[Health] Need help

[Black Sheep]

Hi everyone,I am a 50 year old obese man with an 83 year old equally or more obese mom in need of cpap treatment for sleep disorders.Last year I succeeded in getting my mom to a sleep clinic and got her a respironics REMstar Auto A-Flex(551P) with SYSTEM ONE heated humidifier with 8.00 to 18.00 cm H2O pressure.She used it for 200 days and then abruptly stopped using it altogether. to your site I learned how to tweek the device and last night I slept with it with 4.00 to 14.00 without humidification to have a first hand experience of what I wanted my mom to do.Without humidification under a ComfortGel Full face mask it was draughty (cold).What I want you guys to do is help me convince my mum is to start using it again.As she had been sleepless for so long (may be 20 years,god knows better!) she is used to being awake from 2.30 to 6.00 she sits ,she reads and so on and in the mornings she doses off(naps) often.I think she is afraid of sleeping at night as she might not be able to read at nights as she is used to do.Any help with statistics or any other wisdom is greatly appreciated.Thanks.

Al

[TheWerkz]

Hi Al,

Welcome to the forum!

You can't actually "make" your mother do anything she doesn't want to do but, maybe we can help her want to be more compliant with her CPAP therapy.

You really need to find-out why she stopped using it after initially using it for over 6 months, what changed?

Was she having problems with the mask leaking or was there some other issue that caused her to abandon its use?

Was it her complaint about the air being too cold or was that just your complaint? The delivered air is usually warmer if you use the humidifier, not only for the warmth but to help prevent dry nasal passages/throat, since the air is being delivered at a higher pressure it doesn't spend enough time in the nasal cavity to get moisturized naturally.

Someone should be able to help alleviate your mother's problem with her using CPAP but we've got to know the underlying reason(s) why she stopped using it in the first place.

Good luck!

Ren

[Black Sheep]

Hi Ren,

Well before and after CPAP(I mean right now) she uses AirSep 8 l/min dual outlet oxygen maker set to 3 l/min with "nasal" (not the "mask") attachment, the kind with two small short pronges inside the nose and the tubes going back behind ears and under the chin.Her foremost concern was as she was afraid full mask would leak and not give her enough oxygen to breath ,so she fastened the straps tight and and understandably she complained is was not as comfortable as opposed to "nasal tubes".Also she used it with humidity set to 2,last night "I" used it without humidity as I thought it would be like the air I breath which I was wrong.I think I should talk with her doctor on possiblity of using nasal mask instead of full face mask.

From the start it was my mistake ,as no DMEs in our town carried the prescribed CPAP my sister toke delivery of it in another city and sent it over,so I wasn't instructed on how to use it on my mom,we just turned it on without knowing what our options or choices could be in terms of user adjustments.

Also another problem old people are used to doing things in a certain way and hate change, especially if they were of "being the boss" type,and to compound things further when I argue with mom ,my dad sides with her besides knowing fully well that using CPAP is not an option it is a must do thing.

Do you think any of these problems could be solved?

Thanks

Al

[TheWerkz]

Hi Ren,

Well before and after CPAP(I mean right now) she uses AirSep 8 l/min dual outlet oxygen maker set to 3 l/min with "nasal" (not the "mask") attachment, the kind with two small short pronges inside the nose and the tubes going back behind ears and under the chin.Her foremost concern was as she was afraid full mask would leak and not give her enough oxygen to breath ,so she fastened the straps tight and and understandably she complained is was not as comfortable as opposed to "nasal tubes".

I'm pretty sure you're referring to a "nasal cannula" she's using with the oxygen.

According to the mask model you listed in your profile, it should have a port on the left side to allow a connection to a supplemental oxygen tube, so she should be able to use both at the same time, I don't know any of the specifics (I don't use it) but other members here that use supplemental O2 will be able to help answer the question as to how to use it properly, I do know that the CPAP should be turned-on first and then the oxygen generator gets turned-on second to prevent O2 from building-up in the CPAP itself. Respironics also makes a CPAP Pressure Valve to prevent O2 from leaking back into the CPAP flow generator.

Here's a short abstract on CPAP vs. O2 therapies: http://www.ncbi.nlm.nih.gov/pubmed/16585412

Also she used it with humidity set to 2,last night "I" used it without humidity as I thought it would be like the air I breath which I was wrong.I think I should talk with her doctor on possiblity of using nasal mask instead of full face mask.

The humidifier setting has to be tailored to each individual user, I like it really humid but other people like less humidity.

It's trial and error, if you don't feel like it's high enough then try it a little higher until you figure-out which setting is the most comfortable, if the room temperature is fairly cool and the humidifier is turned-up fairly high this can create condensation inside the hose called rainout, you'll know it when the droplets of water splash you in the face, if this happens she'll need to turn the humidifier down a little bit, there's also hose wraps on the market to help insulate the hose from the cooler room temperature that helps prevent rainout.

One of the most critical parts of effective CPAP therapy is finding which mask works well for you, faces are all different as well as user preferences as to which type of mask feels the best and ultimately works the best without leaking.

If your Mother doesn't ever breathe through her mouth when she sleeps then she might be happier with a nasal mask instead of a full face mask.

You could call your local DME's to see who has the best stock of whichever type of mask she's interested in, there's literally dozen's to choose from.

The important thing to help reduce leaks with any mask is to wash the mask cushion daily with a mild liquid soap (Ivory etc.) and dry it then, before going to sleep she needs to wash her face and not apply any lotions or cream's to the area the mask will be touching. If she's adjusting the mask straps so tight that it's uncomfortable and leaving indentations in her face then that's another indicator it's too tight - a properly fitted mask should not hurt.

Here's a link to some fitting information and video's for your mask: http://www.healthcare.philips.com/main/h...ghtfit.wpd

From the start it was my mistake ,as no DMEs in our town carried the prescribed CPAP my sister toke delivery of it in another city and sent it over,so I wasn't instructed on how to use it on my mom,we just turned it on without knowing what our options or choices could be in terms of user adjustments.

Congratulations on getting as far as you did! I was given great instructions on using my equipment when I bought my first CPAP but I see more and more people aren't as lucky as I was with my DME.

You'll find there's plenty of people on this board with the same machine that you have and they should be able to help answer any questions you might have about its operation.

Also another problem old people are used to doing things in a certain way and hate change, especially if they were of "being the boss" type,and to compound things further when I argue with mom ,my dad sides with her besides knowing fully well that using CPAP is not an option it is a must do thing.

The real trick is to make them feel like it was their idea! The only option to using CPAP isn't a good one, you may have to get your Father more involved to ensure she'll continue to use her CPAP, it's just as important as her supplemental O2, in fact, whenever she has an apnea she's not getting ANY air or supplemental O2.

There should be more replies shortly.

Ren

[trish6hundred]

Hi Black Sheep,
WELCOME! to the forum.
First of all, What TheWerkz has said.
I hope you can figure out why your mom suddenly stopped using her machine. It'sv very admirable that you are trying to encourage her to use it but try real hard not to argue because that can just make your situation worse. My mom hated her machine at first and it took her a VERY LONG time to get used to it but she eventually did get to where she would use it every night. At first, she would always grumble to me on the phone that it was a pain in the a** but, she would reluctantly mask up. Another thing is that she had trouble manipulating the headgear and chinstrap, but she eventually got that down pat.
In other words, she got to where she didn't rebel against the machine.
Best of luck to you, and your family in this time ofdifficulty and I hope this helps you in some way.
Hang in there for more suggestions.

[PaulaO2]

Ask her if her will is up to date. Then take her to a funeral home to pick out her casket. Perhaps even take her to a nursing home so she can pick one of those out, too. Death from untreated sleep apnea related issues and the other illnesses, conditions, and diseases made worse by untreated sleep apnea is a slow, painful, exhausting way to go.

Like Werkz said, they make valves to attach an oxygen line to the mask or hose. A full face mask is only needed if she opens her mouth at night and breathes from her mouth. If she doesn't do this, then she doesn't need a full face mask. Then there's chin straps that help keep the mouth closed and she can use any mask she likes.

There's a lot of different masks available to her. The mask is by far the most difficult part of this as well as the most important. You can have the best machine in the world but if you hate the mask, it's an expensive door stop.

Her machine is basically set to "wide open". Perhaps narrowing that range some will help with her comfort. Even if lowering that maximum pressure is too low to stop all the events, it is still better than nothing. And she can then slowly increase it again as she gets used to it again.

[Black Sheep]

Wow guys you overwhelmed me by replying so quick and brought years of joy and gratitude to my eyes.

Well as to asking her if her will is up to date and all that,it is quite true that I am the black sheep of the family in the sense that I don't take nonsense at all costs even to the detriment of my popularity in my own family,but I'm not that "black" as to jolt her with all that.

I am going to ask my DME for my options in nasal masks and to narrow the wide open settings and turn up humidity to see what her reaction would be.

God willing I feel very optimistic as to the final outcome.

Once again guys and I hope you all to.

Al

[PaulaO2]

Sometimes, a jolt is what it takes. But I understand your hesitation.

Get a copy of her sleep report and find out what was the pressure they decided was optimum. Then set the APAP about 4 below and about 2-4 above.

And talk to her. Ask her what she didn't like as well as what she did. No use fiddling with the mask if that wasn't what bothered her.