Husband not cured of sleep apnea but he says he is!
by Bridget
(England)
I am really desperate to know what to do as my husband for 24 years, has had a cpap machine for a year now and I still claim he has the symptoms and side effects of sleep apnea, of which some is describer on here.
They are: moodiness, irritability, maybe depression. There has been no weight loss. He has brought no money into the family for 2 years now. Please what can I do to better our family life?
We have 2 children aged 17 and 19, nearly 20. 19 year old working and living at home, starting uni in Sep this year so moving out. We can't get him to go to doctor. He keeps telling me he is ok. Yesterday he said:"I have got insomnia so will ask doctor for some sleeping tablets." He can't see it as it is. He says he has problems falling asleep.
He goes to bed any time between 3 and 6 am. When he gets up he goes straight on the computer for hours. Sometimes he goes to bed again. He is always ill with something. Don't know what to do. Have even said I will throw him out, which I actually mean but then I feel sorry for him and tell myself off. What can I do?
Answer
Dear Bridget,
If your husband has
obstructive sleep apnea, he should snore during sleep. However, if he is using the CPAP machine to treat his sleep disorder, it's difficult to see the symptoms, because he is covering the face with the CPAP mask.
So, if you see the symptoms of sleep apnea while your husband is sleeping, such as
breathing stops during sleep, or
loud and irregular snoring, the article about the
husband who doesn't want to use the CPAP can be very helpful for you.
But if your husband is using his CPAP machine and mask every night, then it's possible that the treatment is not effective. Maybe the air pressure is wrong, or he has
air leaks from the CPAP mask.
In this case, the problem is that your husband thinks the CPAP is effective for him and he can find other causes for his depression and irritability. And you can't prove he has sleep apnea, unless a doctor says so.
However, you can do something about it. Every patient with CPAP should have a CPAP
follow-up study after every year of therapy.
The following five questions have been advocated as a simple template for assessment of obstructive apnea patients at annual review or at times of change in health status:
- What interferes with your use of CPAP?
- Are you sleepy during the day?
- Does your bed partner observe snoring or breathing pauses when you use CPAP?
- How has your weight changed since CPAP was initially prescribed or last adjusted?
- When was the last time your CPAP equipment was checked?
Why should a patient with sleep apnea should have a follow-up CPAP study every year? With this study, the sleep doctor will check if the patient has improved with his life quality after 1 year of CPAP therapy.
The present polysomnographic parameters such as
AHI, oxygen desaturation index, and movement arousal index are compared with the same parameters pretreatment.
Symptoms that encourage the patient (your husband) to have a CPAP follow-up study are:
- Persistent somnolence on CPAP therapy warrants further investigation. Compliance issues need to be checked and any sleep hygiene issues should be teased out.
- Significant weight gain may necessitate an increase in the prescribed CPAP pressure, which may be inadequate.
- Therapy may be complicated by a coexisting additional sleep disorder, such as narcolepsy, or a comorbidity, such as hypothyroidism, which needs to be addressed.
- Increased alcohol use and nasal obstruction may also contribute to late failure of therapy.
Bottom line... I suppose that who brings the money in the house is the boss (the follow-up study costs money). So the
boss should say to the patient with sleep apnea: "let's go to investigate if you still have sleep apnea. If not, then.........."
I hope it helps. Don't be afraid to comment back.
Remy Thierry
Founder of Sleep Apnea Guide