Living with Mild Cognitive Impairment (MCI)

HABIT Healthy Action to Benefit Independence & Thinking

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Thu, Aug 16, 2018 2:40pm

The Importance of Treating Sleeping Apnea in MCI: Getting Started

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

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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.

I'm thankful that my husband doesn't have this, but I have a good friend whose husband is struggling with sleep apnea. I'm going to share this page. Thanks for great suggestions.

Excellent informative comments/information for anyone who is currently using CPAP to treat obstructive sleep Apnea.

Great information, Dona. I shared the post in Connect's Sleep Health group https://connect.mayoclinic.org/group/sleep-health/

There are several discussions where members are talking about adjusting to the CPAP and BiPap machines, asking questions, sharing tips and getting good sleep, like these ones:
> Cpap and sleep https://connect.mayoclinic.org/discussion/cpap-and-sleep/
> Stuffed nose from CPAP https://connect.mayoclinic.org/discussion/stuff-nose-from-cpap/
> CPAP machine for travel https://connect.mayoclinic.org/discussion/cpap-machine-for-travel/
> cPAP silicone allergy https://connect.mayoclinic.org/discussion/cpap-silicone-allergy/

My husband has MCI and sleep apnea and refuses to use a CPAP. He is degenerating quickly into more dementia type activities.

@jal333

My husband has MCI and sleep apnea and refuses to use a CPAP. He is degenerating quickly into more dementia type activities.

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@jal333

I am so sorry to hear of his decline. I can understand your concern about his refusal to use the CPAP.

Is his refusal to use the CPAP typical for him (not trying new things), or does it seem to be part of his MCI and/or dementia? Would he be willing to try any of these new masks?

Teresa

@jal333

My husband has MCI and sleep apnea and refuses to use a CPAP. He is degenerating quickly into more dementia type activities.

Jump to this post

Hello @jal333, welcome to Connect. I'm sorry to hear that your huband has MCI and sleep apnea and refuses to use a CPAP. As a new user to CPAP I can tell you I don't like it either but it's better than the alternative when you stop breathing.

Does your husband have any friends that use a CPAP? Sometimes it helps to talk with others in the same situation.

John

@jal333

My husband has MCI and sleep apnea and refuses to use a CPAP. He is degenerating quickly into more dementia type activities.

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

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

@jal333

My husband has MCI and sleep apnea and refuses to use a CPAP. He is degenerating quickly into more dementia type activities.

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Hi @stephenluptak — were you able to try different masks to see if it helped with the fit and gouging into your face?

@nussey

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

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Hi @nussey, Welcome to Connect. I'm glad you found that a nasal pillow worked better for you. It does confirm that each of us are different with what works for us. Thanks for sharing.
John

@jal333

My husband has MCI and sleep apnea and refuses to use a CPAP. He is degenerating quickly into more dementia type activities.

Jump to this post

I tried various masks but after a few months,the plastic in each of these masks would cut into my face. Therefore, i discontinued CPAPs against the advise of my physician. A friend made several suggestions, but none would be covered by my Medicare Advantage plan.

@nussey

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

Jump to this post

I am not familiar with nasal pillows, Please tell me more.

@nussey

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

Jump to this post

@stephenluptak

Here is a website that displays nasal pillows. https://www.verywellhealth.com/what-are-nasal-pillows-3015323

Thanks!

@stephenluptak there are also CPAP mask liners you can get that cover the part of the mask that touches your skin and helps keep your face from getting irritated or sore. Here's an example of one to give you an idea but there are others available.

https://www.sleeprestfully.com/Silent_Night/

John

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