Posted by GBoogie on January 24, 2003 at 17:17:51:

In Reply to: Interesting chat w/sleep lab people posted by permagrin on January 24, 2003 at 16:19:26:

Permagrin,

I went back and read your original post from forum 108. Mind if I make some suggestions from my experience with my Mom? I've posted about her a lot, but the short version is that she has mild dementia/cognitive impairment that has reversed completely on 2 occasions when she got about 7 consecutive good nights of sleep. She had an autoPAP which is how I was able to see the strong relationship between sleep and cognitive impairment.

She got her first CPAP the day after the Superbowl 2 years ago, 1-29-2001. It has been a long, long road.

I have tried everything to get CPAP to work for her on a reliable basis. Mouthbreathing happens to be her problem. She has had 2 surgeries to fix her deviated septum. She still mouth breathes.

I have designed and am currently 'tweaking' a medical device that I hope will keep her mouth shut all night and force her to nasal breathe. I really hope it works, but I realize it may not.

Her next step, and it's one I think you should seriously consider, is the only form of treatment available 20 years ago before the invention of the CPAP: A trach tube. Yes, I'm serious.

I think a brain 'injured' or 'insulted' by severe OSA is very sensitive to bad nights of sleep. Notice Mom only got better when she had consecutive good nights of sleep. Not 4 out of 5, not 5 out of 6, but 7 out of 7.

A trach tube, with all it's cosmetic downside, is an absolutely 100% effective treatment for OSA. It won't help if he has Central Apnea, though.

Take some time to read the posts from trach patients in the non-CPAP forums. Many say they hated the idea of getting one, but once they had it, they loved it. Or at least they loved the way they slept and felt.

If my invention fails, Mom will get a 'permanent' button-trach. It will be 'permanent', but it may only be in for a few months. My thinking is that after 90 or 120 consecutive nights of apnea-free sleep, her brain won't be fragile. It will be able to deal with less-than-perfect CPAP therapy just like everybody else. When she has a bad night, she will be tired, but not cognitively impaired.

I have posted previously listing medical journal articles about the relationship between OSA and cognitive impairment. Search away. Perhaps this would help convince a doctor that has not read these articles and is not aware of the connection.

It wasn't easy to find a surgeon willing to do the trach. But Mom is 71 and they were all ready to write her off to Alzheimer's. (Luckily I have found one who is willing to do it.) If Mike is younger, you may not face as much resistance. Some trach patients say they spend about as much time caring for their trach as they do brushing their teeth and flossing. During the day it can be plugged up to allow for normal speech. In winter, it isn't visible under a shirt you would normally wear.

Also, I found 5-htp helped with Mom's anxiety. But nothing helps as much as good sleep.

As far as the epilepsy, some think sleep deprivation can make epilepsy more likely. An epilepsy could be apart of his problem. There are types of epilepsy that can cause behavioral changes, neuropsychological changes, coordination problems. These may all go away with treatment of OSA if sleep deprivation and oxygen desaturation are his only 'triggers'. But you may also want to take him to a comprehensive epilepsy center.

What city are you in, by the way?

GBoogie

Follow Ups:

• Re: Interesting chat w/sleep lab people permagrin 18:35 1/24/03 (1)
  • Re: Interesting chat w/sleep lab people GBoogie 22:01 1/24/03 (0)
• Re: Interesting chat w/sleep lab people - Sleepy Coote 18:20 1/24/03 (0)

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