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Need to find a solution for my wife. Any suggestions?
#1
Need to find a solution for my wife. Any suggestions?
Several years ago my wife had a sleep study, and it was determined she needed to be on CPAP.   When they tried to fit her for a mask it was determined she needed a full face mask because her mouth would open.  However, she said she couldn't handle the full face mask because it made her feel claustrophobic.  I know she won't use a nasal mask with a strap to hold her mouth closed because having something holding her mouth closed would also freak her out.  I've tried to sell her on the hybrid style where her mouth is covered and the top is like a nasal mask while her nose isn't covered, but she said she tried that when they did the fitting, and it didn't help.

As time as gone on I think she is becoming more in need of therapy, but she won't even consider it.  Meanwhile she complains of being tired all the time.  At night I'll hear her silent like she isn't breathing, followed by a big snore as she takes in a sudden rush of air.  She also can snore pretty heavily at times.

I keep telling her that if I can handle it at the high pressure I'm on, she can handle it, too. But, seeing what I have to go through with my severe, high pressure situation probably isn't helping her think she can do it--even though it's likely she won't need the high pressure I deal with.

Does anybody have any ideas of alternatives?  I'm afraid she's going to end up with a real problem one of these days.
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#2
RE: Need to find a solution for my wife. Any suggestions?
I have the same issue--claustrophobia. I've tried lots of full face masks and couldn't keep them on.

So I use a nasal mask and need something to keep my jaw closed. My case--I mouth breath.

Check out soft cervical collar.

I've posted here a lot. One member suggested I try a collar. I had an old pad that I thought was worn out. It's a "Dr Dakotas--sleep well my friend" It's meant to stop snoring. I used it with a nasal mask a couple of nights ago and it was miraculous. The strap needs attention. I've worn it for several nights now.

Other members do all kinds of things to prevent mouth breathing. I even made a pad myself to go under my chin. It is very old now.
I hope this helps.

Dave
DaveL
compliant for 35 years /// Still learning!



I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#3
RE: Need to find a solution for my wife. Any suggestions?
http://www.apneaboard.com/wiki/index.php...cal_Collar

This wiki article explains what works.

Dave
DaveL
compliant for 35 years /// Still learning!



I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#4
RE: Need to find a solution for my wife. Any suggestions?
Even moderate pressure will help her obstructive sleep apnea, but if the majority of her events are hypopnea, a CPAP like the Resmed Autoset with the EPR function will be best. The only way to know she won't tolerate nasal therapy is to try it. You cannot predict this in a diagnostic study when the patient is struggling to take in air due to obstruction or flow limitation. The cost of a Resmed Airfit P10 For her or regular is surprisingly low compared to any full face, and includes 3-sizes of nasal pillows. My suggestion is to turn her on to a good CPAP therapy with limited pressure and as much EPR as you can get, and use the nasal pillows. If they work, problem solved. If she opens her mouth, success will depend on the degree to which she maintains some positive airway pressure. Not treating the problem clearly is not working.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Need to find a solution for my wife. Any suggestions?
(12-07-2021, 08:55 PM)DaveL Wrote: I have the same issue--claustrophobia. I've tried lots of full face masks and couldn't keep them on.

So I use a nasal mask and need something to keep my jaw closed.  My case--I mouth breath.  

Check out soft cervical collar.

I've posted here a lot.  One member suggested I try a collar. I had an old pad that I thought was worn out. It's a "Dr Dakotas--sleep well my friend"  It's meant to stop snoring. I used it with a nasal mask a couple of nights ago and it was miraculous.  The strap needs attention. I've worn it for several nights now.

Other members do all kinds of things to prevent mouth breathing. I even made a pad myself to go under my chin. It is very old now.
I hope this helps.

Dave

Thanks.  I'll try showing her this, but I'll be a bit surprised if she goes for trying it.  I once mentioned to her investigating a new negative pressure device I once saw to see if it could work.  It's a collar that fits around the neck and applies negative pressure to pull the airway open instead of pushing it open from the inside with high pressure.  She didn't sound too keen on wearing a collar, either. That's kind of the problem. Any idea I present to her seems to get rejected out of hand.
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#6
RE: Need to find a solution for my wife. Any suggestions?
(12-07-2021, 08:58 PM)Sleeprider Wrote: Even moderate pressure will help her obstructive sleep apnea, but if the majority of her events are hypopnea, a CPAP like the Resmed Autoset with the EPR function will be best.  The only way to know she won't tolerate nasal therapy is to try it. You cannot predict this in a diagnostic study when the patient is struggling to take in air due to obstruction or flow limitation.  The cost of a Resmed Airfit P10 For her or regular is surprisingly low compared to any full face, and includes 3-sizes of nasal pillows.  My suggestion is to turn her on to a good CPAP therapy  with limited pressure and as much EPR as you can get, and use the nasal pillows.  If they work, problem solved. If she opens her mouth, success will depend on the degree to which she maintains some positive airway pressure.  Not treating the problem clearly is not working.

The difficulty is getting her to be willing to even try it.   She thinks of the mask situation, so it seems like it's as much or more that than the pressure part, although that will probably be an issue as well if I can get her to try it.  You're right.  Not treating the problem isn't working, and I'm worried about what's going to happen in the future with it untreated.

The ironic thing is it was her and my dad (who also had sleep apnea) who pushed me into getting a sleep study done because she could tell I was having major problems when I slept.
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#7
RE: Need to find a solution for my wife. Any suggestions?
The main ideal of the Airfit P10 is that it is the most minimal mask solution available. Easily removed, and possible to even talk with it on. If she won't tolerate any contact on her face, then she might want to see if she is a candidate for a non PAP solution like the Inspire implant. I will say that unless insurance covers it, Inspire is totally unaffordable. You might want to consider getting professional help and therapy for the claustrophobia problem as a first step. It can be overcome with cognitive behavioral therapy. Since this is directly interfering with a medically necessary sleep apnea therapy, it may be covered. https://cogbtherapy.com/claustrophobia-treatment
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Need to find a solution for my wife. Any suggestions?
Let me add another option. Mandibular Advancement Devices. They serve to pull the jaw forward in order to open up the airways. I used one for years some time back in order to treat my snoring, little did I know about OSA then, but I think it saved my life.

I changed to CPAP because years later, I realised it was slowly changing my teeth alignment, but I think it really helped me get compliant to CPAP use, like, immediately. (getting used to sleeping with a foreign object in contact with the body)

This just sits in the mouth, nothing hanging out over the facial area.
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#9
RE: Need to find a solution for my wife. Any suggestions?
If you can talk her into trying PAP, I would recommend trying ResMed's Hybrid AirFit F30. I have tried and used many different styles of masks and the F30 is my favorite so far.

You can read my review at AirFit F30 Review.

The Philips Amara View is very similar to ResMed's F30. I have one although I have not used it yet. I plan on using it for a few months and then write up a review on it too.
RayBee

~ Self-Treatment - via ApneaBoard experts.
~ Self-Pay - no help from Kaiser other than getting my script, then a pat on the butt and out the door.
~ Self-Educated - via ApneaBoard experts, its many users, and posted reference material.
~ Complex Apnea - All Night AHI=34.2/h, Supine AHI=45.5/h
~ Using a 2021 16" MacBook Pro M1 Max, 32 GB, 1 TB, macOS Monterey V12.2.1.
~ Pay no attention to the dog behind the cup, he ain't a docta, and does not give medical advise.

I-love-Apnea-Board
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#10
RE: Need to find a solution for my wife. Any suggestions?
Could you set up your machine outside the bedroom and during the day or evening so your wife could try it out? The P10 sounds like a good option for a trial run. The settings should be different from yours: maybe min EPAP at 4, pressure support at 3, and max IPAP at 7 (essentially fixed pressures).

While she's using the machine, she can also play around with positioning her tongue so she can open her mouth and yet have no air come out.

The CBT for claustrophobia sounds like a good idea too.

In your wife's position, I imagine it's easy to feel you're being pressured without an understanding of what your particular problems are. i know you are pursuing this out of love for her -- both so she can feel better during the day and so she can reduce the risks of serious disease down the road. I hope she gets that!
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