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My husband was finally diagnosed with sleep apnea after a battalion of other tests, and treatments. He does the sleep study, and gets his diagnosis. We go to the DME supplier and get his machine, mask, tubing, etc. We get a lesson in how the thing works, how to clean it, and when to come in so the tech can read the card and see what is going on. 

First week was GREAT! He slept every single night with the mask, not a bit of trouble. His skin color came back, and he was acting like his old self. That lasted one whole week. In the three weeks since, it's been a battle every damned night to get him to keep that mask on. I don't feel like I can sleep, because I feel like I have to stay awake to keep an eye on him. He frequently tries to sleep on his stomach, which I try to deter, because he either shoves the mask so hard up against his face that it causes him pain (he has trigeminal neuralgia on the left side), or, it just slides off and winds up blowing air into his eye or against his cheek. So needless to say, we are back to square one, I have to nag him to get out of bed. By the time I get him up, he's left me 10 minutes to get him to work, and I am frustrated with that. I deal with chronic pain, so the stress from all this arguing and wrestling over that damned mask makes my pain worse, so here we are, two totally grouchy people in the morning. He's grumpy because he doesn't rest when he can't breathe, and I'm grumpy because I've been "arguing" with him all night long, and have just spent 20 minutes or so begging him to get up and get dressed before he makes himself late. 

 

So far, we have tried: 

Ocean nasal spray 30 minutes before bedtime (DME company recommended that)

I've adjusted the straps on his headgear - he had them way too tight and off center. 

We have lowered the temp on the heated air line, and dropped the humidity from 4.0 to 2.0 (suggested by the DME place)

 

Only other suggestions we have gotten is that he may need to go to a full face mask (which I don't think he will like - he hates the nasal pillows)

Buy and try a CPAP pillow. I don't mind buying one, but they are $60 here, and I don't want to spend $60 on a "mistake"

 

I am just about at my wit's end with this whole thing. I've been fighting all this time to get to the bottom of what was causing all these seemingly random issues, and now that we know, and can treat it, the treatment is there but not being used. I know that he's not doing it on purpose, more often than not, he's confused when our dog comes and gets me to come put his mask back on him. More often than not, he will argue with me about it in his sleep, telling me he doesn't have to wear it, he's not going to wear it, etc. I just want him to be well, and he's not going to get well if he won't use his equipment. 

I just don't know what to do from this point.....any advice?

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Candy, IMHO you need to deal with your own pain issues. You need a good nights sleep.  If you are not getting sufficient relief from the meds tried by the family doctor, try a pain clinic.  I have chronic leg pain that will keep me awake at night and even wake me up- I just take another pill when it wakes me up, but the pain clinic has dramatically reduced my pain and improved my sleep.  IMO you need to leave him be, he is going to have to decide that he feels better with CPAP and the health issues are reason enough to keep using  the machine.  By all means continue to be supportive and help him to remember to take his meds.  I do the medbox for my mate once a month and that has improved her compliance with her med regimen.  I would continue to be supportive of the CPAP, but I wouldn't lose any sleep if he is not using i his machine every night.  There are some masks that work better than others for stomach sleepers- your DME should be able to help you with this.  Also the ramp time can usually be increased to 45 minutes- your DME can change the settings, but may need a doctor's  order. I think the bottom line is he can use all the help you can give him, but ultimately it's up to him to decide to use his machine.  I commend you for your commitment to his health and wish you both good luck.  It takes some of us longer than others to decide to use the machine no matter what, and that means dealing with issues such as mask fit, humidification, and ramp time- comfort issues.
Well said Amy.

Amy said:

He has to buy into the need for the cpap.  I hate to say this but you need to not be sleeping and watching him all night because you then end up sleep deprived and that helps no one.  Yes it sounds like he may need a different mask. 

When we get patients at the lab we have one night to find a mask, fit it, titrate to the proper pressure and convince the patient they really need the therapy.  Sometimes the mask we choose is not right for long term use by a specific patient. 

If he is a belly sleeper the right nasal pillows should work but if he is a mouth breather than a full face mask should work better. 

Whatever you do he has to take some responsibility for his therapy otherwise you are going to be arguing with him for a long time.  I tell you this from experience of living with men who have sleep disorders.  I finally had to let go and let them do what they needed to do.  My ex does not wear his CPAP and there is nothing I can do.  But he knows that if he wants to go back to using it he has a whole lot of support behind him.

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