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   What would you do in the case where an undiagnosed apnea patient was to afraid of being trapped to wear a mask long enough to be diagnosed?  Mind you this person only has an IQ of 69 and will never progress past an age of 14.  He also suffers from attacks of fear so great it disturbs his sleep and wakes or keeps him up at night.

 

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i am not a doctor, but perhaps his sleep doc can prescribe an anti-anxiety medication for the night of the sleep study. i suppose the reason for running the test if he's going to have ongoing anxiety about a mask attached to his head (i.e., CPAP not an option) is that he might be a candidate for surgery or an oral appliance if diagnosed. 

this is a good question for a sleep tech -- they run these tests for a living. we have a few of them helping others on this forum.  let's hear from them.

Both ideas sound good to me.  I will try waiting for a pro to comment.

Mike said:

i am not a doctor, but perhaps his sleep doc can prescribe an anti-anxiety medication for the night of the sleep study. i suppose the reason for running the test if he's going to have ongoing anxiety about a mask attached to his head (i.e., CPAP not an option) is that he might be a candidate for surgery or an oral appliance if diagnosed. 

this is a good question for a sleep tech -- they run these tests for a living. we have a few of them helping others on this forum.  let's hear from them.

I am sure the sleep clinic can try to work with him on accommodating his needs.  I know my sleep tech told me they get quite a few people with significant limitations and challenges.  Just let them know the situation and they should come up with a plan.


Rock Hinkle said:

I have many had Downs patients with these same problems. A sleep aid would be a necessity for a patient of this type. That is if the referring doc OKed it. Make sure to request a 1 on 1 situation as this will benefit both pt and tech. I would bring the pt in prior to the study to get familiar with the tech and the lab. The lab may also offer a mask to help with systematic desensitization period.

 

 This pt may benefit from a Home Sleep Study, or oximeter test as well.

 

Good luck! Let me know if I can do anything to help.

   I have not spoken with this friends doctor but he seems to have just given up without any suggestions.

My friend is very stubborn and apparently is of the opinion that there is no way to get a study without mask.  I would blame his doctor for not caring enough about his patients.  However I will inform my friend of his options.

Might be time for a new doc. A home study may be the best way to go for this patient. It would at least give an idea on the need for further testing. The downfall of this procedure is that it may miss underlying issues. Your friend's doc could also request the PSG be done as a diagnostic only procedure. This would ensure that a mask would not even be seen on the first night in the lab.

jim allAn said:

   I have not spoken with this friends doctor but he seems to have just given up without any suggestions.

My friend is very stubborn and apparently is of the opinion that there is no way to get a study without mask.  I would blame his doctor for not caring enough about his patients.  However I will inform my friend of his options.

Medication for anxiety is a last resort. The process will take about 10 to 14 days. Talk with the child patient regarding jet pilots or astronauts. Allow the child to play with a full face mask. Allow him to take it around with him throughout his day. He can wear it at will. You may also want the sleep lab to make a braid of old wires. Mom-Dad or caregiver can play with the child applying the wires loosely with paper tape. after a few days mom or dad should go into the sleep center with the child. The Lab technologist will attempt to show mom or dad how to apply the leads. Allow the parent caregiver to be part of the hookup. This is only a mock visit. The following few days the parent will apply and reapply the leads dring play time. The child should be allowed to wear the pap mask at will.

It is a long process but reduces the stress on the child. A parent should be allowed to stay in the room with child or if possible sleep in the same bed. It should be made into a camp out type of activity.

The child should be a one on one in the healthcare setting. It will ease patient frustration and the technologist frustration.

Goshes, DW. We are of a like mind on this situation. It is time intensive but much of the acclimation "play" can be done by the parents/caregivers prior to the actual sleep study and titration.
Aparently you missed one important comment on this problem.  The friend is almost 40 years old ACTUALLY.  This complicates matters greatly.

D. W. Conn said:

Medication for anxiety is a last resort. The process will take about 10 to 14 days. Talk with the child patient regarding jet pilots or astronauts. Allow the child to play with a full face mask. Allow him to take it around with him throughout his day. He can wear it at will. You may also want the sleep lab to make a braid of old wires. Mom-Dad or caregiver can play with the child applying the wires loosely with paper tape. after a few days mom or dad should go into the sleep center with the child. The Lab technologist will attempt to show mom or dad how to apply the leads. Allow the parent caregiver to be part of the hookup. This is only a mock visit. The following few days the parent will apply and reapply the leads dring play time. The child should be allowed to wear the pap mask at will.

It is a long process but reduces the stress on the child. A parent should be allowed to stay in the room with child or if possible sleep in the same bed. It should be made into a camp out type of activity.

The child should be a one on one in the healthcare setting. It will ease patient frustration and the technologist frustration.

So, no parents then. That leaves the caregivers to perform the role. This 40 y.o is still only 14 mentally and requires the assistance a 14 y.o. w/that "mind set" or "hang up" regarding sleep study "wiring" and CPAP and mask.
So sorry.  Your mention of parents made me realize I made a mistake somewhere or have been badly misinformed.  My friends parents are alive OK and not that old.  So judging by their age My friend can't be more than 30, but that is still a problem.  He doesn't live with his parents because he is almost impossible to control.  He is right and can not be convinced otherwise. 
  
Judy said:
So, no parents then. That leaves the caregivers to perform the role. This 40 y.o is still only 14 mentally and requires the assistance a 14 y.o. w/that "mind set" or "hang up" regarding sleep study "wiring" and CPAP and mask.
He lives on his own w/no supervison, no custodial care?

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