A family member has copd and is waking up only an hour after lying down

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She has recently been diagnosed with COPD, within the last 6 months.  I am not very familiar with this disease.  We got her on a low dose steroid which was helping but it seems she is having trouble sleeping again.  She has Nebulizing treatments, Brovana and Pulmicort but does not use them every day as she should.  She doesn't feel it makes a difference, in fact after having the treatments she complains of having greater difficulty.  I would love any advice on this subject.  She also has CHF but her 02 saturation lying on her side is 96 on 3L of 02 as prescribed by her dr.  So I don't think fluid is the culprit.  

 

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  • Posted

    Hi P

    It would be helpful to know this woman's age, as that affects everything.

    Both brovana and steroids can interfere with sleep. According to my pulmo, the pulmicort is no worse than a cup of coffee. However, adding a cup of strong coffee on top of the other 2 = I understand why she can't sleep. Talk to her doctor about this. He might have her try using the nebulizer at different times of the day/evening, or he might do something else.

    The pulmicort is a good pulmonarydecongestant. Yes, it (& the other neb med) may make her cough more during & immediately after treatments. The doc may want that, as in trying to get gunk loosened & out & stop more from forming. Ask the doc, but in the meantime explain that nebulizer treatments are often expected to produce some coughing & that she should give them a fair chance.

    Of course if she's 90 & has broken a rib before from coughing, you may want to rethink that.

    The doctor is the person who knows exactly what is expected from these meds with this particular patient, so that's really the person to talk to. You can look up a lot of stuff online but you should be careful & stick to sites such as this one.

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    • Posted

      Thank you this isn't helpful. She is 90 years of age, recovering from a hip fracture in May. She has been on 3L o2 for several years. After surgery her respitory problems worsened.

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    • Posted

      Breathing issues can be aggravated both by surgery and by the anesthesia but also by prolonged inactivity.

      You, too can look up the meds just as I did. Perhaps you'll find some radically different info; I'm on the generic for pulmicort specifically to make it easier to deal with all the gunk in my lungs.

      Some pulmos ONLY give oxygen if the patient has significant stroke risk and will never give it just for COPD.

      Talk to her docs if she'll let you.

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  • Posted

    This is something your family member should be discussing with her doctor and if you are her carer maybe go with her to the doctor.

    Inhaler meds should be taken as prescribed, if the meds are not working this should be discussed further with her doctor, to stop taking the meds without letting the doctor know could put the family member at risk.

    Brovana is a bronchodilater (it widens the airway) pulmicort is the preventative medicine, it helps prevent inflammation in the airways and lungs both intended to aid improved breathing and help avoid exacerbation of symptoms.

    The medicines really need to be taken as prescribed for a minimum of 3 weeks before any conclusion can be arrived at if the medicine is helping or not.  Worth giving it a go as the doctor will only recommend an alternative option.  But if she complains of having greater difficulty breathing, perhaps try one in isolation of the other to determine which inhaler causes greater difficulty.  

    We cannot advise of CHF but this along with COPD and the family members syptoms definitely need discussing with her doctor, so as to be sure what the problem may be and how best she can be helped.

    Some people with COPD cannot sleep flat, they need to raise the upper chest, sometimes a couple of pillow will be enough, add a v shaped pillow on top of that if it helps.  If the airways are narrowed (the inhalers taken regularly as prescribed can open airways making it easier to breathe) narrowed airways can make sleeping more difficult.  If the back of her throat is collapsing she should mention this to her doctor, (have you noticed if she snores) maybe test for sleep apnea / apnoea  - just a suggestion.

    In brief the recommendation is communicate the situation with her doctor.

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