Help for my noncompliant father in law?

[dans]

Hi,

I am a new CPAP user myself and (with the exception of a mask rash and some issues with head colds) I have had a remarkably smooth transition to nightly CPAP use. My 72 year old father in law, on the other hand, was diagnosed with OSA many years back, prescribed a CPAP machine and has never really used it. His wife has worked with a DME to get him up to date equipment (last I checked he has a fairly modern APAP machine), they have tried all kinds of different masks, to no avail.
His primary complaints are:

1) Light sleeper so the mask disturbs his sleep
2) Gets up frequently to use the bathroom, but due to poor manual dexterity (diabetes related) he cannot fasten and unfasten the mask properly.
3) Mouth breathes so cannot use a nasal-only mask

He has a number of other health issues so OSA may be the least of his worries... or it may be complicating everything else. I see the same symptoms that I had pre-treatment: falls asleep anywhere and everywhere, no energy to do anything, no memory, etc. It's sad. I'd like to help him but he does not have the attitude that he can / must do CPAP therapy, so the machine sits unused on the nightstand.

Any suggestions?

[Julie]

Hi, nice to see you caring about him when you're just learning things for yourself (and BTW have you tried turning down the humidifier to get rid of the headcolds?). This does sound like a challenge though - the problem of his not being able to refasten the mask on his own needs to be addressed (it's not as much a compliance issue after all) and I wonder if someone has tried to tweak headgear from another mask to work with his mask if it makes it easier to use, or just gotten creative with the one he has (some people here have come up with all kinds of fixes). As far as the bathroom breaks go, they could be strictly diabetes related, in which case he may not be well controlled (and needs to be seen by his MD), or they could be the kind that disappear once on Cpap for many people, but if he's not getting full therapy (mask fit, noncompliance, etc.) then he's in a vicious cycle about it, or he may have a prostate problem that needs looking into. Hopefully he isn't drinking a lot of coffee near bedtime - that would making sleeping well difficult, of course, and could provoke GERD, which so many of us have - raising the head of the bed up on blocks of some kind, by just 6 inches often makes a big difference there.

It's obvious that you want to help, but some of the above need to be worked on with his doctor(s) - how closely is he followed for the diabetes and/or anything else?

[dans]

I've seen a dramatic improvement in my quality of life after starting CPAP and at this point I can't imagine going without it, so to see my father in law suffering from the same symptoms and refusing treatment is very sad. I have told him about my situation and the positive impact that CPAP has had for me, but he basically denies that he has a problem and goes back to his mid-day nap.

I don't think I am in a position to help him deal with his other health issues. He is under the care of an internist and multiple specialists, who manage his medications and help him through various medical crises. I think his diabetes control is OK but not great - I see him checking his blood sugar and self injecting insulin regularly. I am not privy to his medical info to know much more. One of his daughters is an internist so I'm going to talk to her about it.

The mask issue may be the first and easiest thing to resolve, if anyone has recommendations on full-face masks that are easy to take on/off at night with limited dexterity. (Actually I'm thinking it might be easiest if he just disconnects the hose and reconnects, leaving it on while using the bathroom. Haven't tried this myself with a FFM so not sure how practical it is.) Alternately I'm going to advise him to put the mask on at night and just take it off completely at the first bathroom break if he can't reattach it - on the theory that some therapy is better than none. Also I'm going to suggest that he nap sitting up. Simple changes that may help.

As for coffee, he's mainly an herbal`tea drinker, not sure if that is associated with GERD as well

[BlackSpinner]

They sell quick disconnects for the hose - you might want to check those out. That way he doesn't have to take off the mask.

[snuginarug]

My machine has a quick disconnect hose and mask system. Just last night I made a quick trip to the bathroom quite easily. It worked quite well with my FF mask. I am as new as a newbie can get, so it didn't take any skill or practice to pop the hose off the mask and then push it back on.

[Billy6]

Hi,
I am a new CPAP user myself and (with the exception of a mask rash and some issues with head colds) I have had a remarkably smooth transition to nightly CPAP use. My 72 year old father in law, on the other hand, was diagnosed with OSA many years back, prescribed a CPAP machine and has never really used it. His wife has worked with a DME to get him up to date equipment (last I checked he has a fairly modern APAP machine), they have tried all kinds of different masks, to no avail.
His primary complaints are:
1) Light sleeper so the mask disturbs his sleep
2) Gets up frequently to use the bathroom, but due to poor manual dexterity (diabetes related) he cannot fasten and unfasten the mask properly.
3) Mouth breathes so cannot use a nasal-only mask
He has a number of other health issues so OSA may be the least of his worries... or it may be complicating everything else. I see the same symptoms that I had pre-treatment: falls asleep anywhere and everywhere, no energy to do anything, no memory, etc. It's sad. I'd like to help him but he does not have the attitude that he can / must do CPAP therapy, so the machine sits unused on the nightstand.
Any suggestions?

I just bot one of those dental devices from my dentist and it seems to work, as sleeping on my back is no longer a problem. Naturally as soon as I bought it, I find one on the internet called ProSnore II. They send you impression trays, you send it back and they send you back the custom device all for about $139. I might get one of these too, just to have a spare for travel.

[chunkyfrog]

Share your positive personal experiences with him.
Do not hesitate to rave on if the mood hits you.
That's how I tipped my brother into getting hearing aids--he loves them.
--and it's how he tipped me into getting my sleep study/cpap.
Love and communication--wear him down!

[LoQ]

When the student is ready, the teacher will appear.


Your FIL is not ready. You can't control other people.

[Tovi]

I totally empathize. My dad also refuses to use his CPAP, says he "knows it's wrong, but has given up". I just tell my dad the positives about my own experiences. I've shared with him that it was tough at first, but I'm starting to feel better and it's only been a couple months. But in the end he's his own person and makes his own choices. I feel sad for him, because I know how tired I was and I also worry about his health. But he needs to decide for himself that he's willing to put the work in for his own health.