Sleep apnea on the trail

[stilllife]

How do you deal with it?

[litetrek]

I have sleep apnea and sleep in a hammock usually. I bought a foam neck brace at the drug store and put it on tightly so that my neck is straight and cant bend much. It keeps my airway open and is better than doing nothing. Sleeping on my side helps me.

I've read that there are prescription devices that you can get that adhere over your nostrils that somehow (forget the details) help with sleep apnea. I'm skeptical about how well they work and my wife, the nurse, just laughed at the concept. They are FDA approved though. Breathright strips help me a little.

I'd be very interested in knowing other things people have tried.

[gwschenk]

How do you deal with it?

I poke them with a stick, that wakes them up and they stop that gawdawful gagging and wheezing.

[Hatchet_1697]

I have it and invested in a 10oz Z1 travel CPAP machine, a light 2 day battery (15vdc), and heavier 1.3lb 5 day battery. Both have USB charging too for my phone. Then went ultralight on everything else. 11-15lb base weight w/CPAP depending on WX.

In a Shelter with someone who has it -- I always bring ear plugs! Enough to share :). I recognize the horrible sound apnea makes and in the morning tell them to get it checked out. Most have no idea they have it.

Carrying the extra weight really sucks, but a good nights sleep is precious when hiking and worth it. My campsite/ Shelter mates appreciate it too.


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[nsherry61]

I have moderate sleep apnea when I sleep on my side and pretty much stop breathing on my back unless I am using my CPAP machine. My sleep apnea is reduce in a hammock, but not eliminated.

Over the last year, I've dialed in a system that works for me as well as my CPAP, much to my significant surprise. I traveled through Europe for three weeks last month without a single sleep apnea issue!!! It was awesome.

My system is two parts and weighs roughly 0.6 oz - significantly less than my CPAP:

1) a mandibular advancement device
2) a nasal dialator

In other words, I bought a $100 moldable mouthpiece on the internet that holds my jaw slightly forward - there are dozens to choose from on the internet, none of which are certified to do what they claim. Then I also stopped by my local pharmacy and bought these little plastic spring things that hold my nasal passages open, kinda like BreathRite nasal strips, but from the inside.

It's hard to express how exciting it is to be able to truly sleep really well in the back-country or while traveling without having my CPAP beside me!!

It took experimenting with two different mouth pieces with two different amounts of mandible thrust and also several days of practicing before the mouth piece stopped keeping me awake from awkward mouth feeling and drooling and dry lips. My mouth just got used to the feeling over time, I learned how to close my mouth around the mouthpiece so I stopped drooling, and I make a point of putting chap stick on my lips before going to sleep and also learned how to lick my lips with the mouthpiece in.

In all, a truly awesome WIN!

40250

[MuddyWaters]

How do you deal with it?
Avoid shelters is the best way ...

If your referring what someone that has it should do to deal with it, avoiding shelters still applies.

I understands a few bring portable cpaps, some have some dental appliance I knows nothing about, but they swears by.

[stilllife]

I have moderate sleep apnea when I sleep on my side and pretty much stop breathing on my back unless I am using my CPAP machine. My sleep apnea is reduce in a hammock, but not eliminated.

Over the last year, I've dialed in a system that works for me as well as my CPAP, much to my significant surprise. I traveled through Europe for three weeks last month without a single sleep apnea issue!!! It was awesome.

My system is two parts and weighs roughly 0.6 oz - significantly less than my CPAP:

1) a mandibular advancement device
2) a nasal dialator

In other words, I bought a $100 moldable mouthpiece on the internet that holds my jaw slightly forward - there are dozens to choose from on the internet, none of which are certified to do what they claim. Then I also stopped by my local pharmacy and bought these little plastic spring things that hold my nasal passages open, kinda like BreathRite nasal strips, but from the inside.

It's hard to express how exciting it is to be able to truly sleep really well in the back-country or while traveling without having my CPAP beside me!!

It took experimenting with two different mouth pieces with two different amounts of mandible thrust and also several days of practicing before the mouth piece stopped keeping me awake from awkward mouth feeling and drooling and dry lips. My mouth just got used to the feeling over time, I learned how to close my mouth around the mouthpiece so I stopped drooling, and I make a point of putting chap stick on my lips before going to sleep and also learned how to lick my lips with the mouthpiece in.

In all, a truly awesome WIN!

40250
I have had a lot of success using the Theravent strips that is sold at drug stores for snoring. It actually puts a slight back pressure on the airway that works remarkably well for my mild apnea. I don't think its's perfect but it seems to be as effective as my cpap. I want to do a sleep study while wearing the strip to see what the real numbers are. I use the Lite version of the strips.
Which mouth piece did you settle on?
Thanks,

[moldy]

I have it also. The best thing I have found that's practical is to sleep in a hammock.

[OkeefenokeeJoe]

Lose weight (which shouldn't be too hard if you spend considerable time on the trail). In most cases, that will pretty much cure any sleep apnea issue.

[litetrek]

I have moderate sleep apnea when I sleep on my side and pretty much stop breathing on my back unless I am using my CPAP machine. My sleep apnea is reduce in a hammock, but not eliminated.

Over the last year, I've dialed in a system that works for me as well as my CPAP, much to my significant surprise. I traveled through Europe for three weeks last month without a single sleep apnea issue!!! It was awesome.

My system is two parts and weighs roughly 0.6 oz - significantly less than my CPAP:

1) a mandibular advancement device
2) a nasal dialator

In other words, I bought a $100 moldable mouthpiece on the internet that holds my jaw slightly forward - there are dozens to choose from on the internet, none of which are certified to do what they claim. Then I also stopped by my local pharmacy and bought these little plastic spring things that hold my nasal passages open, kinda like BreathRite nasal strips, but from the inside.

It's hard to express how exciting it is to be able to truly sleep really well in the back-country or while traveling without having my CPAP beside me!!

It took experimenting with two different mouth pieces with two different amounts of mandible thrust and also several days of practicing before the mouth piece stopped keeping me awake from awkward mouth feeling and drooling and dry lips. My mouth just got used to the feeling over time, I learned how to close my mouth around the mouthpiece so I stopped drooling, and I make a point of putting chap stick on my lips before going to sleep and also learned how to lick my lips with the mouthpiece in.

In all, a truly awesome WIN!

40250
What are those internal nostril dilators called? I want to buy some. I had that idea and made something out of small diameter copper tubing. It works but falls out usually after a few hours

[litetrek]

Lose weight (which shouldn't be too hard if you spend considerable time on the trail). In most cases, that will pretty much cure any sleep apnea issue.
Losing weight is always a good idea, but sleep apnea has more to do with the size of your neck and the size of your throat.

[john844]

I have it and invested in a 10oz Z1 travel CPAP machine, a light 2 day battery (15vdc), and heavier 1.3lb 5 day battery. Both have USB charging too for my phone. Then went ultralight on everything else. 11-15lb base weight w/CPAP depending on WX.

In a Shelter with someone who has it -- I always bring ear plugs! Enough to share :). I recognize the horrible sound apnea makes and in the morning tell them to get it checked out. Most have no idea they have it.

Carrying the extra weight really sucks, but a good nights sleep is precious when hiking and worth it. My campsite/ Shelter mates appreciate it too.


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What batteries are you using? I am carrying almost 6 lbs for my cpap and battery that lasts 3 nights.

Time for me to try something else.

Thanks, John

[Hosh]

Lose weight (which shouldn't be too hard if you spend considerable time on the trail). In most cases, that will pretty much cure any sleep apnea issue.

Actually there are 2 sources of apnea, obstructive which is most common, influenced by being overweight, large neck size and flat chins. The other is central apnea which is related to brain function. Central apnea is more common at higher elevations and is less understood than obstructive.

[Hatchet_1697]

What batteries are you using? I am carrying almost 6 lbs for my cpap and battery that lasts 3 nights.

Time for me to try something else.

Thanks, John

Hi John, First, never take medical advice, or medical device powering advice, from a forum -- too many quacks like me on them :)

That said I've researched the heck out of this problem trying to lighten up. CPAP machines have different voltage and current requirements so what you need depends on the machine you have. Look at the wall adapter and use those values, but you probably already knew that.

My Z1 is light but requires 15VDC 2A and it's hard to find a 15V battery, Bix Power has them, my 5d is the MP100-15. They carry other voltages too.

https://www.bixpower.com/MP100-15V-p/bat-mp100-15v.htm

I carried the Z1 and MP-100 in a waterproof loksack from Deep Gap, NC to Springer this Spring on an 8 day hike no problem. I have mixed apnea (central & obstructive) and have no choice but to carry.

My 3d batt isn't sold anymore.

Oh, and don't use a humidifier, they need way too much power.

Hope it helps!



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[john844]

Thanks Hatchet. I don't have and central apneas and don't use my humidifier. My sleep quality is horrible without my cpap, so I also have to carry it. I initially tried to get a travel cpap from my supplier, but that exercise was futile. The kept telling me that there were no options available, which I knew was misinformation. I have to guess that my current cpap is inefficient in it's power consumption.

Do you have your cpap set in auto mode, or are you setting it on a constant pressure? I know that higher pressures use more power, so limiting my max or using lower pressure while on trail might get me better results too.

Thanks,
John

[nsherry61]

For those that alternatives to CPAP (i.e. nose and mouth braces) don't work for, ResMed has a brand new AirMini travel CPAP that looks very promising. It doesn't look like they have the battery system finished for it yet, but the unit is tiny and the power draw is supposed to be pretty low. It looks like the power supply output for it is 24V, but I have not found reference to it's power draw (i.e. how many hours of use at 24V you would get would be able to get from any given size battery). The unit itself is apparently about the size and weight of a couple of cell phones taped together.

[stilllife]

Have you guys tried the Theravent nose strips? They work for my apnea.

[nsherry61]

Have you guys tried the Theravent nose strips? They work for my apnea.
No I haven't. I have experimented with a lot of different nasal strips and springs and things to open my nasal passages and in conjunction with a mouthpiece to keep my mandible thrust slightly forward, they work well.

I have not tried any positive pressure nose devices. Frankly, the idea sounds terrible, because my problem is not breathing well and adding a device to make breathing harder sounds horrid. . . that doesn't mean it wouldn't work, it just sounds very annoying.

[ggreaves]

My wife is a dental hygienist and she convinced me to go and have a sleep study back in 2011. She said there are dental appliances that could fix it. After I was tested, I asked my doctor about it and he laughed. They are really only effective for people with mild apnea. My AHI was 117, which means I stop breathing about twice per minute. I've been using CPAP ever since and even used it backpacking and canoe tripping for a few years. But my machine isn't very portable (philips remstar) and I got sick of carrying all the extra bulk with batteries - full mask etc. I'm ok for a few days in the wilderness without it. I'm a hammock camper and try to set up out of earshot of anyone else I'm camping with. I will say though that anybody who poked me with a stick would find that stick lodged in an unwelcome orifice pretty quickly. I do what I can and I'll bring new sealed earplugs and give them away but beyond that, if you're camping with other people, expecting absolute silence is your problem. Don't stay in shelters if you can't tolerate others snoring.

[Hatchet_1697]

...Do you have your cpap set in auto mode, or are you setting it on a constant pressure? I know that higher pressures use more power, so limiting my max or using lower pressure while on trail might get me better results too.

Thanks,
John

After working every angle I could think of I bit the bullet and bought the Z1 Auto myself (my insurance considered it a luxury item LOL). It was the overall lightest (all parts included) and met my needs.

I use it on auto, but if you only have OSA you could figure out the lowest fixed pressure that works for you and conserve power. I stumbled on an obscure fact that might help, the exhale pressure relief settings on these machines affects power consumption. The lowest setting uses the least power and extends battery life.

In my testing I need ~19Wh per night, knowing that helps me plan longer multi-day/week hikes. Resupply now includes recharging. Oh the fun of backpacking with medical equipment, but at least we're out there! The best part, besides the great sleep, is the expression on thru hikers' faces when I tell them what I'm hauling up and down the same mountains as them :)






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[nsherry61]

. . . After I was tested, I asked my doctor about it and he laughed. They are really only effective for people with mild apnea. . . I'm ok for a few days in the wilderness without it. . .
I have "moderate apnea" and sleeping, even 1/2 a night without my CPAP, provides me with intolerable headaches in the morning and completely screws up most of the next day. With a combination of a mandibular advancement device (MAD) and a nasal dilator I no longer snore and over three weeks of travel last month I experienced no symptoms of apnea at all! I am using my CPAP again, now that I am home, but I'm not sure I will spend the money on another one in the future due the the success of my MAD. Clearly what works for me may completely fail someone else. BUT . . .

Especially if you can manage a day or two without a CPAP machine, and especially if you have a connection with a dentist that can make you a custom MAD I would suggest you are crazy not to try it. If your doctor suggests MADs only work for mild apnea, he is NOT well read on the topic. A quick and simple literature search provided me with these references, ALL of which support the efficacy of MADs for many people. Yes, most of the studies were on people with mild to moderate apnea, because untreated or unsuccessfully treated severe apnea has serious health risks associated with even a single night of associated oxygen deprivation. In all, it seems to me that the potential benefit and convenience of being able to use a MAD make experimenting to see if it works for you a worth while effort.

An Oral Elastic Mandibular Advancement Device for Obstructive Sleep Apnea
KATHE G. HENKE (http://www.atsjournals.org/author/HENKE%2C+KATHE+G), DONALD E. FRANTZ (http://www.atsjournals.org/author/FRANTZ%2C+DONALD+E), and SAMUEL T. KUNA (http://www.atsjournals.org/author/KUNA%2C+SAMUEL+T)
https://doi.org/10.1164/ajrccm.161.2.9903079 (https://doi.org/10.1164/ajrccm.161.2.9903079) PubMed: 10673180 (https://www.ncbi.nlm.nih.gov/pubmed/10673180)

Non-CPAP therapies in obstructive sleep apnoea: mandibular advancement device therapy
Marie Marklund, Johan Verbraecken, Winfried Randerath
European Respiratory Journal 2012 39: 1241-1247; DOI: 10.1183/09031936.00144711


Mandibular Advancement Device vs CPAP in the Treatment of Obstructive Sleep Apnea: Are they Equally Effective in Short Term Health Outcomes?
David P. White (https://www.ncbi.nlm.nih.gov/pubmed/?term=White%20DP%5BAuthor%5D&cauthor=true&cauthor_uid=23997711), M.D., F.A.A.S.M.1 and Shirin Shafazand (https://www.ncbi.nlm.nih.gov/pubmed/?term=Shafazand%20S%5BAuthor%5D&cauthor=true&cauthor_uid=23997711), M.D., M.S., F.A.A.S.M.2


Mandibular advancement splints and continuous positive airway pressure in patients with obstructive sleep apnoea: a randomized cross‐over trial
Y. K. Tan P. R. L'Estrange Y.‐M. Luo C. Smith H. R. Grant A. K. Simonds S. G. SpiroJ. M. Battagel
European Journal of Orthodontics, Volume 24, Issue 3, 1 June 2002, Pages 239–249,https://doi.org/10.1093/ejo/24.3.239 (https://doi.org/10.1093/ejo/24.3.239)
Published:
01 June 2002

P.S. The medical profession is extremely conservative and surprisingly slow to adopt new technologies, treatments, and tests. Fully half the time I get advice from a doctor (most often from GPs, but also occasionally specialists), I find out it is not quite correct or that the solution suggested isn't necessarily the best for my particular issue, it's just the easiest or the textbook answer to a question that doesn't quite fit the text. Good doctors rock, but they are surprisingly hard to find!! A great family doctor may be spot on for the straight forward stuff and wonderful to work with, but then utterly incompetent without realizing it on less straight forward matters. It's always worth double-checking what your doctors tell you if you are not happy with the advice or the solution they provide.

[ggreaves]

Thanks for the info - I will check it out!

[yassine]

look for alternatives to cpap mask (https://www.whiteblaze.net/forum/showthread.php/126443-Sleep-apnea-on-the-trail) like wix and Somnoplasty just googling

[JackDuggan]

I have "moderate apnea" and sleeping, even 1/2 a night without my CPAP, provides me with intolerable headaches in the morning and completely screws up most of the next day. With a combination of a mandibular advancement device (MAD) and a nasal dilator I no longer snore and over three weeks of travel last month I experienced no symptoms of apnea at all! I am using my CPAP again, now that I am home, but I'm not sure I will spend the money on another one in the future due the the success of my MAD. Clearly what works for me may completely fail someone else. BUT . . .

Especially if you can manage a day or two without a CPAP machine, and especially if you have a connection with a dentist that can make you a custom MAD I would suggest you are crazy not to try it. If your doctor suggests MADs only work for mild apnea, he is NOT well read on the topic. A quick and simple literature search provided me with these references, ALL of which support the efficacy of MADs for many people. Yes, most of the studies were on people with mild to moderate apnea, because untreated or unsuccessfully treated severe apnea has serious health risks associated with even a single night of associated oxygen deprivation. In all, it seems to me that the potential benefit and convenience of being able to use a MAD make experimenting to see if it works for you a worth while effort.

An Oral Elastic Mandibular Advancement Device for Obstructive Sleep Apnea
KATHE G. HENKE (http://www.atsjournals.org/author/HENKE%2C+KATHE+G), DONALD E. FRANTZ (http://www.atsjournals.org/author/FRANTZ%2C+DONALD+E), and SAMUEL T. KUNA (http://www.atsjournals.org/author/KUNA%2C+SAMUEL+T)
https://doi.org/10.1164/ajrccm.161.2.9903079 (https://doi.org/10.1164/ajrccm.161.2.9903079) PubMed: 10673180 (https://www.ncbi.nlm.nih.gov/pubmed/10673180)

Non-CPAP therapies in obstructive sleep apnoea: mandibular advancement device therapy
Marie Marklund, Johan Verbraecken, Winfried Randerath
European Respiratory Journal 2012 39: 1241-1247; DOI: 10.1183/09031936.00144711


Mandibular Advancement Device vs CPAP in the Treatment of Obstructive Sleep Apnea: Are they Equally Effective in Short Term Health Outcomes?
David P. White (https://www.ncbi.nlm.nih.gov/pubmed/?term=White%20DP%5BAuthor%5D&cauthor=true&cauthor_uid=23997711), M.D., F.A.A.S.M.1 and Shirin Shafazand (https://www.ncbi.nlm.nih.gov/pubmed/?term=Shafazand%20S%5BAuthor%5D&cauthor=true&cauthor_uid=23997711), M.D., M.S., F.A.A.S.M.2


Mandibular advancement splints and continuous positive airway pressure in patients with obstructive sleep apnoea: a randomized cross‐over trial
Y. K. Tan P. R. L'Estrange Y.‐M. Luo C. Smith H. R. Grant A. K. Simonds S. G. SpiroJ. M. Battagel
European Journal of Orthodontics, Volume 24, Issue 3, 1 June 2002, Pages 239–249,https://doi.org/10.1093/ejo/24.3.239 (https://doi.org/10.1093/ejo/24.3.239)
Published:
01 June 2002

P.S. The medical profession is extremely conservative and surprisingly slow to adopt new technologies, treatments, and tests. Fully half the time I get advice from a doctor (most often from GPs, but also occasionally specialists), I find out it is not quite correct or that the solution suggested isn't necessarily the best for my particular issue, it's just the easiest or the textbook answer to a question that doesn't quite fit the text. Good doctors rock, but they are surprisingly hard to find!! A great family doctor may be spot on for the straight forward stuff and wonderful to work with, but then utterly incompetent without realizing it on less straight forward matters. It's always worth double-checking what your doctors tell you if you are not happy with the advice or the solution they provide.





What do you use for a nasal dilator? I have a mandibular advancement device, but I don't seem to get the same results as CPAP as a far as O2 concentration. I measure overnight with an oximeter and have many more SPO2 drops as they call them when I used the MAD.

[Mouser999]

I found in a local Med. Store a strap that fits over my head and keeps my mouth closed. Works pretty well for $10 though there are more expensive
straps