CPAP Help

[babs0321]

My husband has OSA.  He tried surgery before the CPAP and the surgery mad his apnea twice as bad (according to the sleep study).  He had his deviated septum fixed, removal of turbinates in the sinuses and UPPP.  He now has had a CPAP for about 6 monthes but can't stand it.  He can't get used to the mask (he has tried several types), and his sinuses get congested.  He has a ResMed with a humidifier and does sinus rinses daily.  He also has tried taking precription inhalers and nose sprays.  He is seeing a new ENT on Thurs as his old ENT and Pulmonoligist just keep telling him he will get used to it.    When he uses it I see a difference in his daily attitude.  I don't think he realizes it is helping and he stops using it because of the side effects.  Now that you have the backround I have 3 questions.  

Could he actually have OSA as a symptom of another disorder?  
Any tips to help him get used to the mask?
Could depression (untreated) make OSA worse?

Any info would help.  My husband is miserable and his depression from this disorder is worsening.  We are about to have our second child and I am terrified that a crying newborn at night will make his depression and moods worse.  Please help. Thank You. Barbra

[Abhijeet Deshmukh, MD]

Hello.

Is your husband overweight ? If yes, has he been given any weight loss plan ? OSA is an independent diagnosis. But there are many factors which contribute to it. And one of them is the weight.

Depression is a co-morbidity. It is very important that he overcomes his depression. Is his depression still untreated ?

All these symptoms are inter-related. They increase each other's severity. Untreated depression leads to a disruption of the sleep architecture, which can worsen the OSA.

And to comment upon the CPAP, I would like to mention that CPAP is not always useful after the UPPP has been done. He may, however, benefit from oral appliances.

The most useful way of helping him get used to the mask is to have him understand the implications. The side effects have to be weighed against the benefits. Once he has the insight, he will get used to it.

You will have to do a lot of talking.

Regards

[Sam888]

BTW, I forgot to ask.  When you say your husband has tried many masks, were they all from Resmed?  The masks do take a while to get used to.  I find the Mirage Activa works well for me, but it has a strong exhalation port.

[Sam888]

His UPPP surgery has complicated his OSA.  xPAP is not very effective when this surgery has been done. The other surgeries may also be playing a role.

OSA and depression are tied together. If you can't sleep well for an extended period of time, you;ll become depressed and down.  You can develop anxiety as well as a result of sleep deprivation.   His ENT specialist wont do anything for him, sadly. He needs to see a sleep specialist.

Bottom line, fix the sleeping problem, he'll feel better all around.

Good luck.