Better Sleep Better Health

As the summer months approach and thoughts drift to vacation plans around the country and abroad, many people who have been treated for Obstructive Sleep Apnea with continuous positive airway pressure, or CPAP, may wonder how to maintain a healthy night’s sleep away from home.

Traveling by airline with a CPAP

Since 9/11 many restrictions have been put in place to increase security on airlines. One inconvenient measure has been the reduction of the number of bags allowed as carry-ons. This is one instance where having a CPAP machine and knowing your rights can come in very handy. The FAA classifies CPAP as a medically necessary device. This means that passengers are allowed to bring the machine and its bag on board as an extra carry-on. Savvy travelers can will find that CPAP bags, when well packed, can provide much needed valuable real estate in these times of $50 checked luggage. TSA handlers are generally well versed with CPAPs but may ask you to remove the machine from it’s bag for additionally screening, including swabbing for explosive residue, at the security checkpoints. If you happen to encounter an overzealous TSA agent that tries to make you check your CPAP, present them with this document issued by the Department of Transportation stating the machine is to be allowed through. An official note from your doctor showing medical necessity doesn’t hurt either, especially in foreign lands.

International Travel

Most currently produced PAP machines from major manufacturers utilize international power supplies. This means they can automatically adjust for different voltages, such as 240, without the need for special equipment. This eliminates the danger of burning out a PAP while on vacation. However, travelers will still have to bring plug adapters along to fit into different sized wall outlets. And it is prudent to look up contact information for your CPAP manufacturer in the destination country. If something goes wrong with your machine, having a certified repair center nearby can mean the difference between a memorable vacation and a ruined trip.

Camping with CPAP

Many people think that having a CPAP will stop them enjoying outdoor trips such as camping , hunting, and hiking. But newer CPAP machines are very portable and easy to use without a constant power source. There are now reliable battery powered CPAP units that can be recharged on the road via car adapters. Depending on the pressure level used, these units can provide overnight power for several nights before needing a recharge. Don’t want to spring for another machine? No worries, universal battery packs are also available for most major CPAP machine models on the market. These batteries are small, long lasting, and utilize the latest in battery advances. And most major companies, such as Resmed and Respironics offer car cigarette lighter adapters which make RV or car camping with CPAP easy.

For more information about traveling with CPAP, contact a qualified DME provider like the ones at Oregon Sleep Associates.

Recently two stories of overly tired air traffic controllers have made headlines. First, an air traffic controller inadvertently dozed off at Ronald Reagan Washington National Airport, leaving two cargo planes to land themselves. Then reports came out detailing a Nashville controller purposely sleeping during a busy shift. These incidents are frightening considering the important responsibilities these individuals are given every day.

One would expect sweeping changes to the follow such revelations about air traffic security, yet as an open letter from the chairman of the National Sleep Foundation to the FAA shows, the changes needed are not happening:

“Americans are justifiably concerned by the recent spate of incidents involving air traffic controllers who fell asleep on duty.  But now that the FAA/DoT has outlined the steps it intends to take to address this problem – minor tweaking of the controllers’ work/rest schedules combined with a threat of stricter disciplinary action against offending controllers in the future – the public’s response ought to escalate from concern to alarm.

This is because the announced changes amount to tokenism – gestures more likely to assuage public anxiety than to meaningfully reduce fatigue in air traffic controllers.  For example, although it is true that extending the time off between shifts (from 8 to 9 hours) will probably result in more sleep (which is good) it will not result in adequate sleep (the amount of sleep necessary to sustain normal alertness during the night shift).  Prior research shows (and common sense dictates) that a significant portion of the 9 hour break will be devoted to commuting, eating, personal hygiene, socializing with family, etc.  If the FAA was truly serious about optimizing alertness in air traffic controllers, and if the policy makers based their decisions on scientific evidence, the time off between shifts would have been extended to at least 12 hours – and scheduled napping would now be encouraged during work shifts, rather than prohibited. Likewise, prior sleep research (and, again, common sense) suggest that the threat of more severe punishment will have no beneficial effect on alertness.  Those air traffic controllers who fell asleep did not do so because they were not properly motivated to maintain wakefulness.  They fell asleep because they had a significant, physiological need for sleep.  And they probably didn’t even realize they were falling asleep – sleep onset can be insidious. (Think about it. If sleep onset was not insidious, would anyone ever fall asleep while driving an automobile?)

Also, it should be pointed out that both the airline industry and the FAA have known about this problem for decades.  In 1981 the National Transportation Safety Board (NTSB) published a special investigative report on air traffic controller fatigue. However, the recommendations outlined in that report were essentially ignored – and classified as “Closed—Unacceptable Action” in 1989.  Since then, the NTSB (which is the congressionally-mandated special investigative body charged with determining causes of transportation accidents) has issued more than 80 new fatigue-related safety recommendations.  Care to guess how many of these recommendations have been implemented?

History is replete with accidents resulting in human death and injury caused by sleepy transportation workers, and the NTSB routinely cites air traffic controller fatigue in its findings. One tragic example is the August 2006 accident involving Comair flight 5191 in Lexington, Kentucky, in which the air traffic controller cleared the plane for take-off on the wrong runway, resulting in a crash that killed 49 people. Unfortunately, given the inadequate response to the recent incidents, we can expect more sleep and sleepiness-related errors and accidents involving air traffic controllers in the future.”