July 20, 2010
There are many resources available regarding tips for travel while on vacation, but one thing that can definitely ruin your vacation is poor sleep. You may never think that you will suffer from sleeping problem until it happens, and by then, it’s too late. Besides the various stresses of travel, including delayed flights, misplaced luggage, or traveling with children, the last thing you need is to lay down in your hotel bed, and start tossing and turning, unable to sleep.
On the other hand, you can go to sleep with no problems, but wake up feeling like you slept for only 3 hours. This can happen due to worrying about your lost luggage, persistent ear pain and hearing loss since getting off the plane, or an uncomfortable mattress or pillow. If you are a poor sleeper to begin with and especially if you normally can’t sleep on your back, then the following travel tips could prevent your vacation from turning into a disaster.
Tip #1. Keep your nose clear.
If you have a history of ear or sinus discomfort while flying, or if you have any degree of nasal congestion due to allergies or colds, then take preventive measures to open up your nasal breathing passageways to prevent ear, nose or sinus problems which can keep you up at night. Your ears and sinuses are connected to your nose through very narrow passageways. If you have any form of nasal congestion or inflammation, these passageways can become more narrow, and the rapid pressure changes during your flight (usually when descending) can aggravate more swelling and a partial blockage of your sinuses or ears. The middle ears are connected to the nose by the Eustachian tubes, which acts to equalize pressure between your nose and your ears every time you swallow. But when there’s swelling (due to colds, allergies, migraines, or acid reflux) around the Eustachian tubes in the back of the nose, this tube doesn’t work properly and your ears won’t equalize. Not breathing well through your nose can also prevent proper breathing at night, leading to poor sleep.
The simplest way of preventing ear, nose and sinus problems while flying is to decongest your nose using generous amounts of nasal saline (which is a mild decongestant), or over-the-counter decongestants, such as Sudafed tablets or Afrin nasal spray. If you have high blood pressure or are sensitive to Sudafed, it’s not a good idea to take. Afrin, on the hand, can only be used for 2-3 days if you have persistent ear fullness after the flight. For most people, taking a decongestant in the middle of the flight (before descending), should be enough. There are various ear “plugs” marketed for flying. They can be helpful for some people; if it works, keep using them.
Now that you've made it safely off the plane without any problems, you finally make it to your hotel at 9 PM and check in. You're really hungry and stop by the restaurant to grab a sandwich.
Tip #2: Don’t eat before bedtime.
Eating late before bedtime, while on vacation or at home, is the single most common habit that could potentially ruin a good night's sleep. On vacation, it’s tempting to eat later or binge at a great restaurant, but you’ll pay for it that night. For many people, if you have food in your stomach when you lay down, some of the stomach juices can regurgitate up into your throat, causing irritation and inflammation. This can wake you up more often, diminishing deep sleep quality. For people who snore or prefer to sleep on their sides or stomachs, they may actively suck up stomach juices into their throats while sleeping, worsening an already tenuous sleep situation. The general rule of thumb is to eat your last meal about 3-4 hours before bedtime. This also means no snacks before bedtime.
Tip #3. Avoid the Night Cap.
You've stopped your late night snacks, and so far so good. You make arrangements to meet your long-time friend at the hotel bar, but the earliest he can meet is at 10 PM. The two of you meet and decide to have a glass of wine. As you take your first sip, you remember the newspaper article that reported that red wine has an ingredient that could keep you young. Afterwards, you to back to your room to rejoin your wife, and you go to bed. The next morning, for some reason, you feel like you only slept for 3-4 hours. What happened?
There are numerous studies that tout red wines' beneficial health effects. But one aspect of red wine, and all other forms of alcohol, that could be detrimental to your health is its' relaxing effects on your throat muscles. If you already have a slightly narrowed upper airway passageways (like most people), sleeping on your back can cause mild collapse of your tongue backwards. But when you add deep sleep, since all your body's muscles relax the most, adding alcohol can tip you over the edge and cause you to stop breathing. You may wake up subconsciously, or completely awake. This is one of the main components of alcohol that promotes hangovers in some people.
The bottom line is that you should avoid drinking alcohol 3-4 hours before bedtime.
Tip #4. Take Your Own Pillow.
You've stopped your late night eating and drinking alcohol, and you are ready to go to sleep. You lie down to sleep, but something doesn't feel right. After a few minutes of tossing and turning and fluffing the pillow, you realize what the problem is: you miss your own pillow. Yours is much firmer, and the hotel's pillow is too soft. Thinking about your pillow is not something that most people consider before taking trips. You can't bring your own mattress, but you can bring your own pillow, if space allows. On car trips, I always bring my own memory foam, contoured pillow. A soft down pillow could easily fit into a decent sized suitcase.
Don't wait until you are ready to go to bed to find that the hotel's pillow isn't "just right." When you first arrive in your room, after you unpack, test drive your pillow. If it doesn't feel right, ask the concierge for a different type of pillow. Some may even have the memory foam contoured pillow that I like, and some Asian travelers may prefer a roll-like buckwheat-filled pillow.
If you like to sleep on your back, and feel less than refreshed in the morning, try sleeping on your side. If that's not possible, experiment with the roll-like pillow that I mentioned previously, or roll up a towel to just the right thickness. The reason this may help you sleep is that when your head is cocked back slightly when sleeping (unlike softer, down pillows that end up bending your head forward), the space behind the tongue opens up significantly, preventing frequent awakenings at night.
Tip #5. Don't Sleep In.
When you're on vacation, it's tempting to stay up late and sleep in in the morning. RESIST THE URGE. I've already covered in the past few lessons why it's important not to eat late, and why you must go to bed at a reasonable time to allot for your normal sleep duration. If you go to bed late and wake up later in the morning, you've shifted your sleep clock, which will make you want to go to bed later. Once you're back home, along with the clock shift from changing time zones, you'll be doubly affected: time zone shift and a sleep clock shift. This is why it's so hard to get anything done when you get back to work.
To make the most of your vacation, plan your sleep times accordingly so that you can maximize your fun during your waking hours. Spend time outside in the sun, walk, jog, cycle, swim, and relax! If possible, remember to give yourself a day or two to wind down after you come back before you go back to work.
Even if you don't suffer from any problems during your trip, many ear and sinus problems occur AFTER your return trip, usually aggravated by the return flight. You've had a great vacation, but now you're paying for it when you come home. If you had followed my advice during your vacation, you wouldn't have to see a doctor about your ear problem.
July 20, 2010
One of the most common excuses for not wanting to use CPAP is that “I travel a lot.” Even after I explain that many people travel just fine with their CPAP machines, some people are stll reluctant. With advances in technology and increased awareness by the lay public, government officials and medical professionals about the importance of using CPAP for obstructive sleep apnea, traveling with CPAP, although initially a challenge, can be done with relative ease. People use CPAP on planes, and even go camping with it. With the FAA’s recent ruling and instructions on carrying and using CPAP on airlines, it’s become even easier to travel with CPAP machine. I know there are various types of PAP devices, but for the sake of simplicity, I’ll call these devices the generic name, CPAP.
Flying with Your CPAP
The Federal Aviation Administration (FAA) recently ruled that airline passengers must be allowed to use respiratory assistive devices, such as a CPAP machine (Nondiscrimination on the Basis of Disability in Air Travel – May 13, 2009). However, don’t think that you’ll just breeze by security checkpoints at the airport. Here are some common tips that are recommended when you fly with your CPAP machine:
1. Never check your CPAP machine.
2. Always have with you a prescription for your CPAP machine and your latest sleep study. You never know if your unit gets lost or stolen, or breaks down.
3. Attach a medical equipment tag, identifying the contents as such.
4. Let the TSA security agent know that you have a CPAP machine. Remove it from the back and have it scanned separately.
5. Request that security agents change gloves and wipe down the table before inspecting your machine. Wrap your device in a clear bag while being scanned to prevent contamination with germs and other chemicals.
6. Keep a record of the model and serial number in hand, just in case.
7. If you’re going to use your CPAP machine in-flight, check beforehand if there’s an outlet next to your seat, and if you have the right adaptor.
8. If the flight attendant says something about your CPAP being another carry-on, let him or her know that it’s a CPAP machine and under the Americans with Disability Act, it’s not counted as an added carry-on.
9. Consider having your doctor give you a letter describing the need for your CPAP machine.
10. Most CPAP units will automatically convert to the correct local voltage. Check with your instruction manual or manufacturer to confirm this. You may, however, need a plug adaptor, as well as an extension cord, in case your outlet is far away.
Tips On Water
Many people are so focused on the logistics of their machines, that sometimes they forget about distilled water. Make sure you have plenty of distilled water available if you’re going to use it on the plane, or at your final destination.
If you’re not going to use your CPAP device on the plane, then make sure you empty and dry the water chamber before flying (check out expedia for available flights!). If you’re planning on using your CPAP device on-board, there are two options to be able to pass large amounts of fluids past TSA security checkpoints: Have your doctor prescribe distilled water in a pharmaceutical grade bottle. A 500 mL bottle should hold about 16 oz. Another option is to purchase papFLASK, which is designed to pass through security checkpoints with ease.
For whatever reason you don’t have distilled water available, using bottled or even tap water is OK, but try to find distilled water as soon as reasonably possible. Mineral deposits in tap water can build up within the PAP machine and can cause damage if it continues long-term.
Camping or Backing Up with CPAP
For travel to areas that don’t have electricity, or in case you have a blackout, there are numerous battery options available. Each manufacturer will usually have a back up battery recommendations and adaptors.
For more extended periods, various people have written about using a 12 volt deep cycle marine battery with a sine wave inverter. There are numerous other battery options so do your research. Different manufacturers have different voltage needs, so also check with your manufacturer. Since a humidifier uses a lot of energy, most people recommend not using the humidifier if you’re only camping for a few days. There’s lots more information about batteries in CPAP support sites such as sleepguide.com, cpaptalk.com, talkaboutsleep.com, or apneasupport.com.
Have A Back Up Plan
Some patients carry around their oral appliances with them whenever they travel, either using it in place of their CPAP machines or just in case the device breaks. Some people use both the oral appliance and their CPAP machines simultaneously. If you’ve never tried an oral appliance and you’re interested in an alternative option, it may be worth giving it a try now before you need to travel for long extended periods.
No More Excuses
With advances in technology and more acceptance by the medical community as well as the lay public, there’s basically no reason (unless it’s psychological) you can’t travel with a CPAP machine. With knowledge and some flexibility and creativity, anyone can travel with CPAP, even in the more remote areas of the world. There have even been descriptions of solar power being used to recharge batteries used for CPAP. If you travel frequently to the same location, consider purchasing a second unit. Prices for middle of the road CPAP models are in the $300 to $700 range.
The first major challenge is in finding a way to make CPAP work for you. The second major challenge is in un-tethering your machine from your bedroom. Many people are living vibrant and normal lives, despite having to use their CPAP machines while traveling. Or is it because they are using their CPAP machines regularly while traveling? You decide.
June 11, 2009
There are many resources available regarding tips for travel while on vacation, but one thing that can definitely ruin your vacation is poor sleep. You may never think that you will suffer from sleeping problem until it happens, and by then, it’s too late. Besides the various stresses of travel, including delayed flights, misplaced luggage, or traveling with children, the last thing you need is to lay down in your hotel bed, and start tossing and turning, unable to sleep. If you are a poor sleeper to begin with and especially if you normally can’t sleep on your back, then the following travel tips could prevent your vacation from turning into a disaster.