DH refusing to use CPAP

NylaBlue

 For six years my husband has worn a CPAP full face mask to bed each night. Even though he gets up 6-8 times a night due to anxiety and overactive bladder, he put the mask back on when he returned to bed. But, in the last week he will put it on then remove it within minutes or refuse to wear it at all.

Has anyone experienced this with a LO who uses CPAP and do you have any suggestions? I wash the mask and tubing regularly and replace worn parts as needed. The headgear fits well, no leaks.

M1

Nyla what stage is he now?there's going to be a point of no return on this one and you may be there. You could ask his sleep doc about switching to Bipap, sometimes those are easier to tolerate, but I wouldn't hold out great hope. Good luck, that's a tough one.

Quilting brings calm

My spouse does not have dementia, but he’s not fond of his long time CPAP machine either.  He bought a chin strap to keep his mouth closed and said the mask is easier to tolerate when he used the chin strap.  There are also smaller masks that your spouse might prefer. 

Of course there’s a  possibility that your spouse no longer understands the point of the CPAP machine or that he just can’t tolerate something over his face anymore. 

May flowers

Do you think he might be willing to switch to the nasal pillow mask? I used a CPAP for a few years and it was so much more comfortable for me than the face mask.

harshedbuzz

NylaBlue-

My dad used his CPap with concentrator right up until he died which sort of surprised me. He had COPD in addition to OSA so perhaps he liked the breathing assist. Or maybe it was because he'd had it for years before he developed dementia. 

His version of less oriented to time resembled time travel. I wonder if your husband is living in a past time when he didn't need the device and has sort of forgotten that he's been prescribed and why. It looks as if he was already diagnosed with dementia before the device came into his life according to your bio.

If you can get him to use if for part of the night or naps, I'd take it as a win. Maybe his pulmo and neurologist have ideas or would be OK if discontinued. Perhaps he'd do better with nasal pillows; my mom prefers those. 

HB

Love&Light

Hi Nyla. When we first moved my Dad into MC, he was using his CPAP. There came a point in time when the nursing staff asked if we  could discontinue the use of it as he was not wearing it and during their rounds they would have to wake him to put it back on. They felt the trade off of waking him and the effect it had the next day was outweighing the benefit of wearing it.

ST_niece

Yes, my aunt used a CPAP before her dementia progressed. She stopped using it, and when she entered a care home, the staff were not able to convince her to keep it on at night. Now she lives in my house, and does not use CPAP. I allow her to sleep as late as she wants to make up for poor quality of sleep (while waking her up to give breakfast in bed and morning pills). Her doctor approves of letting her sleep in (sometimes to 1pm). Her mood is much better than when care home was getting her up at 7am.

She also takes melatonin and mirtazapine at night to help improve quality of sleep.

mommyandme (m&m)

My mother used a Cpap for decades and she still needs to but doesn’t. She got to a point where she didn’t know what it was for. It became not worth the hassle. I think she stopped using it on the border of stage 5/6, which was about two years ago. I know this info doesn’t help with any solution except for giving it up. 

Sorry! 

dayn2nite2

The CPAP hill is not a hill I'm going to die on.

NylaBlue

 Thank you so much for your comments and suggestions, including the different mask options.

I will ask his pulmonologist for ideas, but I suspect, as others have suggested, the concept of the CPAP is just something else gone down the memory hole as DH moves through stage 6. 

Unfortunately, when not using the CPAP he snores loudly. I can wear ear plugs and did, pre-CPAP, but now I’m afraid I won’t wake when he gets up at night. I know this in turn is solved with a bed alarm, but then we risk waking our condo neighbors with an ear-splitting alarm half a dozen times a night.  

I know this is the dementia equivalent of a first world problem. I still have it much, much easier than others on this board!

May flowers

Another thought, would raising the head of the bed help with the snoring? Just a thought. It helps my DH snore less.

RIM

My father lost memory, cognition, hallucinated, was then dx with Alz, due to sleep apnea.  Severe sleep apnea, is very serious.   Prior to cpap, he would snore, pee excessively and I saw him rise up in the bed and literally gasp for air.  With 3 months of cpap treatment,  his memory and cognition returned and has remained good, as he utilizes clap. .

For most,  sleep apnea is positional.  Lying on the side, as opposed to on the back, will make it easier to breath.  Even while wearing the cpap mask, its recommended to have the person sleep on their side.  

Since your husband won't wear the mask, have him sleep on the side.  If you have a hospital bed, raise the head of the bed 30 degrees, as someone has already posted.  

Sleep apnea increases urine output, which is causing your husband to get up and pee.  

Mask option: 

https://www.youtube.com/watch?v=Ccx4FVynS8M

Belt to encourage sleeping on the side: 

https://www.amazon.com/CPAPology-Positional-Natural-Anti-Snore-Sleeping/dp/B07DP49Q8Y/ref=asc_df_B07DP49Q8Y/?tag=hyprod-20&linkCode=df0&hvadid=366402391883&hvpos=&hvnetw=g&hvrand=10494729299404054418&hvpone=&hvptwo=&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9007237&hvtargid=pla-787748194319&psc=1&tag=&ref=&adgrpid=76640857419&hvpone=&hvptwo=&hvadid=366402391883&hvpos=&hvnetw=g&hvrand=10494729299404054418&hvqmt=&hvdev=c&hvdvcmdl=&hvlocint=&hvlocphy=9007237&hvtargid=pla-787748194319

mommyandme (m&m)

As far as earplugs… I put an earplug in one ear, then listen to whatever relaxes me through the pillow with the other ear.  Then after my relaxing sounds have ended I have one ear available for necessary loved one noises. But at least I initially fall asleep.  I go back to that process as needed throughout the night.

Sorry for your troubles. 

NylaBlue

 @RIM, thank you for your suggestions. I agree it’s best to continue CPAP use; getting him to keep the mask on is the issue. As I related in my initial post, this started less than two weeks ago. Prior to that he used the CPAP consistently, 7-9 hours a night for six years. 

His urinary frequency isn’t the result of sleep apnea; frequent peeing, day and night, has been a problem for years, even as he consistently used CPAP. I check the therapy results every day on the Resmed Myair app so I know he had good results until recently.

I’ve reached out to his pulmonologist and his PCP. I hope a different mask option will work but as M1 suggested my husband’s stage 6 brain may be too confused at night to keep any of them on.