My 53 year old dh ( currently untreated sleep apnea) has had several job losses in he last several years, so our medical coverage has been spotty..
hence- he has made no strides recently to solve the apnea problem.

He just started a new job 2 weeks ago.  OMGosh! Today he fell asleep during a meeting and his new manager spoke to him about this. YIKES!
In the past (within the last 5 years, I think) he's tried a few things:
--Had sleep study and has the report. This was completed in Pennsylvania.
--Tried Cpap and was much MUCH worse. This had nothing to to do with my attitude or his about the CPAP. He slept in the spare bedroom and so my attitude about the noise levels was not an issue. He was like a zombie the next day after he tried the CPAP. He was in terrible shape.
--Tried a dental appliance awhile back and he felt it didn't really help him.

He is very fit and not obese at all. He is an avid bicyclist. He has a new job. How can he take time off work to visit doctors or to do a sleep study? OMGosh!

I am thinking hard about getting treatment without messing up his new job...I see that his overbite is pronounced even though he wore orthodontia when he was a teen. ...I spent a few hours reading about dental appliances tonight. Maybe he could try a different dental appliance. Maybe they have improved.

HELP! Our medical coverage has just kicked in and soon I will have an ID card and I can schedule appointments with the correct specialist docs. We live in Melbourne Florida within an hour of Orlando. I need to find a specialist who excels at treating people with overbites.  Not sure where to start... Any tips or suggestions are most appreciated. How can I find the right doc with the most up to date knowledge on treating with dental appliances?

By the way, something tells me that my dh job issues are related to the sleep apnea. This is truly worrisome. Hey, pardon the irony, but this is the stuff that causes insomnia. Thanks in advance for any tips or suggestions.

I'm only going to address the CPAP issues -
I've only been on my CPAP for two weeks now almost and I was exhausted for the first week....more exhausted than before I was on a CPAP. I'm just now starting to see an improvement. In the other posts I've read, some people say it's taken them 3-4 months. Each person varies. If he only tried his CPAP for one day, I strongly suggest he give it more of a chance than that.

You might want to post this in the CPAP category rather than the spouse category. This doesn't seem to be quite as active as the other ones.

Thanks for the reply.

If the CPAP makes things worse for my dh, even if it is for a short time, then it is not a good solution for us. The outcome could be devastating if he was worse than he already is...I have caught him falling asleep while driving, as it is now. I hope that we can solutions that provide immediate improvements.

His job is new and I still haven't gotten our medical coverage info. I will inquire about it today.

Meanwhile, I am insisting that dh get to bed by 10 PM so that he can get enough sleep. Laughing now...I am "putting him to bed" before my teen gets to bed. I have read that the individuals with sleep apnea must change their sleep behavior. That is, they must consistently get enough sleep.

I always listen to his breathing patterns as he enters into sleep. I hear the snoring, then hear silence, then hear how he gasps for breath as he  starts to breath again.  I  nudge him from time to time, but he gets beligerent. (sp?)

Thanks for trying to help. I do appreciate the support. I wish we could find a good outcome with immediate improvements...Maybe it is a pipe dream...

TCMG,

Post specifically why he can not use his CPAP.  Is it hard for him to exhale against the pressure?  Is he claustrophobic?  Is his mouth/nose drying out?  Etc.  We have helped literally thousands of people become compliant CPAP users.  There are only a handful of people who truly can not use a CPAP because of physiological reasons.  Sleeping more will not help him; he will never get enough sleep.  His throat is collapsing repetitively throughout the night and he is going without oxygen every time.  Every time he sleeps without compensating his Obstructive Sleep Apnea (OSA), his health is further degenerating.

Yes, his work issues are due to his apnea, but OSA is about much more than overwhelming fatigue, it is trashing his cardiovascular system.  It is also an unfortunate common misconception that you have to be an overweight, middle-aged male to have OSA.  OSA comes in all shapes, sizes and ages (see our pediatric forum).

It sounds like he only tried the CPAP for one day?  I am sure that anything which is important to him he gives more of an effort.  As maf79 said, it can take awhile to fix the minor issues.  They may seem insurmountable, but they are not.  How severe is his OSA?  Severity is measured by the Apnea/Hypopnea Index and is the number of events per hour.  The severity of his OSA helps determine the chance for an optimal outcome with different treatment options.  Mild apnea may respond well to a dental appliance.  To go that route, you need to find a dentist who specializes in sleep medicine.  The accrediting agency is listed in the stickies of the dental appliance forum.

In case you are not aware of the effects of untreated OSA, some of them follow.  Keep us posted and keep asking questions.  You sound like a great wife, but your husband and you need to address why he finds a CPAP uncomfortable and not be dismissive of its use; at least until you find out if a dental appliance will work.

Vicki

The effects of untreated sleep apnea are severe and systemic.  Some of them are; increased blood pressure, increased risk of heart attack and stroke (from the constant cycling in and out of hypoxia and increased blood pressure), heart arrhythmias, nocturia (because the increased pressure in the right heart ventricle makes the body think there is too much blood volume so urine is produced), headaches (probably from the hypoxia), fatigue (duh), memory and concentration problems, weight gain (sleep deprivation causes weight gain for several physiological reasons, one being the alteration of the hormones leptin and ghrelin), apnea induced seizures, there is a link to diabetes, there is a link to GERD, night sweats, depression, anxiety (each apneic event is a true suffocation and elicits the "Fight or Flight" adrenalin response), Fibromyalgia-like symptoms, impotence, relationship and job issues, car accidents, etc.


_________________
Being defeated is often a temporary condition. Giving up is what makes it permanent.
Marilyn Von Savant

That which does not kill you makes you stronger-Friedrich Nietzsche
Friedrich must of had apnea.

There are many ways that he can become accustomed to a CPAP before using it at night.

Start with:
1. When he is reading or watching tv (or any sedentary activity), he can wear the mask initially (an hour a day for a week)
2. Then he can connect the mask to the actual CPAP (using the ramp feature) to get used to the airflow (for an hour a day). It will build up to the actual pressure he needs for him to get used to.  
NOTE: Combine 1 and 2 if he's comfortable.
3. Then he can start taking naps with it. Do this for a week or however long it takes.
4. Then move onto sleeping with it. Hopefully he has gotten to used enough that it will be more comfortable to sleep with it.

One night or one week (or even a month) of him being overly tired is better than a lifetime -- for both you and him. Are you able to drive him to work during the adjustment period? Or your teenager you mentioned (since it's summer)? How about paying a neighbor teenager (just trying to come up with ideas)? Can he take a cab? I don't know if money may be an issue since he just started a new job. I don't know where you live, but what about carpooling? There are carpool websites that you could look at. His safety (and health) as well as others is obviously the most important issue here. You don't want to end up alone from a car accident or a heart attack (not meaning to scare, just being realistic).

Keeping his job is second important issue. Is his new boss understanding? Can he discuss this and tell his boss he is getting treatment? If he is getting treatment and is compliant, I would think the boss would be understanding unless he has no heart. Sometimes honestly is the best policy. Now, I work at a GREAT place so sometimes I forget about the other non-so-great places out there.

I really hope for both of you that you are able to figure something out. I don't know what it is like on the spouse's side, but I can imagine it gets lonely. I hope you can urge him to try the desensitization steps.

We know he has a problem and we are trying to fix it. We will get medical coverage again soon. This will help us fix the problem.

I'll try to find the sleep apnea report from the past. We moved twice and I don't know where it is. My husband claimed that the report indicated he had moerate sleep apnea. (I remember that he said something about 20 instances per hour)

DH claimed that the cpap made him feel as though he had no sleep at all. I remember his behavior and his haggard appearance. I was afraid for him the day after he tried it. He was much worse. I confined him to our house and asked him not to drive or to make any decisions. It took about 2 weks before he was better from that one episode.

I do not know why the cpap didn't work. No idea...If he were to try it again, the only time to try it would be during a 2 weeks or more vacation but unfortunately he is a new employee and does not have vacation time during 2009.  He cannot risk going to work in a state of pure exhaustion.

I was not clear when I described our situation. Let me clarify things a little. He tried the cpap for a single night and had terrible results. Then some time passed and he also tried a custom made dental appliance. He tried the  dental appliance for much longer, probably a few months.  I  don't know why his custom made dental appliance did not work. He was soring away whenever he wore it, event he first night.  He didn't feel any more refreshed in the morning. If I were him, I would have called the doctor who made the dental appliance and I would have said that it was not working and I would have asked the doctor to modify it to make it work. Maybe he thought it was too expensive to keep going back and getting new custom made dental appliances, so maybe that is why he decided against it.

Now we have moved (far away) and there is no chance to get the original doctor to explain to us why the custom made appliance is not effective or to modify it. I must find a new doc. I really don't understand your words about where on this forum I would find that information. What are "stickies"?  Once I get the information about our medical coverage, I will hunt down the right specialist.

My instinct tells me my dh's problem is the overbite. I read some research papers and I saw that there are new dental appliances now. Maybe the new ones would be better than the one he has now. If he gets a new one and it doesn't work, then I will be much more assertive this time and I will force him to go back to the doctor and let him know that we have no satisfaction.

Even though we spent so much out of pocket money on the sleep study, the cpap trial and the dental appliance and we saw no improvements, we are still hopeful that we can find a solution.

A sticky is a normal post like this only it is at the top of the section and says sticky like this:

Sticky: CPAP Machine Information / What to look for
(the word sticky is in red to get your attention)

Sometimes they say "information" instead of "sticky." They are just tidbits of information that the moderators think is important for us. Copy and paste this link and look at the other forums: http://www.apneasupport.org/index.php

As for being more miserable after using a CPAP, boy do I understand?!?! I just started using a cpap two weeks ago (very recent!!). I felt terrible the first 5 days. terrible! But now I'm just starting to reap the benefits. I didn't even feel like taking a nap on Saturday. I was shocked! It was great! I'm still not all the way there, but I do feel a little better. Everyone is different. Some people take longer. Some people get it right away. CPAPs aren't the most comfortable, especially initially, but I am kind of getting used to it. I'm really a beginner at this so I do understand. I'm just determined to not be sleepy anymore because it's miserable.

I didn't read the second post when I just posted .

He fell asleep quickly using the cpap. I believe he can sleep anywhere, any time, with any noise in the backgound, and with anything on his face. He goes into sleep quickly. He is out like a light in minutes. He is a snorer. Within minutes of his head touching the pillow he is sleeping. Sometimes if he has pillows in the corect configuration, he does not snore. I cherish those times. He is not claustrophobic. His complaints about the cpap were not about lack of comfort.

He is not in a friendly environment where he has an understanding boss. He is a newb and he is proving that he is not too old fro the job. (He just turned 52)

Driving is a big concern but yes we could make accomodations about it...There are other concerns too...He makes important decisions during his job.  He is an engineer and he works on calculations. He be at least as alert as he is now. If he makes mistakes in his work it could cost the company $millions. If we were to try the cpap he would have to do it while on a long vacation.

Again, many thanks for caring. I appreciate the support.

I finally decided the reason I was so tired POSSIBLY was that I was waking up many times with my cpap on because it was bothering me so much. I think I have gotten used to it enough that it isn't waking me up as much.

OSA greatly affects memory and alertness.