PAP Aromatherapy – Worth Consideration

One of the huge challenges facing people with sleep apnea is actually getting to the correct diagnosis, as we all know. But, the “double whammy” is that even if they should manage to get that far, there is another very challenging hurdle looming between them and their return to optimum health: treatment.

It is a cruel irony that this ailment not only has proven so difficult to diagnose (for a variety of reasons), but also has such an abysmal compliance rate, ultimately resulting in treatment failure. An alarmingly large number of people just quit treatment within the first month because for them, the “cure” is worse than the disease. Obviously, the result of this treatment failure has a predictable outcome. Untreated sleep apnea, whether by missed diagnosis, or failure to comply with the care plan, has the same horrendous outcome. Physiologically, the body cares not about the reason why the mask is absent.

In that regard, I want to weigh in with an opinion about a product that I have seen mentioned on this board on at least several occasions. Pur-Sleep is a company started by SleepGuy on the forum here. The product offered is a very ingenious in-line diffusion device that allows very small amounts of natural aromatics (in this case, essential oils) to scent the air being delivered to the mask. Importantly, the arrangement allows oils to be used without infusing them into the water of the humidifier, while also avoiding any direct contact with either the mask or the hose.

I am reasonably optimistic that a significant number of people may find that the use of this product, along with any of the other “creature comforts” will lead to better tolerance of treatment, which will ultimately lead to better compliance rates.

One of the most prevalent reasons for giving up on OSA treatment is quite obvious: having a mask strapped onto your face while turbo charged air is blown into your pharynx is not comfortable for a variety of reasons. Many people, including myself, find that donning the mask is somewhat claustrophobic, especially at first, and relaxation may be difficult to achieve no matter how motivated you may be.

From a purely scientific view point, there are some compelling reasons why the diffusion device may prove beneficial. The human sense of smell is quite different from our other senses in some very profound ways. For one thing, it is the only sense that involves the direct interaction between airborne molecules and millions of olfactory receptor cells, which are in fact extensions of the brain itself.

We also know that the sense of smell is regulated by the Limbic System, that part of the human brain which also has been shown to be the “command center” for the regulation of human emotions. This then is the same part of the brain that would regulate such feelings as claustrophobia, anxiety, and irritation, among others.

As we know, many people experience these same unpleasant feelings, especially when first trying to use their xPAP. These issues are so problematic for many people that a very significant number of OSA patients give up during the first week. And, even with steely resolve, a tragically large number of patients will have will stopped using their equipment over the course of the first few years because tolerance to the treatment is so difficult to achieve.

Human responses to odors, both positive and negative, are known to be deeply connected to emotions. The smell of fresh baked chocolate chip cookies, and other memorable aromas, is an accepted part of the treatment of Alzheimer’s patients and others with dementia, in helping to retain long term memories. Additionally, there is an increasing body of evidence in the medical literature demonstrating that aromatics can be effective in reducing stress, anxiety, and the feelings of claustrophobia that are often associated with certain medical procedures (such as MRI) and dental care. Another recent study strongly suggests that newborn babies experience less pain with routine heel prick procedures in the presence of a pleasant, familiar smell.


On the other hand, it would seem reasonable to postulate that the volatile plastic compounds of which the mask and hose are made may stimulate unpleasant feelings in the new user, particularly during the critical first few nights of therapy. Along with the additional discomfort that comes from having the device strapped to the face, a formidable challenge must be overcome if compliance is to be achieved.


I believe that the diffusion device and the natural aromatic that are it delivers has the potential to help a lot of people with their xPAP therapy, particularly people just starting out and people who are struggling to relax and get comfortable. Anecdotally, I’ve tried the Pur-Sleep products and have found that they add just enough of a pleasant smell to my equipment to make the whole experience more enjoyable and relaxing. Given the extremely low xPAP compliance rates, I believe that anything that has the potential to increase xPAP compliance is a good thing.


I commend SleepGuy for his efforts to improve compliance. His website is quite professional without any outlandish claims to hype his product. There’s a lot of other good information on the website, including a White Paper that explains in great detail all of the science behind the products. His website (http://www.pur-sleep.com) includes a link to an eBay store (http://www.stores.ebay.com/pur-sleep) where you can get more information and see the products.


I think the idea of aromatherapy being beneficial in xPAP therapy is very intriguing. I wish I would have thought of it! It may provide substantial benefit for what appears to be very minimal risk and expense. And it may just add hedonic value to your life!


BTW, in my town, a number of merchants encourage the citizens to shop locally as it benefits the local economy. In this case, I think it is fortuitous that we have an opportunity to support the efforts of Sleep Guy in introducing what may prove to be a very helpful new idea.

I seem to be very sensitive to odors, I have a Jack Russell terror named Gizmo and he rarely leaves my side, but every few days I see him jump up startled from a nap on the couch look at his rear end and jolt over to his Companion Road bed then look at me with glassed over eyes like he just had a really bad nightmarish dream or something.

At first I ignored this odd behavior, then I soon realized WHAT he was running from, it makes your eyes glass over and drives you right out of the room it does

Can I get one of these devices and attach it to his butt?



ah the things we do for our dogs, but on the serious side, do you know if any scientific tests have been performed on this aroma delivery device to see how compatible it may or may not be with our traditional autopap machines?

As you know there is a certain amount of patient "feedback" required by these machines so they can properly read the SDB events as they occur from the patient and then respond with correct pressure delivery.

Any time you incorporate a device "in-line" it can impact that ability of the machine to either detect or respond.

CPAP is a totally different animal and usually not a problem. CPAP for the most part is a one-way street (vs. two-way with auto's) so no feedback from patient is required for that therapy to function properly, it just blows at a set constant rate/pressure.

However, an autopap (and even your Bi-pap Auto) needs that patient air flow feedback sensed via the delivery hose for proper operation. I would think a device installed in-line could very well impede that feedback mechanism or possibly make the machine less sensitive to SDB events.

We have seen this happen in other discussions at times with the use of some nasal prong interfaces where they decreased the diameter of the delivery hose which decreased the effectiveness of the machine to respond.

For this very reason, most autopap manufacturers only recommend use of their own mask interfaces with their machines since they have been fully tested as compatible.

As patients we don't always follow that advice since we are always striving for the most comfortable and effective interface to remain in compliance.

[quote="Snoredog"]I seem to be very sensitive to odors, I have a Jack Russell terror named Gizmo and he rarely leaves my side, but every few days I see him jump up startled from a nap on the couch look at his rear end and jolt over to his Companion Road bed then look at me with glassed over eyes like he just had a really bad nightmarish dream or something.

ROTF laughing Snoredog...and he looks at you as if you did it.....??

Drbandage, because I know you have high regard for accuracy with words, just a few clarifications . . .

drbandage wrote:In that regard, I want to weigh in with an opinion about a product that I have seen mentioned on this board on at least several occasions.

Good on ya, doc. You state up front that this is an opinion. Opinions are what this forum is about. Opinions are what makes this forum great.

drbandage wrote:One of the most prevalent reasons for giving up on OSA treatment is quite obvious: having a mask strapped onto your face while turbo charged air is blown into your pharynx is not comfortable for a variety of reasons.

Hmm . . ., based on the postings to this forum, I would have guessed that the most prevalent reasons folks give up on treatment are:

- incorrect treatment pressure
- ill fitting mask
- sinus blockage
- aerophagia
- CPAP intolerant - BiPAP needed
- CPAP intolerant - APAP needed

Most folks seem to get over claustrophobia quickly, within a day or two, although a few may take longer.

drbandage wrote:From a purely scientific view point, there are some compelling reasons why the diffusion device may prove beneficial.

This is purely conjecture on your part, doc, not science. Sure, the device may prove beneficial, but then again, it may not. No causal relationship for effectiveness of this product has been established. It may ultimately prove to be a waste of time and money for those who choose to experiment with it. It seems like a cruel hoax . . .

This product will not resolve any of the most prevalent compliance issues listed above. Because of chemical sensitivities and allergies, which many people have, there is also the real possibility that this product may do more harm than good.

drbandage wrote: . . . essential oils . . .

Is this snake oil, doc? Perhaps you merely overlooked it, but as a physician endorsing a product would you care to add a legal disclaimer here?

Regards,
Bill

I don't really know what essential oils are. I do know that I despise people who use tons of perfume and cologne, forcing their odors on everyone they glide passed. Their deliberately planned and excessive odors stuffs up my nose and gives me sinus headaches. Ergo, sleeping later on will be problematic.

However, I clean my entire mask, except the straps, the humidifier tank, and the hose every day because it makes me feel good and I like the smell of clean. The smell of fresh baked bread wouldn't be too bad either. It's like getting into bed after your bedding has been washed and pressed.

Many people here have allergy problems and chronic sinusitis and probably hate cologne and perfume too. If you can detour that with essential oils, and via Google I saw some allergies can be treated with essential oils, there might be a great benefit to this.

I cannot stand scented candles. However, a woman once bought me a blue candle from TJ Max called ocean something, that I loved. There is a certain smell that ice cream sugar cones have that I always loved and sometimes you can experience that same ice cream cone smell from a fresh cut lawn...I have no idea why.

I've even hated to go to movies lately because someone sitting too close to me smells like a french whore and it's usually a boy from age 18 to 30. They are much worse than the girls and the think extra cologne increases their Testosterone.

Those of us with sleep problems are much more aggravated by unnecessary invasive smells and would probably love to be able to smell things that trigger comfort and relaxation.

Allen

Just curious: why do some people seem to have such a negative reaction to the very idea of this new product? I think it sounds lovely. I'm totally compliant with my CPAP treatment, but I definitely like the idea of the mask smelling nice. I know it sometimes smells like the onions I sauteed for dinner, and lavender essential oil would be a distinct improvement. Since the chamber is attached outside of the machine, I don't really see that it would pose much of a threat to the equipment.

I guess I just wonder why some people (not only this thread, but others on the subject) seem so *angry* about it? It's an option. It's not a miracle, but it might be able to improve the experience, and I'm all for it. I ordered mine yesterday.

PAP Aromatherapy – Worth Consideration

Hi Doc. Well I for one think it is a great idea. The last CPAP hose that I purchased came with a very pleasant aroma. It dissipated after awhile and I was back to plain ol' plastic.

Anyway, I visited the site, http://www.pur-sleep.com and I have a suggestion. It would be nice if it were possible to order a sample card or phamphlet that had a sample of each aroma. We would then be able to make a more informed purchase.

Congratulations Sleepguy on what appears to be a great idea and good luck to you and your new enterprise.

Steve

A sample card would be a great idea! I actually ordered the deluxe starter pack just because I wasn't sure which scents I would like and wanted to be able to try them all. Of course, the company makes more money this way, at least form me, but there are probably others who are just holding off due to uncertainty, instead of taking my route!

svh wrote:Just curious: why do some people seem to have such a negative reaction to the very idea of this new product? I think it sounds lovely. I'm totally compliant with my CPAP treatment, but I definitely like the idea of the mask smelling nice. I know it sometimes smells like the onions I sauteed for dinner, and lavender essential oil would be a distinct improvement. Since the chamber is attached outside of the machine, I don't really see that it would pose much of a threat to the equipment.

I guess I just wonder why some people (not only this thread, but others on the subject) seem so *angry* about it? It's an option. It's not a miracle, but it might be able to improve the experience, and I'm all for it. I ordered mine yesterday.

Sarah,

I agree, sauteed onions and garlic in EVOO is a great smell but not for the bedroom. Sometimes you can smell it in the bedroom. Our sleeping problems have a great deal of collateral damage, none the least of which is our mood. If good comforting and relaxing smells will take that edge off, why not. I'm not so sure I'd like lavender or anything having to do with flowers either, but I bet there are some smells that I'd like.

I went onto the site, which must be getting lots of hits, as it was very slow but I think I'm going to order that basic package too, once I see what aromas are in it,

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

I have no vested interest in the company, nor have I purchased their product, but I thought the scientific studies cited in the White Paper provided some compelling reasons why the diffusion device may prove beneficial. It is definitely worth a read.
http://www.pur-sleep.com/uploads/WhitePaperv3[1].pdf

Here's an excerpt:

Pur-Sleep, Inc. White Paper excerpt wrote:Aromatics Improve Sleep
In addition to altering mood and reducing anxiety, certain aromatics have the effect of improving sleep. In an extensive, recent human study, lavender essential oil was shown to increase the percentage of deep or slow-wave sleep (SWS) in both men and women, resulting in higher vigor reports to corroborate the restorative SWS increase. The study concluded that lavender serves as a mild sedative and has practical applications as a novel, nonphotic method for promoting deep sleep. 27 Similarly, a study from Japan also showed that the inhalation of valerian and rose odors significantly prolonged the pentobarbital-induced sleeping time in rats. 28

Aromatics Improve Psychological Variables Associated with Medical Procedures and Pain Perception and Management
In a recent controlled study, ambient odors of orange and lavender were shown to be effective to reduce anxiety and improve mood in patients waiting for dental treatment. 29 Similarly, in another study, aromatics were shown to have the potential to moderate various aspects of mood following an anxiety-provoking task (when individual hedonic preferences are controlled).30 In a study of full-term newborns, exposure to a familiar odor was shown to reduce agitation during routine heel stick procedures and to diminish distress after the procedure.31

A number of studies have focused on the interaction between aromatics and pain. Studies have found that positively hedonic fragrances decreased pain response in mice, whereas negatively hedonic odors increased pain response.32 33 In a more recent study, the presence of peppermint odor resulted in an increase in the individual’s ability to withstand painful stimulus and well as promoted a decreased sensation of pain over time.34 In another study, it was found that while odors significantly influence mood in both women and men, effects of odor on pain perception were experienced only by women, suggesting gender differences in the mechanisms involved in the emotional aspects of mood and pain perception.35

Conclusion
Studies in the areas of CPAP compliance on the one hand and human olfaction on the other strongly suggest that the use of aromatics in connection with CPAP therapy has a high probability of materially improving CPAP compliance rates for a significant percentage of patients undergoing CPAP therapy. In particular, aromatics present an excellent desensitization method. The use of aromatics also would seem to be particularly useful in creating positive moods and reducing anxiety and feelings of claustrophobia for patients undergoing CPAP therapy for the first time.

At the same time, exciting research supports the theory that the smells associated with VOCs released by new CPAP equipment present significant psychological variables for patients undergoing CPAP therapy, particularly for new patients attempting therapy for the first time (when plastic smells in new equipment are at their highest levels). It stands to reason that plastic smells exacerbate feelings of smothering, claustrophobia, stress, anxiety, and irritation.

Pur-Sleep, Inc. has developed a novel, low-cost universal device for diffusing aromatics in-line in CPAP machines and other ventilatory assistance equipment. Pur-Sleep, Inc. has also developed a line of various all-natural aromatics made with 100% pure essential oils (such as lime, orange, lavender, sweet marjoram, peppermint, ylang ylang, and others) that have outstanding hedonic value and high acceptance rates. We are intereseted in developing and pursuing opportunities to directly test the use aromatics in CPAP therapy.

NightHawkeye wrote:It may ultimately prove to be a waste of time and money for those who choose to experiment with it. It seems like a cruel hoax . . .

I see they offer a 30 day unconditional money-back guarantee.

Looks like it wasn't a waste of time and money for some who've already experimented with it:
viewtopic.php?p=149008#149008

It appears some liked it and some didn't. As with all things XPAP-related, looks like YMMV.

My personal opinion is if someone is having a hard time sleeping with CPAP, this is an inexpensive investment in a potential aid. (And that money-back guarantee is a nice surprise. Wish mask manufacturers would offer the same thing.)

I've said it before, and I'll say it again: this is likely a very, very bad idea. Go to a lung specialist doctor and ask him what he thinks about blowing essential oil vapors (that is, chemical vapors) directly into the lungs under pressure for a third of your life (8 hours per 24). I suspect if he doesn't faint outright, he's going to tell you NO NO NO, for God's sake NO, the only thing you should be taking into your lungs under pressure is *air*! What's being proposed here is not the same as the normal, natural process of smelling, instead this is pressurized and continuous delivery of oils/chemicals directly into the lungs, all night long, with no clean air available for that entire time. The mid- or long-term issues with chemical buildup in the lungs could be severe. Please, someone ask a lung doctor, and report back here. I predict he/she goes pale, faints, or at least tries to smack the questioner with a Clue-By-Four(TM).

As far as helping compliance, if someone's bothered by aerophagia, claustrophobia, fitting issues, etc., I sincerely doubt that a delightful apple pie smell being forced into their schnozz and lungs is going to magically make all those problems go away.

But again, my biggest concern would be lung health. Don't blow chemical vapors into your lungs, and especially not 8 hours per day! Stop and think about it, people!

If nobody here has access to a lung doc and can ask and report back, I might look one up myself and do it...

Anonymous wrote:I've said it before, and I'll say it again: this is likely a very, very bad idea. Go to a lung specialist doctor and ask him what he thinks about blowing essential oil vapors (that is, chemical vapors) directly into the lungs under pressure for a third of your life (8 hours per 24). I suspect if he doesn't faint outright, he's going to tell you NO NO NO, for God's sake NO, the only thing you should be taking into your lungs under pressure is *air*! What's being proposed here is not the same as the normal, natural process of smelling, instead this is pressurized and continuous delivery of oils/chemicals directly into the lungs, all night long, with no clean air available for that entire time. The mid- or long-term issues with chemical buildup in the lungs could be severe. Please, someone ask a lung doctor, and report back here. I predict he/she goes pale, faints, or at least tries to smack the questioner with a Clue-By-Four(TM).

As far as helping compliance, if someone's bothered by aerophagia, claustrophobia, fitting issues, etc., I sincerely doubt that a delightful apple pie smell being forced into their schnozz and lungs is going to magically make all those problems go away.

But again, my biggest concern would be lung health. Don't blow chemical vapors into your lungs, and especially not 8 hours per day! Stop and think about it, people!

If nobody here has access to a lung doc and can ask and report back, I might look one up myself and do it...

Guest, it looks like you're rather misinformed about the nature of the proposal here. We're talking about minute quantities of natural aromatics--one drop on a pad that will emit in the parts per million or billion of natural aromatics (like orange, clove, peppermint, etc.). These are natural aromatics like you smell every day, not chemicals, toxins, poisons.

On top of that, if you do contact a lung doctor, please also ask him or her about all of the toxic plastics that we fellow xpappers are forced to breathe into our lungs and bodies every night, all night, 8 hours a day.

I've posted this on another thread but it bears repeating here.

Sorry to be the bearer of bad news here but I came accross this study from the FDA a few days ago and haven't seen a word about it on the forum. I'm quite steamed about this and think everyone on xPAP has a right to know about this.

Turns out that polyvinyl chloride (PVC) is the most common plastic used to make medical equipment, including xPAP. PVC is brittle at room temperature and so [un]healthy amounts of plasticizers, primarily a substance called DEHP is used to make the PVC soft. Everyone is familiar with the clear plastic tubing used for IVs, blood bags, cpap tubing--that's PVC with up to 80% DEHP.

DEHP is not bonded to the PVC and starts to volatilize immediately and continues to release over time. According to the FDA:

"DEHP has been shown to produce a wide range of adverse effects in experimental animals, notably liver toxicity and testicular atrophy. Although toxic adn carcinogenic effects of DEHP have been well established in experimental animals, the ability of this compound to produce adverse effects in humans is controversial."

Safety Assessment of Di(2-ethylhexyl)phthalate (DEHP) Released from PVC Medical Devices (http://www.fda.gov/cdrh/ost/dehp-pvc.pdf). There are a lot of other goodies in that report if anyone cares to read it.

I was pretty upset when I found out about this--that I am continuously exposed to DEHP from my CPAP, all night, ever night but feel rather helpless to know what to do about it (except to raise cain with xPAP manufacturers and give them all kinds of reasons to stop poisoning us).

Some other sources I found ranked xPAP therapy as posing "moderate" risks from phthalate exposures. The docs seem to be particularly concerned about neonates and children on xPAP (as they should be) but what about the rest of us?

Truth be told, there are a number of alternative materials that do not contain phthalates that would certainly be suitable for xPAP hosing and masks, including teflon, silicone, and urethane. But these cost more and manufacturers don't want this to impact their profit margins.

I think the point here might be to air out, wash, and maybe even operate new equipment as much as possible during the day to get out as much of the plastic smells as possible . . .

So whether you know it or not, you are breathing and smelling all kinds of nasty things all night during your xPAP therapy even without the diffusion device and natural aromatics. If you like the smells of styrene, PVC, DEHP, and other phathalate esthers, be my guest. They're blowing into your lungs all night every night undre high pressure whether you like it or not. I think your lung doctor should faint or pass out or throw a fit about these kinds of exposures. It makes me very angry that xPAP manufacturers use PVC and other nasty plastics to make their equipment when less toxic plastics, like urethane, teflon, silicone, are readily available. Make sure you ask your lung doctor about that, too.

And by the way, the person who started this thread, Dr. Bandage, is a Medical Doctor and a professor at a very prestigous medical school in California.

SleepGuy wrote:Guest, it looks like you're rather misinformed about the nature of the proposal here. We're talking about minute quantities of natural aromatics--one drop on a pad that will emit in the parts per million or billion of natural aromatics (like orange, clove, peppermint, etc.). These are natural aromatics like you smell every day, not chemicals, toxins, poisons.

I never said "toxin" or "poison", I said "chemical". And the source is irrelevant, "natural" or not, these are indeed chemicals, as any scientist will tell you. It's a substance other than air which is being put into your lungs under pressure all night. The long-term effects of doing this are not well-known, but I wouldn't exactly want to be a guinea pig to help find out.

And yes, they're some of the same chemicals we smell on a regular basis, but usually briefly and in an open and natural environment. It's not an eight-hour, closed, pressurized system where all the air your lungs can ever get is forced to first pass over a pad containing a very highly-concentrated liquid version of the substance. That's a whole other ballgame compared to just walking through a garden and enjoying the scents.

As for the long statement about chemical vapors coming off CPAP plastics, it's all irrelevant to this discussion unless this "aromatherapy diffuser" product can reduce them, which it cannot. Currently any such hardware-related vapors are unavoidable if you use CPAP. What I'm questioning is the addition of EXTRA chemical vapors to the system, over and above its inherent and unavoidable ones.

Also, I'd be highly, highly, highly willing to bet that, particularly after a brief break-in period, the amount of inherent, hardware-related vapors in the CPAP air are FAR lower than the amount coming off the diffuser product. Let's see, pressurized air passing over a solid, versus pressurized air passing over a concentrated, highly-aromatic liquid placed on a "diffuser pad" that's expressly designed to efficiently evaporate the substance into air? Hmmm, which do you think creates more vapor? I'd say the latter, probably by quite a few orders of magnitude.

No offense intended, but again, in my opinion, it's a bad idea.

You said exactly what I was thinking, SleepGuy. I often think about all the things we breath during the time we are not on the hose. And now you tell us that even that time is suspect? Very scarey indeed. There is no place one can be to escape some sort of pollutants/poisons we are surrounded by 24/7.

When I lived in Europe in the 90's aromatherapy was very common along with other practices most people thought of as "snake oil" remedies or another way to take people's money. I've had positive experiences from aromatherapy. When I wash my mask pillows out with baby shampoo and go to bed that night smelling that faint residue of the baby shampoo,that smell triggers memories of a time when my kids were little, bathtime, and other pleasant memories. What a lovely way to drift off.

When Drbandage talked about the the brain and smells I immediately thought about how in an unpleasant situation (having blood drawn, sitting in a dentist's chair, MY FIRST ATTEMPT AT THE MASK, etc.) that I will block out the unhappy event by "going to my happy place" which ALWAYS is something I associate with smells. Riding my horse in a forest produces that earthy, pine tree smell. Walking my dogs along a sandy ocean beachfront produces that salty ocean air smell.

If aromatherapy produces and induces pleasant sensations in adjusting to cpap I'm for it. There are too many people not compliant for a variety of reasons as Bill pointed out but if this could help anyone with claustrophobic problems which for some, aren't always resolved quickly, then I think it is well worth exploring.

I caught a bit of flack in an earlier thread on this subject.
The Doc gives a very cogent and reasonable treatise on the value of aromas, but fails to address the issue of continual exposure to any odor.

The chocolate chip cookie mentioned is valid. I remember with great nostalgia the smell of my grandmothers caramel cake and banana pudding.

But those working in a chocolate chip cookie factory do not smell it after a while of constant exposure. People who have a dog who poops in their house do not smell it as a visitor will. The brain compensates for it and effectively negates it.

By having 3 or more scents, I would think this would minimize this to a degree

I also mentioned that the placebo effect may be in play here and I am sure the doc knows all about this.

What difference does it make if a person likes it and if they THINK it helps them, then it does.
One minor item that has moi scratching my head.. The doc says something about turbo charged blowing down the throat. I think the pressure is increased, but there is no change in the velocity of the air going down the airway. It is easier to breath in, but the velocity is not affected.
Just my opinion.
I vote for anyone interested to try it, I do not smell the cigarette smoke that others complain about. My brain just tunes it out.
I hate every cigarette I light up and wish I would quit them.