What are the regulations for using a Continuous Positive Airway Pressure (CPAP) machine on a flight?

CPAP Use on Commercial Flights: Regulations and Requirements

Dry cell battery-powered CPAP machines are permitted on commercial flights, but passengers must notify the airline at booking, bring their own device, and ensure it is switched off before landing. 1

Pre-Flight Requirements

Airline Notification and Approval

• Passengers requiring CPAP must inform the airline of their requirements at the time of reservation. 1
• A doctor's letter is required outlining the medical diagnosis, necessary equipment, recent blood gas results if applicable, and device settings. 1
• Approximately 53% of airlines surveyed support passengers requiring in-flight CPAP, though many airlines remain unaware of CPAP policies. 2

Device Specifications

• All airlines that permit CPAP require passengers to bring their own machines. 2
• Battery-operated machines are universally allowed among airlines with CPAP policies. 2
• Only 21% of airlines allow passengers to plug machines into the aircraft power supply, so battery operation should be assumed as the standard requirement. 2
• Many airlines restrict certain CPAP models or battery types, requiring verification of device compatibility before travel. 2

In-Flight Use Restrictions

Critical Safety Requirement

• CPAP machines must be switched off before landing—this is a mandatory safety regulation. 1
• The device may be used during cruise altitude but cannot remain operational during descent and landing phases. 1

Practical Limitations

• For overnight flights, approximately half of CPAP users do not sleep, and none reported using their CPAP machines during flight in surveyed populations. 3
• This suggests that despite permission to use CPAP in-flight, practical barriers often prevent actual usage. 3

Common Travel Problems and Solutions

Check-In Issues

• Problems with checking in CPAP machines occur in approximately 4% of trips, exclusively during air travel. 3
• The majority of airlines (68%) do not charge passengers for CPAP use, though 32% have unclear charging policies. 2
• CPAP machines should be carried as hand luggage rather than checked baggage to avoid temperature extremes in the hold compartment that may damage the device. 1

Technical Considerations

• Over one-third of patients face problems with power cords, adapters, or transport of CPAP machines during travel. 3
• Travelers take their CPAP machines on 81% of trips regardless of mode of travel, destination, or holiday length. 3

Altitude Effects

• CPAP devices without pressure-compensating features will deliver altered pressures at high altitudes due to changes in air density affecting fan-generated airflow. 4
• Machines equipped with pressure regulation features maintain consistent pressure regardless of altitude changes. 4
• This is particularly relevant for patients traveling to or from high-altitude destinations, where delivered pressure may vary systematically unless the unit has compensating features. 4

Documentation Requirements

Medical Letter Contents

The physician's letter should include:

• Medical diagnosis (obstructive sleep apnoea)
• Necessary equipment specifications
• Recent blood gas results if oxygen supplementation is also required
• CPAP pressure settings 1

Patient Preparation

• Patients should verify their specific airline's CPAP policy before booking, as policies vary significantly between carriers. 2
• Confirmation of device model compatibility with airline restrictions should be obtained in advance. 2
• CPAP-related reasons for not traveling are rare (occurring in only 5 cases among surveyed populations), suggesting that with proper preparation, travel remains feasible. 3