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+--- Thread: Using my cpap to screen my dad -- any suggestions? (/Thread-Using-my-cpap-to-screen-my-dad-any-suggestions)
Using my cpap to screen my dad -- any suggestions? - cathyf - 06-14-2021
For my dad's whole life he has been dozing off constantly in virtually every situation. Sitting at the dinner table. On public transportation. In a chair. On the couch...
Ever since I was diagnosed, I've been trying to get my dad to do a sleep study to no avail.
I've decided to take things into my own hands. i've assembled some assorted large sized masks, and I going to hook him up to my cpap, pulse oximeter, & maybe even my old fitbit 3 for an evening of napping. And see what OSCAR has to say about him.
I know to use a separate data card, and to load him into a different profile.
Does anyone else have suggestions?
RE: Using my cpap to screen my dad -- any suggestions? - Sleeprider - 06-15-2021
Pressure will treat his apnea and sleep disordered breathing. You need to compare to a control or before/after, to show an improvement. I would suggest using the pulse oximeter without CPAP, and compare to your trial with CPAP. Typically a good minimum therapeutic pressure is 8.0 cm. For comfort and your test, I would suggest 8 to 12 pressure with 2-3 cm EPR.
RE: Using my cpap to screen my dad -- any suggestions? - cathyf - 06-15-2021
I'm not at all sure that my dad has sleep-disordered breathing -- it's obvious that he has SOME sort of sleep disorder but nobody has seen this as a problem that might be addressed for 85 years!
Part of what triggered this is that when I had my consultation with the sleep doctor who decided that my only problem was that I'm crazy, he said this in the treatment notes:
Quote:Daytime fatigue appears to have multifactorial etiology. Poorly-controlled anxiety/depression and insufficient sleep at night might be contributing to her symptoms. CNS hypersomnia unlikely.
which sent me to the internet to search on "CNS hypersomnia"
...whoa -- what I found was a description of not just my dad, but to a lesser extent my brother and I and two of my brother's three kids.
Picture a family gathering: the five of us asleep on various couches, chairs, the floor, while my mom looks at my husband, my sister-in-law, my younger nephew, and my two kids and they all just laugh.
The last time that I was home I did strap my pulse-ox on my dad for a couple of hours while he slept in front of the TV. He had a rock-solid 98% saturation the whole time.
I did pay attention that every 15-20 minutes of so he goes through this cycle of partial arousal, where he leans forward, puts his forehead in his hands, and then leans back and returns to sleeping.
What I can't figure out -- I've been wondering my whole life! -- is how my dad managed to function. Yes, he drinks lots of coffee, but he never -- as far as I was aware -- was unsafe driving.
RE: Using my cpap to screen my dad -- any suggestions? - sheepless - 06-16-2021
if you set the machine for it's lowest possible setting, min 4, max 4, epr off - to limit it's therapeutic effect - and you see zero or very low frequency of apnea, you won't be able to say he doesn't have apnea because of the machine's therapeutic effect. but an ahi well above 5 would be a pretty good indicator he suffers apnea. you could also spend a night awake to monitor him and/or use audio/video recordings to see how often he pauses breathing; also hear, see and count his gasps, wheezes, chokes, coughs, arousals, etc. besides, he might need to hear and see himself to be persuaded.
RE: Using my cpap to screen my dad -- any suggestions? - cathyf - 06-16-2021
I was thinking 5/6 -- I know that at the beginning 4 gave me claustrophobia. (Heck, with a nasal mask, 7 is a little claustrophobic for me, LOL) And in my own data collecting I always keep min and max at least a little separate. This tells me whether the algorithm is raising, lowering, pegged-at-min, or pegged-at-max at any particular time.
Also I'm reasonably comfortable with the idea of sleeping without the CPAP as long as I have my cervical collar, so if his daytime sleeping looks like he's having apneas I might make him wear the mask all night, too.
My main worry is that the biggest FFMs I have are medium. But he's generally not a mouth breather (well not since he had his deviated septum fixed 47 years ago) so maybe I can make pillows or a nasal bar work on him. I've got mask fit packs for those so I have all sizes.
Wish me luck -- I think it's going to take some bullying, but what are daughters for?
RE: Using my cpap to screen my dad -- any suggestions? - SarcasticDave94 - 06-16-2021
What sheepless is suggesting is lowest possible benefits from PAP and posting it into OSCAR. If the AHI is 5 or above the likelihood of Apnea is fairly well confirmed.
What Sleeprider mentioned is also something of value. Using the pulse oximeter then joined with a PAP therapy. Note the difference. If there's low oxygen off PAP but it increases while on PAP, that too can indicate a PAP may be of value.
As you're likely aware, neither are guaranteed. Then again the lab versions get it wrong sometimes too.
RE: Using my cpap to screen my dad -- any suggestions? - Reptile - 06-28-2021
Long before I was diagnosed with obstructive sleep apnea, I was in hospital on and unrelated matter and a junior doctor wrongly concluded after linking me to an oximeter overnight that I didn’t have sleep apnea. Several years later, a sleep study showed that I did and once treatment started my life was transformed.
I’m not an expert but there is lot more to this business than meets the eye. Can you get your dad a medically supervised study?
RE: Using my cpap to screen my dad -- any suggestions? - cathyf - 06-28-2021
Yeah, as an update, dad was totally not having any part of the cpap.
Having done more research, I'm thinking that it's far more likely that he has ideopathic CNS hypersomnia. Reading this link: https://www.hypersomniafoundation.org/document/ihsummary/ I keep looking for my dad's picture on the flyer! Other than the sleep hallucinations and the sleep paralysis (which I've never seen but they classify as an "occasional" symptom) I've watched him do all of those other things every day for my entire life.
So my dad clearly has something going on as some sort of sleep disorder, and my family has been joking about the "family sleep gene" for forever. My brother, two of his kids, and I all have the "family sleep gene" -- not nearly as bad as my dad, but all four of us are clearly not-typical.
It makes my breathing issues even more interesting to wonder what sort of central nervous system things are layered on top of them!
RE: Using my cpap to screen my dad -- any suggestions? - factor - 06-29-2021
I hear ya. Parents by nature dont listen to their kids.. No matter the age. My mom had a Thyroid problem was going to one place and getting no where fast. I said why dont you see my doctor and he will dig to the bottom. Mom: Yeah sure ok I will... 2 weeks later Mom still feels awful. I said mom when is you next appointment to see the other doctor? Mom:Next week... So I picked her up to take her. Drove her straight to my doctor...
. She was like this is not where I go... I said it is now.. After a short stay in the hospital feeling fine..I commend your efforts but if your dad is 85 yo. He would most likely never admit it to you but he doesn't want his little girls help. Yes you are still his little girl. The one in the pictures not the full grown adult you see in the mirror. He thinks he is doing just fine for all those 85 years..
. No use in changing now..
RE: Using my cpap to screen my dad -- any suggestions? - cathyf - 06-29-2021
Actually it was even worse... I was expecting an argument (which I didn't give myself particularly good odds on winning.) Instead he was just kind of pathetic "do we have to do this?" This is the guy who taught me to argue!
And I had done some more research on this hypersomnia thing. When you go to the Mayo Clinic or Cleveland Clinic web pages they are all excited about this very interesting exotic disease and all of the challenges of diagnosing it, but the bottom line is that if they decide that you have it then there really isn't much that they can do for you. He's 85, been living with this his whole life, and has managed reasonably well.
I'm afraid I'm in pretty much the same boat... If you are hosting the big game and invite me to your house to watch, I'll bring the guacamole. And I'll fall asleep on your couch during the game. More guacamole for the rest of you! (More pathetic is that I'd fall asleep during the game in the stadium!)