Wife won't do sleep study

I'm recently diagnosed with OSA. I've been devouring all the info I can about the subject the last few weeks. This has made me realize that my wife may also have sleep apnea. She is showing many signs of it (tired often, wakes frequently, falls asleep during movies, in the car, snores, carries a few extra pounds, etc.).

I have discussed it with her and she refuses to get a sleep study done. She insists that it is simply because she works at 5am five days a week (she does), works hard at work (she is a stocker at Costco), and has three kids to care for too. Since I work nights, she deals with the kids in the evening/night and that is very taxing on her. All of this is true and it may genuinely be that she just doesn't get enough sleep. However I'd like her to get a sleep study to be sure.

So my question is this. She's pretty much just flat refused a sleep study regardless of the arguments I've tried, but has agreed to try my cpap for a night to see if it shows anything. Once I get my S9 Autoset with data next week, if we set the pressure to 1 and she used it for the night, if she had OSA would it show up as multiple events for her since the pressure is so low? If she used it with a pressure of 1 and it showed no events, would that indicate that she doesn't have OSA, or it is so mild that minimal pressure resolves it, thereby indicating that cpap therapy wouldn't offer much help anyway?

These are obviously just my (maybe not so well-informed) thoughts on the matter, so please help educate me. Also, please be nice because this is still my wife that we're talking about, so I'm allowed to say that she can be stubborn and a PITA, but you can't.

Oh, one other thing. I'm sure someone will point out the fact that if she's using the machine then that means that I'm not. However, since she works early mornings and I work nights, there are two days a week that she is leaving for work as I'm getting home. Therefore she could use it for the whole night and I could still use it during my sleep.

Hi - I think what you're trying to do is terrific, making sure your wife does not have OSA, but if it were to turn out that she does, whatever else may or may not be going on (thyroid problems, just not enough sleep, other sleep problems besides OSA, etc.), you want to be sure she is not turned off by your experiment, rather than anything. I'm not familiar with the autoset, though use an autopap (DeVilbiss Intellipap) but I've never heard of a pressure of '1' and if you mean to try her on the lowest pressure - the default ones built into most machines are 4 and (the highest) 20, but I would not want to try out anything on e.g. 4, as no one can really breathe very well at all on that setting, and it's basically used only as the jumping off place for the ramp feature (the one you use at the beginning of therapy to get used to air being blown in... it moves you up gradually each night over e.g. 20 minutes, to your prescribed pressure), but I'd otherwise try her at something like at least 6 or 7, not even as high in fact as I believe more of us seem to end up at (around 10) but at least high enough so that breathing is not uncomfortable... and she wouldn't need the ramp at that level either. Plus it is highly unlikely that just having air blown into her system at that very low setting could possibly do harm of any kind... it's not even oxygen after all, just room air, only at a slightly more regulated rate than would be normal (and if she does have OSA, 'normal' would not be a good thing in any case).

Tekcor1 wrote:I'm recently diagnosed with OSA. I've been devouring all the info I can about the subject the last few weeks. This has made me realize that my wife may also have sleep apnea. She is showing many signs of it (tired often, wakes frequently, falls asleep during movies, in the car, snores, carries a few extra pounds, etc.).

I have discussed it with her and she refuses to get a sleep study done. She insists that it is simply because she works at 5am five days a week (she does), works hard at work (she is a stocker at Costco), and has three kids to care for too. Since I work nights, she deals with the kids in the evening/night and that is very taxing on her. All of this is true and it may genuinely be that she just doesn't get enough sleep. However I'd like her to get a sleep study to be sure.

So my question is this. She's pretty much just flat refused a sleep study regardless of the arguments I've tried, but has agreed to try my cpap for a night to see if it shows anything. Once I get my S9 Autoset with data next week, if we set the pressure to 1 and she used it for the night, if she had OSA would it show up as multiple events for her since the pressure is so low? If she used it with a pressure of 1 and it showed no events, would that indicate that she doesn't have OSA, or it is so mild that minimal pressure resolves it, thereby indicating that cpap therapy wouldn't offer much help anyway?

These are obviously just my (maybe not so well-informed) thoughts on the matter, so please help educate me. Also, please be nice because this is still my wife that we're talking about, so I'm allowed to say that she can be stubborn and a PITA, but you can't.

Oh, one other thing. I'm sure someone will point out the fact that if she's using the machine then that means that I'm not. However, since she works early mornings and I work nights, there are two days a week that she is leaving for work as I'm getting home. Therefore she could use it for the whole night and I could still use it during my sleep.

You say you were recently diagnosed and will be getting an autoset, but you have listed a S9 Escape in your profile which does not give out the diagnostic data you are looking for.

Call your machine supplier immediately, before they can give you the escape version of your machine, and tell them that you will only accept the elite version of your machine. If they do not sell you the elite, and tell you that you have to take the escape, ask them for your prescription back and walk away, and go somewhere else to get your cpap.

That will give you access to the data that you need.

The insurance company will pay your supplier the exact same amount for the elite version as they do for the escape version. The supplier has to pay more for the elite, so they lose a bit of profit - that's the primary reason they are giving you the escape. But since they'd rather have some profit than no profit, they should agree to the switch. BEWARE - if they tell you that YOU have to give them more money for the "upgrade", again, walk away without the cpap and go elsewhere. There should be no increase in cost for you, due to the insurance agreements.

Thanks for the reply Julie. You brought up some things I hadn't even considered. It never occurred to me that 1 wouldn't be the lowest pressure. More importantly, I hadn't thought about the fact that I hate the ramp feature because at the lowest pressure I don't feel like I'm getting enough air. Probably wouldn't bode well for her using it all night at that low pressure. Like you said, wouldn't want to sour her on the treatment the first time.

LSAT wrote: You say you were recently diagnosed and will be getting an autoset, but you have listed a S9 Escape in your profile which does not give out the diagnostic data you are looking for.

You're correct, I currently have an S9 Escape. However, I will be exchanging next week for an S9 Autoset thanks to the helpful members on this forum. I can't wait to be able to actually see if this thing is helping or not!

I used my APAP to screen both my sister and her husband 2 years ago just like you propose to do with your wife. She had all the classic symptoms..snores, fatigue, headaches, high blood pressure and he had only snores.

The lowest the machines will go is 4 cm. When I started my sister out with a small range or 4 min and 10 max it took her about 30 seconds before she was screaming she was suffocating. So I had to increase the minimum to 6 cm and she was comfortable and able to use the machine. It never went above 6 cm and she had zero AHI. A few snores and flow limitations was all that showed up. While there is some therapeutic value at 6 cm it doesn't look like she had OSA but she reported she felt better. I wonder now about UARS but she has blown it off and would rather whine about feeling horrible than try again. Of course I suppose it could have been placebo effect.

My brother in law did seem to have OSA. Pressure went to 9 and we had obstructive events with AHI of around 3.
He has also blown it off. Since he only has snores as a symptom he doesn't see the benefit despite all my sermons. Of course his brother also has OSA (sleep study confirmed) and it doesn't help that his brother has also blown off the therapy as being "too hard to to sleep with the mask" and he tells my BIL that "I sleep fine"...Duh...he had the sleep study for a reason.. Oh well.
You can lead a horse to water but everyone knows the rest of that story.

For screening or testing purposes on your wife use the lowest minimum she can be comfortable at and just set the max to 10. You only need to see if there are pressure responses and if there are any events when screening.
Worry about fine tuning later if needed. If pressure is set to 20 the pressure variations might disrupt sleep and thus not get a good screening.

Geez, see if you can borrow/rent a recording Oximeter. That is more definitive, and does not involve trying to keep a mask on a person.

The RT at one of sleep clinics said that when a person is persuaded by family, someone else to try sleep apnea treatment, they will usually quit soon anyway. They will be just looking for a reason to quit.

There are a lot of other reasons why she might feel tired which a doc can find out, from low Thyroid, which docs will not do much about, to restless legs, to lung problems, to heart problems.

Best wishes to both of you anyway.

Your wife is a lucky woman. If you can't get her to a sleep center I doubt you can get her to have a thorough physical. Your idea of using your AUTO machine is a good one. I would be concerned that the mask may not fit. My last prescribed pressure was 4/8 (currently I've self titrated to CPAP pressure of 10) so she may be able to tolerate the pressure of four. I did without any feelings of suffocation. Has she indicated a willingness to try the machine?
Some members have resorted to overnight video taping to show that a person actually stops breathing during the night. An audio recording may serve the same purpose. Can you observe her for a few hours while she sleeps, or do your work schedules make that impossible? An observation by a spouse that a person has apneas during the night can be pretty convincing. There are wakefullness tests for sleep apnea that you can find on the internet. Perhaps one of these would convince her to at least see a physician.
Some questions to ask her:
Do you have the following?
Loud snoring
Excessive daytime sleepiness or drowsiness
Tendency to sleep at inappropriate times
Inability to sleep or remain asleep
Sleepiness while driving
Acting out of dreams
Creepy, crawly sensation of the legs

One link for the Epworth- http://www.umm.edu/sleep/epworth_sleep.htm
another link for a quiz - http://www.dreamdoctor.com/faqs/sleep-apnea-quiz.html

Perhaps she would be willing to have an in home sleep study, or you could purchase a pulse oximeter which will show O2 desats , but not apneas.
The more you push her the more resistant she may become, I hope she is willing to do some reading from the above links.
Good luck, keep us posted

Why not just leave her alone for a bit....till she sees how well you do at being a successful hose head. Once she sees that its no big deal, she will relent and get tested with your machine or at a sleep lab. She is probably overwhelmed with what you are going through and worrying about you that she is just a little gun shy at this point. Don't bombard her with the fact she may have the disease too, just let her relax and accept what is happening at the moment. After all, you are partners, what you feel, she feels.
Cheers and good luck
Nan

Side note...using an overnight Oximeter may or may not give you a definitive idea.

If there are significant desats...yeah probably some events occurring and probably sleep apnea
BUT
If there or no significant desats it doesn't necessarily mean no events occurring. It simply means no desats of any significance.
Not everyone with OSA will have significant desats.
I have been helping someone that during the sleep study only saw desats to 95% (normal baseline was 97% to 98%) but had an AHI of 64.

I would wait a while. It is sort of like stopping smoking, the converted are very very likely to see it as a way to cure all ills and get a bit ..... "pushy" about it.
Apologize to her about your fervour and help pick up the slack when you get your energy back. If that doesn't help ask her to do it for your peace of mind as a favour, because you want to be sure she is there to share your life and you are now scared shitless about the possible effects of OSA.

Some people have symptoms that are serious. Others just feel lousy and tend to doze when watching TV.

I had wakeups in the middle of the night with heart palptations. Doctors never mentioned SA, but sent me for stress tests and even the cardiologist missed it. I finally read some posts by other people with the same symptoms and signed myself up for a sleep study. I had an AHI of 64, mostly hypopneas.

APAP promptly fixed my palpitation issues. Sometimes people need some encouragement, but tend to resist the demands of others. Give them something to read that outlines the symptoms and maybe they'll seek help once they realize they may benefit. It can't hurt to be tested.

Most people don't like to be told what to do--especially by their spouse.
Patience. If she sees you learn, acquire friends here, and get symptom relief, that could be a motivator.
As you have seen, some people simply refuse to do xPAP, just as some refuse to quit smoking. Understandably, there's not much acceptance of that attitude on this board, but if it's your mate and you value that relationship, in the end, you have to learn to live with it.

Tekcor1 wrote:I have discussed it with her and she refuses to get a sleep study done. She insists that it is simply because she works at 5am five days a week (she does), works hard at work (she is a stocker at Costco), and has three kids to care for too. Since I work nights, she deals with the kids in the evening/night and that is very taxing on her. All of this is true and it may genuinely be that she just doesn't get enough sleep. However I'd like her to get a sleep study to be sure.

I agree with those here who say you cannot push her into it if she doesn't want to do it.

I read and hear a lot about many folks who apparantly have a difficulty accepting the idea that they may have sleep apnea. Hence, they'll come up with many more logical sounding excuses for it (which also could be true). In any case, just be aware of that, let her see how well you are doing with it and hopefully when she gets sick and tired of being sick and tired, she'll come around.

I suggest that you start your therapy, get settled in, and then let you wife see how much better you feel. Then, she may realize how much good therapy can do for someone who has OSA. Let her decide that she wants to feel better, too.