Living with Mild Cognitive Impairment (MCI)

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PUBLIC PAGE
Aug 16, 2018

The Importance of Treating Sleeping Apnea in MCI: Getting Started

By Dr. Dona Locke, HABIT AZ Director, @DrDonaLocke

shutterstock_464922347

Why are we talking about sleep apnea in MCI?

Sleep apnea is a very common sleep disorder in the general population and also a common sleep disorder in our patients with Mild Cognitive Impairment (MCI). Sleep apnea is a sleep disorder where individuals stop breathing at night (and then gasp themselves into breathing again). Take a look at this link if you want more information on sleep apnea. My husband actually has sleep apnea, finally diagnosed after we were married, and I discovered the extent of his snoring and gasping for breath at night (in between the scary silent pauses when he wasn’t breathing at all).

In our patients with MCI, sleep problems are a significant cause of “excess disability”—it makes a person’s memory or thinking problem worse. One of our major aims in the Mayo Clinic HABIT Healthy Action to Benefit Independence and Thinking © program is to identify and treat anything that could make MCI worse. Sleep apnea is one of those that is very common.

Using a CPAP machine, or continuous positive airway pressure machine, or a related device, is a very common treatment recommendation, and CPAPs are very effective treatment. The problem is many, many individuals, including my husband, have trouble adjusting to using a CPAP machine. But treating your sleep apnea goes beyond just helping your memory: treating sleep apnea also has a major impact on your physical health. Importantly, complications of sleep apnea also increase your risk of heart problems and heart disease...Not to mention sleep deprived bed partners!

First steps to adjusting to a CPAP

Some individuals take to a CPAP or related device right away. For others, it is a struggle. I will get to some behavioral strategies for helping yourself adapt next week, but first, it is important to be sure you’ve done all you can to be sure you have the equipment that is the right fit for you. Sometimes, all it takes is the right mask and voila! CPAP and (quiet) dreamland are all yours. The variety of device options is not my area of expertise, so first, be sure you’ve explored with your physician or device supplier the following:

  1. Have you tried a variety of different masks? For my husband, he finally needed to move from a mask that covered his nose to a “nasal pillow” type mask that fit at the bottom of his nose.
  2. Have you confirmed that the pressure is set optimally for your needs? This is typically done at your sleep study visit, but it never hurts to ask if you feel that the pressure is too much or too little (if you feel it is too much, but your physician has confirmed it is correct, I’ll be providing some behavioral options next week).
  3. Have you explored other device options that may help ease the adjustment? For example, does your device offer a humidifier? Do you even need a humidifier? Does your device offer a “ramp up” period so that the pressure gradually increases when you turn it on? Perhaps you could benefit from a BiPAP rather than CPAP. A CPAP has the same continuous air pressure all the time while a BiPAP has two levels of pressure—one that is harder when you breathe in but lower when you breath out. Do you need a chin strap to help keep the mask on through the night and your mouth closed?

These are just a few observations as a spouse of a loved one who had to explore lots of equipment before finding what was right for him. Turns out, he needed the pressure ramp up because he couldn’t tolerate the full pressure right away. He also really needed the humidifier. We live in Arizona, and his first machine didn’t have one. Talk about a dry mouth in the morning!

Now that you know why it is important, and some important first steps to try with your doctor, check back next week for more behavioral strategies if adjustment is still difficult.

@nussey

I struggled with a variety of masks. A nasel pillow was the answer for me.

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Hi, @nussey, and welcome to Mayo Clinic Connect. I think it's helpful to others who are new to using a CPAP to know that struggling with a variety of masks, as you explained happened to you, is not unusual. Really glad to hear you found a solution.

There has been quite a bit of discussion recently in the Sleep Health group on Connect about CPAPs and sleep, and I'd invite you to join in, if you'd like. In particular, you may want to check out this one that @colleenyoung mentioned earlier in these comments: https://connect.mayoclinic.org/discussion/cpap-and-sleep/.

COMMENT

@stephenluptak — I am planning to see if I can find a mask liner myself as the bottom of my nose and upper lip are getting chaffed by the mask during the night. The liners are supposed to protect the bare skin from the mask material and still hold the pressure without being too tight.

Have you tried a mask liner?

John

COMMENT
@johnbishop

@stephenluptak — I am planning to see if I can find a mask liner myself as the bottom of my nose and upper lip are getting chaffed by the mask during the night. The liners are supposed to protect the bare skin from the mask material and still hold the pressure without being too tight.

Have you tried a mask liner?

John

Jump to this post

I did try mask liners for a while; for me, they were only negligible assistance

COMMENT
@johnbishop

@stephenluptak — I am planning to see if I can find a mask liner myself as the bottom of my nose and upper lip are getting chaffed by the mask during the night. The liners are supposed to protect the bare skin from the mask material and still hold the pressure without being too tight.

Have you tried a mask liner?

John

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@stephenluptak — might be dumb question on my part but I was wondering if you tried different brands of mask liners or which one you have tried? I may have the same result but I'm hoping there is something out there that might make it a little more comfortable. Thanks for any suggestions.

COMMENT

Hi. The one I tried had black foam around the edge

COMMENT
@stephenluptak

Hi. The one I tried had black foam around the edge

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The one that I have been looking at is the Silent Night mask liner – https://www.sleeprestfully.com/Silent_Night/ which is just cloth.

COMMENT

So, I just called my local medical supply store where I got my Dreamware full face CPAP mask to see if they carried the mask liners. The lady gave me a great tip that I want to share with everyone. She told me they have the liners but you can take an old t-shirt and cut out a piece the size of the mask and then cut the holes in it. Then just place it between your face and the mask. She said it works much better than the liners and it's cheaper ☺ Now I just have to find an old t-shirt that's not my favorite and give it a try tonight.

COMMENT
@stephenluptak

I used a CPAP for 15-years. I quit due to the gouges it cut into my face.

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Please read up on the serious side effects of not using a CPAP and go out and find a mask that you can tolerate. I feel so much better since I began using mine and I know that my body is better off. I am more rested for sure. Now I can't sleep without it. Don't give up!

COMMENT
@johnbishop

@stephenluptak — might be dumb question on my part but I was wondering if you tried different brands of mask liners or which one you have tried? I may have the same result but I'm hoping there is something out there that might make it a little more comfortable. Thanks for any suggestions.

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I have developed a serious sore on my nose but cannot get help with mask. I tried nose and mouth ones without success. I need help.

COMMENT
@macjane

I have developed a serious sore on my nose but cannot get help with mask. I tried nose and mouth ones without success. I need help.

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Hi Jane @macjane, what type of mask are you using now? I had tried the Dreamware full face mask that is similar to the Amara View mask – both cover your mouth and make contact with the bottom of your nose. I liked the mask but it felt like it was causing my nosed to stuffed up even though I breathe mostly through my mouth at night. Before that I had a Fisher-Paykel full face mask that did a number on the top of my nose and it became a sore quickly. I therapist at the medical store sold me a small tube of petroleum free skin emollient (RoEzIt brand) and it made the nose feel better and helped quite a bit.

Last month I finally think I've found a full face mask that works for me. It's a ResMed AirTouch F20 that has a memory foam edge instead of the silicone that would rub sores on the top of my nose. It's different in that you can't wash it with water and they recommend you replace it every month. I've found that I can clean it with a CPAP wipe every morning and then put it in my SoClean CPAP cleaner and it keeps it disinfected and clean. I'm hoping to see how long it holds together. It's really soft and easy on the nose.

https://www.resmed.com/us/en/healthcare-professional/products/mask-series/airtouch-20-series/airtouch-f20.html

Do you have a local medical supply store near you that you can talk to a sleep medicine therapist? I had really good luck with one in our area.

John

COMMENT
@johnbishop

Hi Jane @macjane, what type of mask are you using now? I had tried the Dreamware full face mask that is similar to the Amara View mask – both cover your mouth and make contact with the bottom of your nose. I liked the mask but it felt like it was causing my nosed to stuffed up even though I breathe mostly through my mouth at night. Before that I had a Fisher-Paykel full face mask that did a number on the top of my nose and it became a sore quickly. I therapist at the medical store sold me a small tube of petroleum free skin emollient (RoEzIt brand) and it made the nose feel better and helped quite a bit.

Last month I finally think I've found a full face mask that works for me. It's a ResMed AirTouch F20 that has a memory foam edge instead of the silicone that would rub sores on the top of my nose. It's different in that you can't wash it with water and they recommend you replace it every month. I've found that I can clean it with a CPAP wipe every morning and then put it in my SoClean CPAP cleaner and it keeps it disinfected and clean. I'm hoping to see how long it holds together. It's really soft and easy on the nose.

https://www.resmed.com/us/en/healthcare-professional/products/mask-series/airtouch-20-series/airtouch-f20.html

Do you have a local medical supply store near you that you can talk to a sleep medicine therapist? I had really good luck with one in our area.

John

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John it was the F 20 that caused the horrific nose sores. Jane

COMMENT
@macjane

John it was the F 20 that caused the horrific nose sores. Jane

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Was it the AirFit F20 or the AirTouch F20. The AirTouch with the memory foam is really soft.

COMMENT
@johnbishop

Was it the AirFit F20 or the AirTouch F20. The AirTouch with the memory foam is really soft.

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The medical store actually gave me an AirFit F20 mask that I used one night and kept it as a backup. I found a reusable/washable mask cover/liner that fits over it that may help protect your nose if you have the AirFit mask.

CPAP Mask Liners – Reusable Comfort Covers (#8090) – Amazon link where I bought mine
https://www.amazon.com/gp/product/B071LQQD66/ref=oh_aui_detailpage_o04_s00?ie=UTF8&th=1

COMMENT
@johnbishop

@stephenluptak — I am planning to see if I can find a mask liner myself as the bottom of my nose and upper lip are getting chaffed by the mask during the night. The liners are supposed to protect the bare skin from the mask material and still hold the pressure without being too tight.

Have you tried a mask liner?

John

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John, We were disconnected but you originally mentioned an F20 AirTouch Mask. I used an F20 Mask as I said but it caused awful marks on nose. When I tried to look up these masks again, I saw a reference number 63000 but then saw an F63003. I could not see difference. Can you help me? Thanks, Jane

COMMENT
@macjane

John, We were disconnected but you originally mentioned an F20 AirTouch Mask. I used an F20 Mask as I said but it caused awful marks on nose. When I tried to look up these masks again, I saw a reference number 63000 but then saw an F63003. I could not see difference. Can you help me? Thanks, Jane

Jump to this post

Hi Jane @macjane, I posted pictures of the AirTouch and AirFit F20 in another discussion. It's another good discussion for CPAP questions.

Groups > Sleep Health > Cpap and sleep
https://connect.mayoclinic.org/discussion/cpap-and-sleep/?pg=9#comment-127007

COMMENT
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