Provent therapy.com

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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NightMonkey
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Re: Provent therapy.com

Post by NightMonkey » Tue Feb 21, 2012 3:37 pm

jnk wrote: If your condition is mild enough to try it without a PSG, go for it and post a review.

Oh no, I should have said I would definitely not try it overnight. Just for an afternoon power nap.

I sometimes turn the phones off and curl up on my side on the sofa in my office. There is an electronic alarm I set for 20 or 30 minutes. It seems I can sleep about that long without any bad apneas (subjective judgement).

If that seemed to go well I might try napping on the sofa at home with one of my GFs watching TV beside me and ready to awaken me if I start snoring or stop breathing. (Probably should ask Lindsey, the hydraulics engineer, to observe if I am breathing in while there is a positive pressure in my airway. )

Well, not to get too far ahead. Next step is to ask the sleep doc for a script.
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Re: Provent therapy.com

Post by jnk » Tue Feb 21, 2012 3:55 pm

Two bucks is a lot to pay for a 20-minute nap. Just sayin'.

Partial closings can cause arousals as easily as apneas in many people.

Afternoon naps aren't generally considered good sleep hygiene. Get your full sleep at night, if you can, so that you don't need or want to nap. Experimenting with that may pay off more than playing with Provent.

That said, I look forward to hearing about your experiments.

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NightMonkey
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Re: Provent therapy.com

Post by NightMonkey » Tue Feb 21, 2012 6:01 pm

jnk wrote:Two bucks is a lot to pay for a 20-minute nap. Just sayin'.

It's a fine bargain when I have a big night planned.
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Passiflora
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Re: Provent therapy.com

Post by Passiflora » Mon Feb 27, 2012 10:48 pm

EDITED

My husband's sleep doctor recently recommended Provent or a dental device as first line treatment for mild sleep apnea.

A CPAP prescription was offered after I brought it up, but there was encouragement to try Provent first. Reasons given were that is was less cumbersome, much easier to accept and adapt to, very effective for many patients, and highly portable. I felt CPAP was the gold standard, it was being used by close family members who could offer support, and CPAP was readily available in the home (thus costing less) than Provent or a dental appliance.

After further encouragement to try Provent first, my husband agreed. The DME told me that insurance never pays for any of their clients' Provent supplies. They were to charge us $70 for the 30 day supply. We decided to wait and think on it. A year supply would be $840, assuming you never used them for naps. Insuranced paid 100% for my Auto CPAP (normally they pay 50% but we had met our out of pocket limit for that year). Insurance paid about $850 for the initial appointment with the DME, the Quattro FX mask, the PRS1 Auto CPAP and the rest of the initial supplies. Had we paid half of that and paid for a mask replacement at 6 months, monthly disposable filters, and maybe a new hose, we still would have spent less than on a year of Provent... which as other members have mentioned potentially requires additional sleep studies to assess whether it is working... thought air flow would be difficult to assess since the nasal passages are blocked while wearing Provent (no room for a cannula).

I went online to look at the Provent website and you can look up physicians in your zip code that are registered with the company. In our very large metropolitan area, only 3 practices (my husband's included) came up within a 100 mile radius.

My husband plans to test out Provent eventually and I'll report back here when he does.

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Last edited by Passiflora on Wed Feb 29, 2012 5:02 pm, edited 2 times in total.

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archangle
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Re: Provent therapy.com

Post by archangle » Tue Feb 28, 2012 12:58 am

Passiflora, that just doesn't sound right. What kind of doctor were you talking to?

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Passiflora
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Re: Provent therapy.com

Post by Passiflora » Tue Feb 28, 2012 8:15 am

EDITED

If anyone has seen guidelines that recommend Provent or a dental appliance as first line, I'd like to see them. My understanding is that an oral appliance can be considered a first line option for patients who are unable or unwilling to try CPAP. Not sure about Provent.

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Last edited by Passiflora on Wed Feb 29, 2012 5:04 pm, edited 1 time in total.

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Re: Provent therapy.com

Post by NightMonkey » Tue Feb 28, 2012 4:48 pm

Passiflora wrote:...because my husband, even with mild sleep apnea (I think his AHI was 4 over the night but higher while on his back), wakes up throughout the night, is tired in the morning, suffers from depression and irritability, takes a nap when he comes home from work, and has to drink a lot of caffeine every day to feel marginally better. Then at night there is the snoring, the sudden gasps and gurgles followed by coughing (can we say reflux?) which lead to full wake ups.
If I were your husband, here is what I would do.

1. Have a close look at the sleep study (get a copy) and if you can trust the doc ask him to go over it with you. If indeed his AHI was 4 for the night and it is worse on his back, then by simple math that means his AHI is less than 4 on his sides (or stomach). Ask the doc about his AHI on his sides, how long he slept on his sides, and what sleep stages did he hit on his sides.

2. If, as well as can be determined, his AHI is much less than 4 on his sides, I would go into a trial at home sleeping exclusively on sides. Use the tennis ball trick or similar to make sure of no backsleeping.

3. Wean completely off caffeine - no coffee, no soft drinks containing caffeine, no chocolate. Take it down over several days to prevent withdrawal.

4. Stop all daytime naps. Go to bed the same time every night.

5. Learn what good sleep hygiene is and practice it religiously. Points 3 and 4 are part of this.

6. After a couple of weeks of 2 through 4 make a subjection evaluation of how your husband is feeling and performing. This evaluation will also include your observations of his sounds and movements during the night.

If he sticks with the program for several weeks and shows no improvement you have to consider another plan of action. If he shows significant improvement you have to consider what this means and whether he should continue with the program or do something else.

Based on what you have said so far I am not yet convinced that CPAP is appropriate for your husband.

Does he have any health problems beside what you mentioned so far?
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Passiflora
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Re: Provent therapy.com

Post by Passiflora » Tue Feb 28, 2012 5:50 pm

EDITED

I agree with many of the suggestions... sleep hygiene, limiting caffeine. I think trying to sleep on one's side or stomach is okay but it can cause joint discomfort, etc. I had been an exclusive stomach sleeper but it has been nice since starting CPAP to be able to sleep on my back and side... thus I'm not fond of the idea of restricting oneself to certain sleeping positions.

I think CPAP could help my husband wean off caffeine and naps. Before I started CPAP, I absolutely had no choice but to sleep up to 12 hours a day. I was drop dead exhausted and my attempts at sleep hygiene were fruitless.

I remember reading a clinician's opinion that he wouldn't recommend weight loss over a CPAP trial to improve sleep apnea because if losing weight were easy, everyone would do it... trying to shed pounds, sleep less, and function without some sort of aid (e.g., caffeine, sugar, stimulants, activity, etc.) is very hard when you are physically unable to sleep well.

Shedding pounds is great of course... but avoiding naps and avoiding caffeine won't reduce the AHI or RDI, will they?

I feel like since starting CPAP myself, I am finally able to utilize and benefit from sleep hygiene measures... they do help me to feel more rested and healthier... I'm just thinking that sleep hygiene will be of marginal benefit as long as a sleep breathing disorder goes untreated.

I just so appreciate CPAP. It has freed me from some medications as well as given me back more productive time in the day.

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Last edited by Passiflora on Wed Feb 29, 2012 5:07 pm, edited 1 time in total.

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Re: Provent therapy.com

Post by NightMonkey » Tue Feb 28, 2012 6:05 pm

Passiflora wrote: We have a copy of the sleep study. AHI 4, RDI 16. He woke up often when he dipped into REM sleep. He experienced REM for less than 6% of the night.
What were the AHI and RDI during REM?
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Passiflora
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Re: Provent therapy.com

Post by Passiflora » Tue Feb 28, 2012 9:22 pm

This was an ARES Home Sleep Study.

Overall AHI 4, RDI 16
Supine AHI 7, RDI 20
Non-supine AHI 2, RDI 13
REM AHI 6, RDI 32

Oxygen saturation
Mean 95.3
Min 84.6
<90% 2.3
<85% 0.1

Supine position for 45% of sleep time
Sleep efficiency 81.9%
REM 5.5%

Pulse
Mean 66
Min 48
Max 90
Arousal/hr 65

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Re: Provent therapy.com

Post by NightMonkey » Wed Feb 29, 2012 10:04 am

Supine AHI 7, RDI 20
Non-supine AHI 2, RDI 13
Supine position for 45% of sleep time
I guess he slept in non-supine positions 55% of sleep time??

That is a good bit of the night and I see him as a candidate for forcing himself into non-supine positions all night long. That should give him a good reduction in AHI and RDI.

But the RDI of 13 in non-supine positions IMO calls for treatment. Being awakened 13 times per hour makes for an unhealthy person.

I heartily encourage non-supine sleeping and fanatical sleep hygiene practices for anyone in this condition.

You and your husband are very well informed, appear to have good decision making skills, and now have to make a decision on whether to next try Provent, oral appliance, or CPAP.

Good luck,
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Passiflora
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Re: Provent therapy.com

Post by Passiflora » Wed Feb 29, 2012 10:45 am

Thanks for sharing your insight NightMonkey. I really appreciate it. As I was thinking about sleep hygiene and the awakening component of the RDI, it does seem that RDI should decrease with good sleep hygiene. Excessive naps in themselves, can make it harder to stay asleep at night.

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Gerald?
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Re: Provent therapy.com

Post by Gerald? » Mon Mar 05, 2012 3:32 am

Lizistired wrote: I have an appt with a new dentist who I know has apnea and thought I would ask him for a script to try it. I have fairly mild OSA(AHI 11) but lots of arousals and pretty serious desats without xpap, and I suspect this would cause more. I do have a Zeo and an oximeter to monitor the results to some degree though.
Has anyone seen better deals on trials?
Lizistired

Did you ever try Provent?

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Re: Provent therapy.com

Post by Lizistired » Mon Mar 05, 2012 6:28 am

Gerald? wrote:
Lizistired wrote: I have an appt with a new dentist who I know has apnea and thought I would ask him for a script to try it. I have fairly mild OSA(AHI 11) but lots of arousals and pretty serious desats without xpap, and I suspect this would cause more. I do have a Zeo and an oximeter to monitor the results to some degree though.
Has anyone seen better deals on trials?
Lizistired

Did you ever try Provent?
Not yet, my appointment is this thursday.

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Gerald?
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Re: Provent therapy.com

Post by Gerald? » Mon Mar 12, 2012 10:19 pm

Lizistired wrote:
Gerald? wrote:
Lizistired wrote: I have an appt with a new dentist who I know has apnea and thought I would ask him for a script to try it. I have fairly mild OSA(AHI 11) but lots of arousals and pretty serious desats without xpap, and I suspect this would cause more. I do have a Zeo and an oximeter to monitor the results to some degree though.
Has anyone seen better deals on trials?
Lizistired

Did you ever try Provent?
Not yet, my appointment is this thursday.
Had a chance to try it yet?

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