U.S. airlines have long made flying with a continuous positive airway pressure (CPAP) machine, essential for managing sleep apnea, a seamless experience for travelers. Passengers are allowed to bring a CPAP machine on board as an extra carry-on bag at no additional cost, a policy that is well-received since it helps protect the devices from damage or loss when checked in. With approximately 33 million Americans using CPAP machines, according to the National Council on Aging, many travelers simply stow their devices in the overhead bins and do not require them during the flight.

However, my recent experience with Icelandair highlighted the stark differences in policies when traveling internationally. The headaches began more than a week before my late August flight from New York to Reykjavik. While reviewing the airline’s website, I noticed the instructions regarding CPAP machines: “CPAP machines are accepted on board. One CPAP machine may be carried in addition to your carry-on baggage allowance. Your CPAP machine’s make and model must be added to your booking at least two business days prior to departure. Please contact our Service Center to add this to your booking.”

After navigating a lengthy hold time, I successfully informed an Icelandair representative that I would be traveling with a CPAP machine, which fits into a 14-inch by 12-inch case.

The day before my flight, I attempted to check in online, only to discover that I had been reassigned from the extra-legroom aisle seat I had paid for months in advance to a middle seat with no legroom.

Frustrated, I called Icelandair again and spent 20 minutes on hold to understand the situation. The agent informed me that my original extra-legroom seat was in an emergency exit row and had been assigned to another passenger due to my CPAP machine. When I inquired about the reasoning behind this policy, explaining that the machine would be stowed in the overhead bin and wouldn’t hinder emergency procedures, I received no satisfactory answer.

The agent took 41 minutes to resolve my seating issue, ultimately moving me to an extra-legroom window seat. She mentioned that had I not called to complain, I would have been stuck in the middle seat without extra legroom, and I would not receive a refund for my original seat. Additionally, she contradicted the information on Icelandair’s website, stating that the CPAP could either be checked or be the only carry-on.

The next day at JFK, the counter agent informed me that the airline’s telephone representative had been incorrect, and I could bring both my CPAP machine and a carry-on bag on board. However, I was forced to awkwardly open my suitcase on the floor to retrieve my CPAP machine. Despite my request not to note the CPAP in my reservation, the agent recorded that I would be carrying it, which immediately switched me back to a middle seat without legroom.

After 20 minutes of confusion among two counter agents, they eventually managed to assign my wife to my original extra-legroom window seat while placing me in her non-extra-legroom seat, advising us to switch once on board.

Upon arriving in Iceland, I contacted Icelandair officials to explain the challenges I faced. They assured me they would prevent similar issues on my return flight. However, I was later informed that I had again been moved from my previously paid-for extra-legroom seat due to it being in an emergency exit row and was assigned “the best legroom seat in the plane,” as described by Icelandair’s North America communications manager, Michael Raucheisen.

This change puzzled me, as Raucheisen had stated in an email that as long as I had no medical conditions preventing me from assisting the crew in an emergency, I was fit to sit in an emergency exit row. I found it perplexing that I was moved despite being “willing and able” to help in such situations.

A few days later, when checking in at Reykjavik airport, the counter agent expressed confusion about my assignment to the fifth row. After explaining my situation and showing her the emails from Icelandair, she was finally satisfied.

Unfortunately, the fifth-row seat turned out to be one of the most uncomfortable I’ve ever experienced. The upper-class curtain brushed against my lap during takeoff, and the seat was narrow—lacking a seatback tray according to Seatguru.com.

Additionally, a metal bar securing the upper-class seat in front intruded on the floor space, making it uncomfortable to position both feet without encroaching on the middle-seat passenger’s area. I found myself standing for portions of the flight due to discomfort, and the video screen extending into the aisle posed a hazard for passengers and flight attendants navigating the narrow passage.

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