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Forgive me for wanting to lighten the thing a bit... guess I won't do that again.

JohnBFisher wrote:

avi123 wrote:... About falling, I wonder if taking rehab physical therapy for "Balancing" could help. ...

Thanks for asking. It won't help me the same as it would help someone that does not have degeneration. Instead, I need to just push ahead and concentrate on keeping going.

For example, I've been in VERY busy environments before (such as at a State Fair). The crowds and the sounds stress my cerebellum. At one point one year it reached the point that it felt as if the world was turned 90 degrees. I was standing straight and walking ... I had to focus only on what my eyes were telling me, because my sense of balance was telling me that I was on my side walking along a wall.

That amount of variability requires that I constantly focus on walking or getting about. And that amount of concentration on those perfectly automatic things we do tends to tire me.

The physical therapists to whom I've talked said that in my case that same variability makes it very hard to "reset" my sense of balance. And they felt that what I do helps more than anything else. Still, I walk with at least one and sometimes two hiking staves to help keep myself upright. I don't need it for support. But without it, I am much dizzier than I am with it.

sir, as you are using bipap so you started using it from begining of the apnea or does your degeneration made you to bipap from cpap after sometimes.

JohnBFisher wrote:

mayur wrote:... he has co-ordination problem in walking and speech vocal problems and snoaring , dream enactment are because of OSA. and there is serious respiration problems after using cpap. ... but there is no improvement through this treatment neither in OSA nor in cerebellar atrophy.

I have to agree that the cerebellar atrophy might lead to either central or obstructive sleep apnea. Essentially if the atrophy impacts the brain stem, then it may lead to central sleep apnea. However, those same coordination problems can lead to coordination problems during sleep. So, it can also contribute to obstructive sleep apnea.

As others have noted, it's important to get his apnea under control. Being tired due to poor sleep will only make all his other symptoms worse. Trust me, I *know* all too well. I have Sporadic OPCA (OlivoPonto Cerebellar Atrophy). Essentially that means no one else in the family has it and it appears to be degeneration of my brain stem and cerebellum. It continues to progress. And when my sleep is poor, my symptoms are worse. Also when my symptoms are worse my sleep is also worse than normal.

Hope that helps.

sir,
i would like to bring you back in this conversation. its been almost 8 months using cpap in auto mode but there is no improvement in his condition now they have added clonazepam 0.5 mg can it be helpful. episodes of dream enactment are not to a large extent as they were before using cpap but they are still there and with a good frequency.

sir, my current ongoing post is " cpap not enough to stop episodes of sleep apnea. whats next?" hope you will share your experience once again.

thanks

mayur wrote:... i would like to bring you back in this conversation. its been almost 8 months using cpap in auto mode but there is no improvement in his condition now they have added clonazepam 0.5 mg can it be helpful. episodes of dream enactment are not to a large extent as they were before using cpap but they are still there and with a good frequency.

sir, my current ongoing post is " cpap not enough to stop episodes of sleep apnea. whats next?" hope you will share your experience once again. ...

If I understand correctly, it is your father that's having the problems. You note that "episodes of dream enactment are not to a large extent as they were before using cpap". In which case he has what it known as REM Behavior Disorder:

http://www.sleepfoundation.org/article/ ... -and-sleep

As you can see from the article, clonazepam is the primary medication to help reduce the episodes where he acts out his dreams. It further notes:

When clonazepam doesn't work, some antidepressants or melatonin may reduce the violent behavior.

It is probable both the apnea and the REM Behavior Disorder is due to problems with the brain stem and cerebellum. He may have a "Parkinson's Disease" type disorder. It may just be Parkinson's Disease, or it might be one of the disorders that acts like Parkinson's. Either way, you might want to try melatonin .. and probably chat with your father's doctor about other possible medications.

You might want to check with his doctor if the medication is not surpressing the REM Behavior Disorder as well as it should. Also, he might need higher pressure as the neurological problems increase. For example, on my bad days (when I've been under a lot of stress), I need a higher pressure setting than what was prescribed. I happen to have a unit that will adjust the pressure as needed. He might also need a BiLevel unit (a BiPAP) instead of just CPAP. About 20+ years ago, I found that CPAP was no longer working. My pulmonologist ordered a new sleep study. The sleep technician found that I did better with BiLevel therapy than CPAP. I had a lot more "spontaneous arousals" .. that is, when I would shift from a deep level of sleep to a lighter level of sleep without it being connected to breathing issues .. when I used CPAP than when I used BiLevel. My pulmonologist admitted he did not understand WHY it would make a difference, but could clearly see that it did make a difference. So, they moved me to BiPAP then. I now know that it was an early sign of my neurological problems. You might want to see if a Auto BiPAP might be a better choice for your father.

I hope that helps. I wish I could offer better advice. But your father will probably require frequent "tuning" of his therapies to make sleep as effective as possible.