Another approach to Provent

[chunkyfrog]

Maybe they have to sign a promise that they won't.

[pats]

I keep hoping to check in and see some people with oximeter readings comparing nights on Provent to nights on CPAP, but no joy.

Just wondering if any of the Provent users have done this?

I plan to do it once I'm through the basic getting used to Provent.

However, my sleep doctor said my oxygen levels were not that bad in the untreated sleep study, so it may not tell us much. Zeo readings may be more interesting. It appears that I do breathe in light sleep and my brain somehow forces me back there from REM or deep sleep whenever the oxygen begins to drop.

I've been leaving off both the Zeo and the oximeter while I adjust to both APAP and Provent.

I may take an oximeter with me to the Andes, but if I do that I also need to take a laptop to read the data. I'm thinking of only taking my phone and a Kindle Fire.

[pats]

Maybe they have to sign a promise that they won't.

No, I didn't sign anything to get my Provent supply.

It may be that people who are adjusting reasonably well to XPAP but also trying Provent are relatively rare. To do the comparison, you have to be able and willing to use either.

[SleepingUgly]

I just saw this new thread about Provent and don't have time to read it all right now. Is anyone here using Provent successfully and can give me advice? I had a thread going, but don't know if I should continue to post there, and maybe put a link here, or post here...

Well, the short story is that I can fall asleep with it, but I can't stay asleep with it. I wake up and my mouth is dry, my nose feels dry and stuffy (even though I don't think it really is stuffy) and I have the sensation that I'm having trouble breathing. I fall in and out of sleep, getting terrible sleep, until I quit. Last night I tried it with a touch of Ambien and a chinstrap, but still woke up at 3:45am with the same scenario. I have no idea if I'm breathing out of my mouth or not. I called Provent and the support person said that a dry mouth doesn't necessarily mean you're breathing out of it, and that it does abate over time.

I cannot afford to fail Provent in terms of tolerance as I have already essentially failed CPAP/APAP/bilevel, so I need all the tips I can get for how to adjust to it. Thanks!

[pats]

Well, the short story is that I can fall asleep with it, but I can't stay asleep with it. I wake up and my mouth is dry, my nose feels dry and stuffy (even though I don't think it really is stuffy) and I have the sensation that I'm having trouble breathing. I fall in and out of sleep, getting terrible sleep, until I quit. Last night I tried it with a touch of Ambien and a chinstrap, but still woke up at 3:45am with the same scenario.

I am a Provent beginner, so it is presumptuous of me to offer you advice, but we Provent-users need to exchange all the ideas we can.

I got both the problems you described, dry mouth and waking up feeling as though I'm having trouble breathing. I think there may be a couple of realities contributing to the trouble-breathing sensation. One is that it does take more force to breath out against the Provent, so it may take time for the muscles to build up enough stamina to do it for 7+ hours straight. The other is that there may be a slight increase in CO2 that is supposed to encourage breathing.

My approach to both problems centers on a carefully adjusted chin strap. I use a Ruby adjustable, and have it set so that it closes my mouth if I relax all my jaw muscles, but presents practically no resistance to deliberate mouth opening. In my case, that eliminated dry-mouth, so mine must have been due to mouth breathing. The next part of the strategy is difficult to remember in the middle of the night: If I wake up feeling stuffy etc., I try to remember to open my mouth and take several deep breaths. I can then go back to getting settled in to sleep, breathing only through my mouth and ignoring, as far as possible, the Provent in my nose.

Maybe someone with more Provent experience will have better ideas that will help both of us.

[billbolton]

I'm betting every cpap company's engineers would like data on that.

You lose then, since it's already been done.

[ozij]

I just saw this new thread about Provent and don't have time to read it all right now. Is anyone here using Provent successfully and can give me advice? I had a thread going, but don't know if I should continue to post there, and maybe put a link here, or post here...

Well, the short story is that I can fall asleep with it, but I can't stay asleep with it. I wake up and my mouth is dry, my nose feels dry and stuffy (even though I don't think it really is stuffy) and I have the sensation that I'm having trouble breathing. I fall in and out of sleep, getting terrible sleep, until I quit. Last night I tried it with a touch of Ambien and a chinstrap, but still woke up at 3:45am with the same scenario. I have no idea if I'm breathing out of my mouth or not. I called Provent and the support person said that a dry mouth doesn't necessarily mean you're breathing out of it, and that it does abate over time.

I cannot afford to fail Provent in terms of tolerance as I have already essentially failed CPAP/APAP/bilevel, so I need all the tips I can get for how to adjust to it. Thanks!

This should go on your original post, with a link to the present one, if you prefer posting here.

[pats]

I stuck to Provent for a complete night, without switching to APAP, for the first time last night, and I'm feeling fine this morning. I'm reasonably sure I'm going to be able to adapt. Now I'm trying to decide whether to stay with Provent tonight, or alternate a night on Provent with a night on APAP so that I stay acclimated to both.

[avi123]

I pass

[NightMonkey]

At this point I continue to maintain that everyone should have an analysis of positional affects on their condition before experimenting with Provent. Many will find that positional therapy is more effective than Provent at no additional ongoing cost and no inconvenience of trying to get little thingies glued air tight onto the nostrils.

I'm sorry - I misunderstood the emphasis on "before" as meaning you meant they should not be tried simultaneously, the way I'm doing it.

There is a problem with skipping investigation of positional therapy and jumping ahead to positional therapy plus Provent. Positional therapy satisfactorily treats some people and it does it easily, with little inconvenience and with no expense to speak of.

So if a patient jumps from diagnosis directly to "positional/Provent" he may suffer a lot of difficulty and expense unnecessarily for many years.

For my newly diagnosed friends, especially ones with mild cases, I like to see a doctor do a thorough "positional analysis" of the sleep study meaning a close look at how much time was spent in non-supine sleep broken down by sleep stage and RDI and AHI in each stage.

My current sleep doctor does this for all mild cases and prescribes positional therapy as appropriate. So it is not just that Provent can be avoided with a thorough positional analysis but CPAP can also be avoided in some cases.

The fact that Provent is available and prescribed might possibly cause you to miss a much easier, much cheaper therapy.

A simple question to the doc could be something like, "In the sleep study how did I do in nonsupine positions and is there sufficient evidence to say that nonsupine sleeping by itself would be successful or would not be successful in treating my mild apnea?"

[pats]

A simple question to the doc could be something like, "In the sleep study how did I do in nonsupine positions and is there sufficient evidence to say that nonsupine sleeping by itself would be successful or would not be successful in treating my mild apnea?"

You seem to believe both I and the professionals treating and advising me are quite incompetent. Why? Other than reaching different decisions from the ones you prefer, I don't think I've shown any particular evidence of incompetence, and you know even less about the professionals than you know about me.

There was no need for me to ask the sleep clinic to do that analysis - they do it for every sleep apnea patient. I was told before the sleep study that one of the possible outcomes was that position change alone might be enough. I was told after the study that it would not be sufficient in my case.

[NightMonkey]

A simple question to the doc could be something like, "In the sleep study how did I do in nonsupine positions and is there sufficient evidence to say that nonsupine sleeping by itself would be successful or would not be successful in treating my mild apnea?"

You seem to believe both I and the professionals treating and advising me are quite incompetent. Why? Other than reaching different decisions from the ones you prefer, I don't think I've shown any particular evidence of incompetence, and you know even less about the professionals than you know about me.

There was no need for me to ask the sleep clinic to do that analysis - they do it for every sleep apnea patient. I was told before the sleep study that one of the possible outcomes was that position change alone might be enough. I was told after the study that it would not be sufficient in my case.

Not only you read what is posted in this thread. Maybe thousands of people will google "Provent" and eventually find this thread. It could be extremely helpful to some small portion of them to know that positional therapy is appropriate for some patients before they pursue other options.

You now say, "I was told ... that (positional therapy) would not be sufficient in my case." Provent's graphic has been posted in the forum several times. The grapic says to me, "Provent therapy is not sufficient in the great majority of cases."

(BTW, you introduced the idea of medical professional incompetence into the thread. If you are interested in the subject just start reading threads here. The forum is rife with complaints and examples of said incompetence.)

My hopes are that you get the best treatment possible and thoroughly enjoy your Andean trip.

[pats]

I would take the XPAP even if the altitude would be a bit higher than its self adjustment. I would also take a mask that could input Oxygen. When the air is thin at the higher altitude the Provent could be a nuisance. It relies on creating a PEEP on exhalation but blocks full air flow for inspiration. To get enough Oxygen at the higher altitude, while having the Provent in your nose, you would rely entirely on mouth breathing, making the Provent and a chinstrap useless.

Check Altitude Sickness:

http://www.altitude.org/altitude_sickness.php

Thanks, but I intend to continue to rely for treatment decisions on the advice of a sleep specialist who has all the relevant information. The HMO travel advisory service has already sent me an altitude sickness leaflet, as well as prescribing Diamox.

[SleepingUgly]

I just saw this new thread about Provent and don't have time to read it all right now. Is anyone here using Provent successfully and can give me advice? I had a thread going, but don't know if I should continue to post there, and maybe put a link here, or post here...

Well, the short story is that I can fall asleep with it, but I can't stay asleep with it. I wake up and my mouth is dry, my nose feels dry and stuffy (even though I don't think it really is stuffy) and I have the sensation that I'm having trouble breathing. I fall in and out of sleep, getting terrible sleep, until I quit. Last night I tried it with a touch of Ambien and a chinstrap, but still woke up at 3:45am with the same scenario. I have no idea if I'm breathing out of my mouth or not. I called Provent and the support person said that a dry mouth doesn't necessarily mean you're breathing out of it, and that it does abate over time.

I cannot afford to fail Provent in terms of tolerance as I have already essentially failed CPAP/APAP/bilevel, so I need all the tips I can get for how to adjust to it. Thanks!

This should go on your original post, with a link to the present one, if you prefer posting here.

True. I have stopped getting notifications of new messages to threads I'm subscribed to + been busy, so need to catch up on all threads.

[SleepingUgly]

I stuck to Provent for a complete night, without switching to APAP, for the first time last night, and I'm feeling fine this morning. I'm reasonably sure I'm going to be able to adapt. Now I'm trying to decide whether to stay with Provent tonight, or alternate a night on Provent with a night on APAP so that I stay acclimated to both.

How many nights have you been on Provent? Were you waking during the night last night but still sticking with it or sleeping through?