Now what??????

[Roxy]

I have been using my cpap for about a month and am 100% complient. There is no question that my husband's apnea is much worse than mine. He had a sleep study about 5 or 6 years ago and had severe apnea then. He tried countless masks, anti anxiety meds, desensitization etc but kept waking up with a panic wearing the mask at home. My husband gave up and stopped using the machine. Since then, he developed high blood pressure and type two diabetes. I was finally able to convince him to go for a new sleep study. My husband went for a sleep study two nights ago but came back home a bit after midnight. He kept waking up in a panic having the wires and mask and couldn't complete the study. He said that his reactions this time were worse than 5 or 6 years ago. The feeling of the mask on his face put him in a fright or flight mode. NOW WHAT?

[kaiasgram]

Hi Roxy -- I feel bad for your hubby. It sounds like he wants to make cpap work but hasn't been able to overcome the panic reaction. Do you know about EMDR? An approach to psychotherapy that can help with trauma, panic and anxiety. Happy to send you more info if you're interested, feel free to send me a pm.

[brucifer]

I'm surprised the sleep lab did not administer Ambien or some other sleep aid. It seems like a waste of time and money to go through all that effort for naught.

[chunkyfrog]

Do not forget that nasal pillows or a cloth mask feel much less confining than the masks they use in labs.
An APAP may limit higher pressure for when it is actually needed and patient is asleep.
Your hubby may also want to check on the feasibility of surgery or HGNS.
Even though these are not as effective or affordable as cpap, they may be better than no treatment at all.

[Sir NoddinOff]

That's a tough one. Maybe a Xanax/Ambien cocktail for the sleep lab? Xanax is an anti-anxiety drug. I know it's not good to mix them, but it is only for one night. Also, he may just have a low tolerance threshold for people poking around on him and telling him what to do (like me in the sleep lab, for example). If he's balking at sleep studies, it's hard to imagine him going regularly for psychoanalyst sessions. Like I said, tough one, cuz it sounds like he's already formed some negative opinions about CPAP.

[49er]

I have been using my cpap for about a month and am 100% complient. There is no question that my husband's apnea is much worse than mine. He had a sleep study about 5 or 6 years ago and had severe apnea then. He tried countless masks, anti anxiety meds, desensitization etc but kept waking up with a panic wearing the mask at home. My husband gave up and stopped using the machine. Since then, he developed high blood pressure and type two diabetes. I was finally able to convince him to go for a new sleep study. My husband went for a sleep study two nights ago but came back home a bit after midnight. He kept waking up in a panic having the wires and mask and couldn't complete the study. He said that his reactions this time were worse than 5 or 6 years ago. The feeling of the mask on his face put him in a fright or flight mode. NOW WHAT?

Hi Roxy,

When I was exploring the possibility of dental appliances, I bookmarked this dental office in New Jersey even though I don't live in the state because it looks like he had worked with patients with severe apnea.

http://www.sleepapneausa.com/about_the_director.htm

Is this office near you?

Of course, I would screen him very carefully. According to a sleep dentist who posts on another apnea board, the TAPIII device works 33% of the time in getting the AHI under 5 and 50% of the time in getting it under 10.

Still, it might be worth exploring.

If your husband is a nose breather, Provent might be worth trying. If I remember correctly, that has a 50% chance of being successful and it doesn't seem to matter how severe the apnea is.

Double check me on that. Also, I can't remember whether that meant getting the AHI below 10 or 5.

Regarding sensitization for cpap, would it help take the standard tips and go even more slowly? Or do you and your husband feel this is not just not going to happen?

I really feel for you all and your situation.

49er

[pats]

If your husband is a nose breather, Provent might be worth trying. If I remember correctly, that has a 50% chance of being successful and it doesn't seem to matter how severe the apnea is.

Double check me on that. Also, I can't remember whether that meant getting the AHI below 10 or 5.

Regarding sensitization for cpap, would it help take the standard tips and go even more slowly? Or do you and your husband feel this is not just not going to happen?

I really feel for you all and your situation.

49er

Provent is generally better than nothing for those patients who can tolerate it, so it may be worth trying at least as an interim solution while working on the other issues.

Does Roxy's husband have a doctor who would prescribe it based on medical history without a recent sleep study? My sleep doctor looked at my sleep study report and the printout from my APAP data card, as well as my general medical history, before prescribing Provent for me for travel use. Can Roxy's husband tolerate a recording pulse oximeter? That is the best test of Provent effectiveness short of a sleep study wearing it.

I am concerned that the same problems would just happen with Provent. With a CPAP, or sleep study equipment, there is no real obstruction to breathing. With Provent, the pressure comes from significantly restricting the exhale airflow through the nose. It is a very strange feeling.

Maybe, very very slow desensitization? Perhaps Roxy could take an old mask, with no hose so breathing through it is easy, and start out by having her husband just hold and handle it in relaxed, no pressure conditions. Then work up to holding the mask to his face for a few seconds at a time ...