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Question for my partner's father (85 year old) 26 AHI treatment?
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Question for my partner's father (85 year old) 26 AHI treatment?
Hi

My gf's father is 85 years old and finally took a home sleep test and was diagnosed with moderate apnea, 26.3 AHI. (I had pushed for the last year to get him tested as he snores a lot, and energy is very low). 

He tried an APAP (from Kaiser) for two weeks, with a full face mask (Resmed 10, with Resdmed F30) no humidifier, no heated hose (due to covid), and struggled with getting mask on/off each night. I coached him for several days and he was able to use it for 4 days out of the 10 days he had it. First 5 days he couldn't use it at all, and each day I worked with him to put mask on/off, and keep trying it. 

He didn't like it, and doesnt think he has a problem or that he needs it (he is in early stages of dementia, and had hip surgery last year, which seems to have affected his cognition). 

He also has stenosis of the heart (ie one of his valves is affected). 

My question is whether I should encourage him to try a cpap machine, hopefully the doctor will prescribe a BiPap (as that seems to be indicated for people with heart/pulmonary issues). If I don't, he will tell the sleep doctor he can't use the cpap and doesn't want to use it. If I encourage him to try a machine for a month or two he may agree. 

The bad part is as his dementia progresses/he gets older and muscle coordination worses, he will find it tougher to use the cpap at some point. 

Hopefully other option is Mandibular device (not sure Kaiser offers that but think they do so). Which will be easier to use, but tougher to monitor his usage or his treatment. 

I know this is a complex case, however though would ask the folks for their thoughts. 

Thanks

S
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