Husband has dementia

[Laser]

Hi there. Hoping to get some advice. My husband and has a rare type of dementia and was recently diagnosed with moderate sleep apnea in November 2016. We conducted the initial sleep test at home, saw the respirologist regarding the results and purchased a Resmed Autoset. An appointment for a sleep study was scheduled for mid December wherein my husband was to spend the night at the sleep clinic. I was going to stay with him, however, I had to cancel at the last minute because he was freaked out. I left 3 messages at the clinic when they finally returned my call. I advised that there was no chance of having this sleep study done and what do we do now? I asked if the respirologist could call me to discuss but he never bothered. The pressure setting he prescribed was 7. My husband took awhile to get used to using cpap and it has helped with snoring and gasping for air. He tried a the mirage nasal mask, which he found very uncomfortable so we switched to an AirFit P10 nasal pillow. I think the pressure setting of 7 is ok but how would I know if it needs to be increased? We live in Ontario,Canada. Any advice would be appreciated. PS. I don't have Sleepyhead but can it be used with an iPad?

[Pugsy]

SleepyHead won't work on an iPad. You need a computer with some way of accessing the SD card contents...either a slot or a USB drive you can hook up to with a card reader/adapter.

Which ResMed AutoSet does he have? There is some data available on the machine's LCD screen but you have to know how to turn it on first.

It most likely will be one of these 2 models.
You can look at it and figure out which it is and then read the manual so you can see the data the machine does offer.
Based on the data you would then maybe make adjustments to pressure if needed but you need to see that data first.
This for the AirSense model
https://sleep.tnet.com/home/files/resme ... -guide.pdf

This for the S9 model which is the slightly older model.
http://www.apneuvereniging.nl/forum/pdf ... manual.pdf

[Guest]

I don't have Sleepyhead but can it be used with an iPad?

I don't know that answer for sure but wanted to say that using SH is the way to find out.
I think Untreated Sleep Apnea does lead to dementia so treating it could very well help, tho it will take time and prob be as gradual as it was to get where he is now.

It will take a lot of reading this forum, asking questions, and possibly getting a used laptop you can use SH on. But there are many here who have self dx'd and treated themselves.

You should know (if you don't) that you should be able to get another mask (within 30 days) if the mask he has doesn't work for him or he doesn't like it. Every mask maker offers that 30 day window but it is up to the supplier and CN is diff than US.

Also if the 7cm doesn't treat his OSA (assuming it is all OSA and no central) you can gradually increase the pressure .5 or 1cm at a time so he won't notice it. But I wouldn't do that w/o SH stats to be sure it is needed and it is effective at reducing the events.

I see Pugsy is replying so follow her lead. Good Luck

[lasee]

Actually the cpap is an airsense 10 elite. I've been recording the information from the cpap since Jan 5. Total leak is 13-14. AHI was 2.5 and gradually rose to 3.0. Total AHI was 1.8 and gradually rose to 2.4 and central AI has consistently been 0.2. I'm inexperienced and I'm not really sure what these numbers mean and will do more digging. Unfortunately there is no cure for this sad and awful disease.

[Pugsy]

Total leak is normally defined as the mask's expected vent rate plus any excess leak.
The ResMed machine subtracts the vent rate prior to reporting leak so the leak rate that gets reported is excess leak only on a ResMed machine.
The on screen leak number you see on the machine is what we call a 95% number and the definition is where a person was at OR BELOW for 95% of the night. People tend to forget the "or below" part of the definition.

ResMed says the machine can compensate for leaks up to 24 L/min (and actually they don't totally go in the toilet until over 35 L/min).
So your 13 to 14 L/min 95% numbers are well below the 24 L/min line. We don't know (have to use the software to know) how far he goes above 14 L/min but we know it is for only 5% of time.
5% of the time even in really big leaks isn't the end of the world.

So all this means his leaks are pretty much within acceptable limits and I wouldn't be worrying about the leaks.
The AHI is also within acceptable limits. It is expected for the AHI to vary from night to night. We don't sleep the same each night.
In general AHI below 5.0 is considered acceptable in the medical community. There are some situations where maybe there is some serious clustering of apnea events that point to needing more pressure despite a low AHI. Unfortunately this can only be seen on the software reports which you can't get just yet.

So the AHI of 2 or 3 that is primarily OA or hyponea is within acceptable limits and doesn't necessarily mean that more pressure is needed.
If the AHI was primarily central events...for sure no additional pressure is needed.

In other words...no urgent need to alter pressures...and leaks aren't of the magnitude to impact therapy or reporting.
Given all you have to deal with I hope that taking this stress off helps a little.
It's not critical that we have the software reports in this situation. Yeah, it's nice to have but not critical.
His cpap therapy is coming along well within acceptable limits.

I had a friend who had this dementia problem come on at a relatively young age. It is heart breaking for sure.

[lasee]

Thanks for all the info Pugsy. Yes, your answer has taken a load off. My husband was diagnosed 3 years ago. He was only 57. Thanks for your kind words.