My husband is diagnosed with complex and severe sleep apnea, and he has rem sleep disorder. Periodically, he stops wearing his bipap Phillips Resporonic Bipap Auto SV Advanced at night for 3 plus weeks. He starts going into deeper depression, he ca not think straight and becomes frustrated, and sleeps a lot during the day. He is defiant and does not cooperate with attempts to help him problem solve to restart wearing bipap. I am about at end of road with trying to get him to be compliant. What do you recommend for patients like this?
Doctors Answers (2)
First, your husband should understand the severity of his sleep disorders, both Sleep Apnea and REM behavior disorder. Then, he has to be responsible and act accordingly. If your husband is having mask issues he should contact his equipment supplier for suggestions. However, he has to be willing to help himself before anyone else can.
Non-compliance with PAP therapy is common but can be overcome. I say it is like learning to wear shoes to bed. Once you become accustomed to doing so you may not be able to sleep without them. Same for a pillow. Obviously, your husband controls his own destiny but if he will accept help it may be best to ask his doctor for a sleep aide to help with PAP compliance. Another option is to find a sleep lab that performs the PAP-NAP. This is a one on one session in the sleep lab for a few hours during the day with a sleep technician helping to fit the mask, work to eliminate leaks, teach the patient how to adjust the mask and "relax". It is just air but with Complex Sleep Apnea there may be oxygen issues as well. If he won't use his device and his oxygen is low, just using oxygen alone for awhile will not only be helpful but may get him used to wearing something on his face and he can then "ease" into wearing the mask at night. Some patients who find the mask annoying will wear it while watching TV or during the day, not even hooked up to the machine. Then later, when the mask is not an issue, hook it up to the PAP device.