Is this sleep apnea ?

wizmo

Hi all, I have been reading here for a long time but have not posted much.

DW is 57 with EOAD around stage 5 (MMSE=12).  She has had several incidents where she has trouble breathing in the middle of the night.  It starts out with snoring loud enough to wake me up.  I try to get her to change position, usually move from laying on her back, changing to the side.  That worked once and she resumed breathing normally after just a few minutes.  When this happens I cannot get her fully awake.  She opens her eyes with a blank stare and is sensitive to turning on a light but will not speak to me.  She can understand part of what I say e.g. try to sit up, breathe through your mouth.  It seems like her nasal passage is slack/collapsed and she cannot breathe through her nose at all.  I have not seen any real cessation of breathing, just that she gasps and struggles to breathe in unless her mouth is well open.  What has worked is propping her up in bed, with me sitting behind her, with constant reminders to breathe through the mouth.  After 15-20 minutes she seems to recover, wakes up fully for a bit then can go back to sleep normally.  Last night when it happened for the first time in months, she said she did remember it happened before.  In the morning of course she has no memory of it from last night or ever before.

Around 2 years ago we did have a simple take-home sleep study looking for sleep apnea and there were no findings.  These incidents are rare, could be a month or 6 months between recurring.  If it is happening more often, I haven't seen any other symptoms during the night.  Discussions with doctors have not gone very far due to low frequency of episodes.  We have a small pulse oximeter and the one time I remembered to use it levels were normal (>95).  I wish I had thought to capture last night's behavior on video using my phone, did not think of it at the time.

Is this sleep apnea, or something else?  If I were not there to help or if I did not wake up I fear what would happen.

Tdrinker46

My experience it very well could be sleep apnea. People who snore are more likely to have it.  Your heart actually stops.  Can cause a stroke.  Suggest you see pulmonologist.

M1

Hi wizmo, if she is stage 5 I would not intervene. She would be unlikely to be able to cooperate for an accurate sleep study or to tolerate a respiratory assist device (cpap machine).  She's snoring, but as you've said you've not actually witnessed apnea. I think in your shoes I would probably leave well enough alone. If the snoring bothers you, could you sleep in another room, with a monitor if needed?

Hal42

Several years ago my wife noticed I had the same type of symptoms at night you described about your wife. During the day I would fall into a deep sleep in my chair for three hours. A pulmonologist diagnosed sleep apnea.  I now use a bi-pap machine to help with breathing and sleep well every night. No snoring!

Because of my experience I suggest you set up an appointment with a pulmonologist.

Rescue mom

It sounds a lot like sleep apnea, which my DH with Alzheimer’s has. But DH (probably stage 6) cannot “handle” or tolerate the machines and C-pap devices. We tried one and he would not tolerate it, couldn’t understand the need for it. His Pulmonologist said those devices rarely work with Alzheimer’s patients except in very early stages. Nor do they do well in the usual sleep studies. Pretty much what M1 said above.

Basically, there was not much to be done. Surgery was considered, but that’s also bad for dementia and I said no.  But this was a couple years ago, shortly before COVID shutdown. They may have better solutions/devices now.

Marta

Wizmo:  sleep apnea does not cause the heart to stop or the person to have a stroke.

The problems that come from sleep apnea are long-term cardiovascular effects which take years to develop.  Your wife likely does not have years and years left.  Since she likely cannot cooperate with a sleep study or with the treatment, there is no point in taking her to be evaluated.

She will not die suddenly from this problem.

Stuck in the middle

I have severe sleep apnea, and have used CPAP for 20 years.  What you describe doesn't sound like sleep apnea to me.  Sleep apnea causes the throat to close, not the nasal passages.  And it happens every time I sleep, not just occasionally.  If my wife had the symptoms you describe, I would tell her doctor and see what he thinks.

wizmo

Thanks for feedback, I will keep her doctors informed of these symptoms.