Diagnosis

KathyBol

I am caring for my husband. We have been to a neurologist twice. At the initial visit, the doctor ordered a sleep study, blood work, MRI, did several tests, and interviewed him. The sleep study confirmed significant apnea, blood test showed Lyme disease, and MRI was "unremarkable". I was encouraged to think that the confusion and forgetfulness could be attributed to these. He has had the medicine for Lyme, and has been trying to get accustomed to a CPAP, to no avail. He is more confused, does not remember our wedding, is confused repeatedly about why he is in this house, who owns it, and if I work here. I try to reassure him, and he seems okay , but the next day, he may started packing things up to "take home". His next appointment with neurologist is in July, should I call for earlier, or would there even be an advantage to that?

SusanB-dil

Hi KathyBol - welcome to 'here', but sorry for the reason.

Whew! much to deal with…

just a couple thoughts - My DH also has sleep apnea, and although it ups chances of dementia, he is still ok. However, it has been 3 years and he never could sleep with the CPAP. It sounds like your DH is also having issues with it. I guess that isn't unusual. Also - the lyme disease. That can cause a lot of confusion and other symptoms. I guess it would be hard to tell if the medication will help, but hopefully it will. Is it known how long he may have had lyme? That may be key.

Belle

@KathyBol My DH uses a CPAP and he has found the masks that just cover the nose are easiest to tolerate. It took him over a year to figure out which mask he liked so maybe asking the sleep clinic for some other masks to try might work.

harshedbuzz

@KathyBol

I am going through something similar with my mom currently. She's been complaining of trouble focusing and with her memory the last month or so. Last month she completely forgot something to which she was looking forward even after being informed of it 3 times- minimum. We started with her PCP to start the process as getting into the memory center will be about 9-10 months. So far, her bloodwork shows evidence of Lyme Disease so we are treating that. (I suspect she may have been infected last July when she complained of severe joint pain— we even ended up in the ER which didn't test for that unfortunately) The doctors says it's too early to see if the medication will result in any improvement in that area. We'll meet again in June after her MRI.

In doing some digging on cognitive issues related to Lyme Disease, it's pretty common for the individual to report issues but still do quite well on the quick screening tests. Mom got a 28/30 on MMSE. As we anticipated the serial subtraction and word recall was where she lost points.

My mom prefers nasal pillow masks, although she's has had a bi-pap forever and can sleep with version IME. Different masks do make a difference for some. There are also oral devices that are appropriate for some people with OSA.

HB

KathyBol

Thanks for your response. My husband is at the point of flatly refusing to use the CPAP. He has been fitted, given another type of mask (still full) and another machine to no avail. We have another appointment coming up with the neurologist.

M1

Kathy, compliance with CPAP is very problematic even when dementia is not in play. Ask if there is any way you could get him approved for BiPAP-it’s much easier to tolerate because the pressures vary between inspiration (higher pressure) and expiration (lower pressure). Typically getting approval for Bipap requires trial and failure of CPAP, but if he really can’t tolerate it the doc might be able to justify that as a failure.

Klynrain

Hi Kathy, there is also the Inspire implanted device for people who cannot tolerate masks. My mom just did another sleep study to get approved for it. The downside is one model cannot be used with MRI machines, but there is another model that you can with certain precautions. I hope you all can get some clarity on the matter.

KathyBol

The meds for Lyme disease did not help with my husband's memory or delusional thinking. He may have had Lyme years ago, and it is very common where we live. My primary care doctor started him on Aricept. We will see what happens, but it seems to be helping. Thanks for all the comments; it really helps to have people who understand what is happening. I appreciate the input!

KathyBol

https://alzconnected.org/discussion/comment/210842#Comment_210842

Thank you, I will try that. He is more adamant than ever!

Iris L.

Your DH sounds like middle stage, not early stage. Does the sleep doctor believe that treating significant sleep apnea with CPAP will improve his cognition or slow progression? Dementia is inevitably progressive. Unless he has significant cardiac or pulmonary illnesses that are treatable via CPAP, it doesn't sound like this treatment will make a difference in his dementia journey, IMO.

On a personal note, I have a diagnosis of cognitive impairment not otherwise specified, along with sleep apnea and several othermorbidities. I do believe that treatment with CPAP has helped my cognition and alertness and focus. But I do not have Alzheimer's Disease.

Please read about dealing with delusions. There are strategies for treating these, there is no cure.

Iris

KathyBol

I spoke with a counselor on the help chat ,yesterday. She was very helpful in explaining the delusional aspect. Thanks for your input, I agree that he does appear to be in the middle stage, even though he does not have a diagnosis , yet.

Iris L.

Much of the "treatment" for the dementias is learning how to provide good care and preparing for the future. Have you prepared your legal papers? Are you preparing your finances? Visit the Spouse/ Partner board and read a lot of threads.

Iris