CPAP

[Kent W]

Unfortunately I have recently been diagnosed with fairly severe sleep apnea and have to use a CPAP machine. I can skip it for a night or two but likely need to find a light, battery powered option for longer trips.

Does anyone have a recommendation?

Thanks!

[Jerry Adams]

I have mild sleep apnea.  I use a CPAP at home set to the minimum – 4.  My AHI averages about 2 or 3 at that level.

I read that if you have mild sleep apnea, 5 to 15, that a CPAP machine will not reduce your chance of dying.  My sleep apnea doctor concurred.  For mild sleep apnea just treat for patient comfort.

In the sleep study, if I sleep on my side, I don’t have sleep apnea.

So, when I’m backpacking, I just sleep on my side.

This information is probably not useful if you have severe sleep apnea.

How many nights per year do you backpack?  What does your doctor say if you just don’t use a CPAP that many nights?  Would it significantly increase your chance of death?

Newer CPAP machines use less power.  But it would take a large lithium battery to supply enough power.  The CPAP machine maker probably sells batteries, but they probably charge 10x what a cheap battery would cost.

If you don’t use the humidifier and set the air pressure to a lower level than normal it will use less power so you’ll need less battery.  It tells you what your AHI is – set the air pressure just high enough.  Maybe if you just got your AHI below 15 it would be sufficient.

Obviously, don’t get medical advice from anonymous internet people but you could ask your doctor about it.

[Jerry Adams]

I was just looking at my Resmed CPAP.  At a pressure of 4, with no humidifier, it took 20 W.  Measured with my Kill A Watt.

For 8 hours, that would be 160 Wh.

A large lithium USB power bank is 20,000 mAH and weighs 1 pound.  3.6 volts.  72 Wh.  That would be about half a night.  Not that that’s a good solution, but it gives you and idea of how heavy a battery would be –  2 pounds per night.

My Resmed takes 24 VDC.  If you could find a 24 volt lithium battery pack, with a cable to directly connect it to your CPAP, it would weigh less and have fewer objects.

Back to my original point.  As my sleep apnea doctor pointed out, my insurance company will only pay for a CPAP if you use it at least 80% of the nights.  If you backpack less than 20% of your nights and don’t use a CPAP, you will still be fulfilling that insurance company requirement.  Not that that’s scientifically based.

I won’t repeat my warning about taking medical advice from anonymous people on the internet : )

[jscott]

“I won’t repeat my warning about taking medical advice from anonymous people on the internet : )”

I will. I have sleep apnea. Jerry’s right: it won’t kill me. It does, however, make me miserable without treatment. Torturers use sleep deprivation to drive their victims mad. Welcome to sleep apnea.

Oh and apnea exacerbates any existing conditions, that MAY kill me.

Jerry’s also right that there are no good options for powering a cpap while backpacking. There are a number of small, light devices that will help, but they require a lot of power. Go to cpap dot com and other sites to explore this.

I’ve spent hundreds of nights out backpacking both before and after my diagnosis. I usually slept pretty well. After diagnosis I used nasal strips and even a cheapy little in-the-nose device that didn’t help at all. A neck collar is light and may help if your apnea is caused by “chin tuck” that blocks your airway. Look this last up! there are also very pricey dental devices to treat apnea that may work for mild cases, but they have their own drawbacks. For most patients, they don’t work.

Sleep medicine doctors are mostly awful and won’t look past the obvious for treatment. You’ll have to figure a lot out for yourself, IME.

in the meantime, use the cpap machine at home. I never spend a night without one. Dreams are wonderful; so is rem sleep.

[baja bob]

I have mild sleep apnea. I use a mouth appliance. It greatly improved my sleep quality.  It also almost completely eliminated snoring.  It cost me $500 from my dentist.
This is the one I have:  https://glidewelldental.com/solutions/sleep-dentistry/mandibular-advancement-devices/silent-nite-sleep-appliance

Maybe check with the sleep doc to see if this a temporary option while hiking. No batteries needed.

[Lowell k]

Does your apnea improve if you sleep more upright than flat? If so, try sleeping in a hammock vs on the ground.

[AK Granola]

I have mild sleep apnea and use nothing. If it were severe I probably still wouldn’t use anything. I don’t care if I die in my sleep. All my docs – regular doc, sleep doc, dentist, another doc – have told me to lose weight as a first remedy. Do you need to lose weight? Eventually, I’ll do it. At least I won’t gain any more.

[Kevin S.]

I need to get another sleep study.  I was put on a cpap years ago when my health had bottomed out – I had gained a ton of weight, stopped being active and was drinking WAY too much alcohol.  I still use my CPAP nightly, but do not when backpacking – but will get a complaint from time to time if I am with a group camping about my snoring.  However, over the last couple years I have dropped a significant amount of weight and re-discovered cycling/bike touring and hiking/backpacking.  I feel I am sleeping much better now, and maybe shouldn’t worry as much about a few nights without it – but would like to know for sure how significant my sleep apnea is currently before going longer than that.

I also just moved to a hammock set up, but have only slept in it one night, and still getting used to it – so can’t really compare yet.

[Axel J]

I was diagnosed with moderate sleep apnea last year but I have had it for years and was always in denial about it, not wanting to be on a CPAP for the rest of my life. After the diagnosis was made, I was offered the CPAP or the dental appliance for treatment and chose the later. Glad that I did and wish I had done it years earlier because I sleep so much better at home and on the trail. My only concern with the appliance is the TMJ and bite are off every morning. There is a second devise to use every morning to realign the bite  but not sure what the long term effect will be.

[jscott]

“My only concern with the appliance is the TMJ and bite are off every morning. There is a second devise to use every morning to realign the bite  but not sure what the long term effect will b e.”

yeah, there’s the rub. many people also find the devices can loosen their teeth. some can make them work, although they’re not very good for those with more severe apnea.

The machine is actually easy to use. I use a nasal mask, that fits under the nose and doesn’t cover my face.

Again, “chin tuck” turns out to be more prevalent as a cause and it’s worth trying a soft foam neck brace to prevent doing that when you sleep. folks effectively close their airway doing this. Lightweight for backpacking too.

[Jerry Adams]

There’s that heavily advertised device – inspire

They implant it in an out patient, one day procedure

Then, you have a “TV remote” that you use to turn it on when you’re sleeping, off when you wake.

The remote must not be very heavy, and it’s good for many days

[DAN-Y]

There’s that heavily advertised device – inspire

They implant it in an out patient, one day procedure

Sompe people experience discomfort with the “Inspire”:

 

 

[DAN-Y]

This kit is what a lot of cpap users need to lighten their cpap for the trails. I used it to create a unique way to rid my needs for a heated tube and heated water chamber. The Heat Moisture Exchange part of the kit is the hikers friend.

https://shop.resmed.com/en-us/sleep-store/cpap-accessories/airmini-n20-setup-pack

 

[Jerry Adams]

how much does the kit weigh, and how much per night for battery?

[DAN-Y]

how much does the kit weigh, and how much per night for battery?

View the cpap and accessories and specs at the link:

https://www.resmed.com/en-us/sleep-apnea/cpap-parts-support/sleep-apnea-full-products-list/cpap-machines/airmini-portable-cpap/

[DAN-Y]

I’m in the process of testing the kit with my Resmed unit. It has the N20 mask that is compatable with the HME unit. This is my machine:

[dmorgan]

I use this Resmed Airmini kit (with the N30 mask option). I use a 24V TalentCell Battery – it’s far cheaper than other options and works just as well ($60 vs $300). Here’s what I get when I weigh it out:

Main Kit

Resmed Airmini: 10.51 oz

Hose (not heated): 2.86 oz

Mask N30 + cushion:  1.06 oz

Humid X filter (optional): .11 oz

Total for kit without battery: 14.54 oz

Battery: 

24 TalentCell Battery (PB240A1 model 22400mAh 82.88Wh Li-ion): 14.41 oz

Cable to attach battery: 1.85oz

Battery + Cable: 16.26oz

I get about 2-3 nights out of this battery in average high Sierra early fall temps.

Total for Kit and Battery: 30.8 oz or 1.925 lbs for 2-3 nights(max) 

A couple notes: This machine is a little loud. You can hear a whoosh of air coming out of the joint where the mask tube and main tube meet (it’s also where the optional humidity filter lies). Some may be bothered by this more than others.

The humid x filter is optional but I find it necessary in dry Sierra conditions. There’s a slightly lighter one to choose from as well. Your experience may vary. Overall, im happy with it – it works – and it’s fine above 10k feet. Am I happy I have to carry this extra weight? Nope, but I need it and getting restorative sleep is worth it.

Also, insurance won’t cover this travel cpap option. It’s not cheap.

 

 

 

[Jerry Adams]

Thanks.  Almost 2 pounds for 3 nights isn’t prohibitive.  Well worth it if you have severe sleep apnea.

Everything from resmed is expensive.  Maybe they have extra reliability because they’re medical devices.  If your non resmed battery works, then it’s just as good as the expensive resmed one.

Is the connector for your battery the same as resmed?  That would be another way for resmed to discourage any competition.

Do you set the cpap to lowest pressure and no humidifier so the battery lasts longer?

[dmorgan]

I find the CPAP pricing in general to be extortive and ridiculously high, but I digress. Yeah, I waited for this to be on sale and it ends up being around $900-$1000 with everything included.

I do set the cap to the lowest pressure I can handle and no humidifier (but the airmmini doesn’t have a humidifier – it just uses the filter – which I DO use – and maybe going without it would increase the time one would get out of the battery a little bit).

The DC power output cable for the airmini and battery was really tough to track down. It’s not made by resmed, but it fits. I found a solid one here: https://www.bixpower.com/product-p/cab-airmini.htm.

 

[DAN-Y]

I use this Resmed Airmini kit (with the N30 mask option).

DMorgan, Is this the type of mask you are using and the one that makes a lot of noise where it connects to the hose?

[DAN-Y]

Jerry, my cpap has an end cap that will replace the water chamber to make it more compact and lighter in weight.

[dmorgan]

Dan-y, that’s exactly the part that makes noise. It’s like a white noise that’s similar to an air filter or fan on at a medium setting  (subjective, I know). I’ll measure the dB when I get a chance.

I should note: I have the Airsense 11 Cpap machine for home use and its extremely quite by comparison. It’s barely at the level of rustling leaves.

[Jerry Adams]

$23 for a cable seems pretty expensive too :)

I have an airsense 10 for home use, very quiet. I left on the water tank but never use it.  Set it to 4 PSI, the lowest setting, and my AHI is about 3.

I had a Philips before but it got recalled.  It was very noisy, but it was the power supply.  Ridiculous that they didn’t make a quiet power supply.  There are zillions of similar power supplies, like for computers, that are quiet.  They still owe me $100 for the recall – I wonder if they’ll every send it to me.  Uh oh, I’m digressing…

[DAN-Y]

My home machine is set at presure 11. Very slight white noise when I inhale comes from the HME unit that I have adapted to the home machine. I am well pleased with the test results.

I no longer need to use distilled water or heat my hose. I’ve increased the length of hose by 4 feet. I keep the hose coiled together with fabric tape. The coil is kept under my covers agains my chest. This is the way I will be able to be in a tent situation using a battery powered cpap. I have a Transcend cpap for trail use.

This little device, HME, is a game changer for backpackers.

[dmorgan]

Dan-Y, that’s smart to to coil up the tubing under the covers/sleeping bag in this way. I’ll have to borrow that technique. I have a tiny velcro strap for it.

The Transcend micro looks great. It’s a few ounces lighter than the Airmini I have and smaller, too. And I agree, the passive (heat moisture exchanger) humidification has huge upsides – especially for the trail. I got used to the noise. P.S. that joint might be slightly louder on exhale paired with the airmini vs home machine.

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