against your carry-on limit.
Here’s Dr. Weiss’s full packing checklist:
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The machine itself, in its protective travel bag, plus your mask (and a spare), tubing, and power cords.
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A cord extension in case the outlets in your hotel or vacation home are far from the bed.
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A universal power adapter for international travel.
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A battery pack or DC converter/inverter if you’re camping, on a long flight, or may not have a reliable power source.
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Travel-sized cleaning wipes or a small brush, extra filters, and a spare mask cushion.
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Your humidifier and distilled water (or water purification tablets) to avoid mineral buildup. (Be sure to empty the humidifier before you board.)
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A copy of your prescription and a doctor’s letter of medical necessity.
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A small carrying case for accessories; a clear bag works well to speed up TSA screening.
The TSA rules most travelers don’t know
Here’s a detail that surprises a lot of CPAP users. “You can bring your CPAP as a carry-on; it does not count as one, so you can still bring another carry-on item,” Dr. Weiss said.
There’s also a water exception many miss. “You can also bring distilled water for the humidifier, as medical devices such as the CPAP are exempt from the liquid rule.”
To move through screening smoothly, Dr. Weiss recommended bringing your doctor’s prescriptions and “an FAA compliance letter, indicating that confirms CPAP as a respiratory assistive device, cleared by the FDA, and that it does not contain any parts or materials known to cause or interfere with commercial aircraft safety.” It’s best to also notify your airline when booking or checking in that you’re traveling with a CPAP.
Can you use your CPAP on the plane?
“Someone with moderate or severe OSA, on a long flight, can use their CPAP in-flight,” said Dr. Weiss. You’ll want to contact your airline in advance, ensure your CPAP is FAA-compliant (almost all newer models are), and have your provider letter and prescription on hand.
For international flights specifically, her advice is straightforward: “Pack your carry-on with the CPAP device, mask, tubing, gear, a cord extension, a battery pack, and a copy of the FAA-compliant prescription letter.”
And if you’re weighing a travel-sized CPAP machine, don’t let the compact size fool you. “They are clinically effective and serve as an excellent travel option,” she confirmed.
Jet lag + sleep apnea: a tricky combination
If you’re crossing time zones, your sleep apnea and jet lag can actually feed off each other. “There is a bidirectional relationship between OSA and jet lag,” Dr. Weiss explained. “Jet lag causes circadian rhythm disruptions and sleep fragmentation, which in turn increases breathing interruptions and lower oxygen levels.” This makes consistent CPAP use even more important when you’re traveling across time zones.
What to do if you forget your CPAP
Life happens, and you can’t remember everything. If you arrive at your destination and realize your CPAP isn’t with you, Dr. Weiss has a practical game plan. First, explore “shipping your device to your travel destination or checking for rental or travel options there”. Just keep in mind that you’ll need your CPAP prescription for any rental.
If a machine isn’t accessible at all, she recommends these short-term strategies to keep your airway as open as possible:
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Sleep on your side rather than your back.
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Elevate the head of your bed.
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Avoid alcohol and smoking, both of which can worsen airway collapse during sleep.
Signs you might have undiagnosed sleep apnea
Traveling can actually be a revealing time for people who haven’t yet been diagnosed, especially when a partner or travel companion notices symptoms. Dr. Weiss said the warning signs to watch for include “loud, persistent snoring, waking up gasping or choking, multiple awakenings during the night, and severe daytime fatigue despite adequate sleep.”
If any of those sound familiar after a trip, it’s worth talking to a doctor when you get home.
The #1 mistake CPAP travelers make
According to Dr. Weiss, two of the biggest mistakes CPAP users can make when traveling are checking their CPAP with their luggage instead of bringing it as a carry-on medical device and simply not bringing it during their trip. Both are easy to avoid by keeping the machine with you during your travels.
As for first-timers anxious about the whole process? Dr. Weiss was reassuring: “Despite the initial stress of doing so for the first time, most patients enjoy their trip, remain compliant with their treatment, and have no trouble bringing their CPAP.”
One small footnote: don’t forget your international power adapter when going to another country. You can easily buy one at your destination if you forget it, but it’s one less thing to worry about if you pack it from the start.
The bottom line
Dr. Weiss’s parting advice is simple: “Be consistent with your treatment during the trip. Bring your CPAP and plan accordingly to make the most of your trip while also maintaining your health.”
Sleep apnea is a serious condition, but it doesn’t have to come between you and living your best life by traveling. With the right preparation — and your CPAP in the overhead bin — you can sleep just as well in a hotel room in Paris as you do at home.
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This article is for informational purposes only and does not constitute medical advice. Always consult your doctor or a qualified healthcare provider before making any changes to your sleep apnea treatment, especially while traveling.
More About Our Expert: Dr. Carleara Weiss, Ph.D., MSN, RN is a clinician scientist in behavioral sleep medicine and circadian rhythms with over 15 years of experience as an adult-geriatric nurse. She is a sleep science advisor for Aeroflow Health, and is also a research assistant professor at the State University of New York in Buffalo, New York.