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Sleep Disorders

Alternative to cpap on death bed

04/24/2007

Question:

I am a 54 year old male that has been on CPAP for 14 years. The last thing that I want is to have a mask on while on my death bed. Would a tracheostomy be the alternative to CPAP? I want to include this instruction in my will and was wondering if this would be the way. Any advice would be much appreciated. Thanks

Answer:

I have to assume that you are using CPAP for the treatment of Sleep Apnea, since there are other diseases where CPAP is being used. Depending on the cause of sleep apnea and its severity, available treatment options include:

On average, men in the United States live to 75 years of age. If you are currently in good health, you won’t have to worry about this issue for another 20 years. In the meanwhile, investigators in Sleep Medicine may have found more about sleep apnea and more options to treat it.

It is reasonable to prepare for the worst while hoping for the best as well. Near the end of life, some people prefer not to use life supporting devices, and may prefer to accept only comfort measures. This is a personal subject, and what is accepted as “comfort measures” varies between individuals. Some would consider CPAP as a comfort measure and others with not, depending on the way it makes them feel at that time.

Alternatives to CPAP near the end of life, usually include supplemental oxygen. Even though not very effective in treating sleep apnea in the long run, oxygen is considered by most, an acceptable, non-obtrusive treatment that does not interfere with comfort. Palliative Care physicians and nurses are most experienced in end-of-life care and can offer guidance in these important decisions.

If you would like additional information regarding sleep and sleep disorders, it is available on the American Academy of Sleep Medicine website. This website also contains a list of Sleep Centers across the country so you can locate one near you if needed. Good luck, and I hope this information was useful to you. Feel free to write back if you have further questions.

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Response by:

Ziad  Shaman, MD Ziad Shaman, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University