A new apnea patient's journey - starting with Provent

I've known for years that I've snored and that, likely, I stop breathing when I sleep. It's impacted at least one of my relationships, where my ex used to have to sleep in the living room. My sister, a nurse, told me during my last visit that I likely have apnea after she observed me sleeping on her couch. One of my friends, a surgical tech, also said I likely had sleep apnea after sleeping over at her house over New Year's weekend. So, I've known I likely have a sleep issue but I never took any action. Why? Because I don't want one of those CPAP machines. I can't imagine having to head-gear myself up every night. I know myself well enough to know I just won't do it.

My main complaint is that I feel like I am in a fog and have to push myself through every day. My focus is my job, and the rest has always taken 2nd seat since I don't have enough energy for both. Home projects take weeks or months to complete. I'm simply too tired.

But then I read this article on NYT a few weeks back: http://well.blogs.nytimes.com/2012/04/0 ... -the-mask/

This, I'd wear. This, fits in with my traveling lifestyle. This, is me in denial that I need a CPAP. This, is me at least willing to get tested. I know CPAP is the gold standard, and enough people have shoved that down my throat for me to believe it's the common therapy. I get it. It still doesn't mean I will ever wear it. But the Provent at least got me moving and we'll see where it goes from there.

So, seeing an alternative, I got an appointment with my Dr who assessed me on the sleep apnea scale. I think it was a 6 - not severe, but enough for me to get the sleep study referral. The sleep study was one of the worst night's sleep I've ever had. It was a split study - 1/2 to get a baseline and the other with a CPAP. I woke up multiple times with the panicked feeling I was being suffocated by that damn machine. We went from the nostril plugs to the nose mask to the full mask and I felt smothered by it on each one. The tech beligerently insisted I got better sleep on the CPAP - the reality was my blood-shot eyes and cranky demeanor did not believe her for one bit. I've always been a deep sleeper and nothing bothered or woke me once asleep, but I swear that infernal machine felt like it was going to be the death of me.

The sleep study showed I have apnea and the Dr., at my request, gave me a script for Provent this afternoon. My experience during the sleep study confirmed I don't want the CPAP machine as a solution. I don't trust it to not smother me again as it did that night. I woke up in panic on too many occasions when I normally sleep through the night.

I picked up the Provent 10-day trial this afternoon for $22. Tonight will be my first night using it - or any sleep apnea therapy (except for the study). I don't expect it to be perfect by any means. But I am going to do my best to push through it. I am aware that Provent works on only about 50% of the people who try it. The NYU studies show there is no real rhyme or reason to when it works - whether it's mild or severe apnea. I'm hoping I'm in the 50% where it works. I found the study posted here on CPAPtalk.com - and the whole series is interesting. Here's the video where Rapaport is discussing Provent: https://www.youtube.com/watch?v=trbAfp6pzZQ

I am doing my own sleep study with this (yes, there is an APP for that!). I downloaded "Snore Monitor Pro" on my iPhone and got a baseline for my snoring, breathing and position last night. I've been told I'm pretty loud and this app revealed I am constantly over the volume of my "fake snore" which created the volume baseline. So I'm pretty loud - it was eye-opening to see it in graph form.

There are other snore monitor apps, and some are free. I chose this one because it monitored breathing, snoring and position. You do have to sleep with it strapped to your chest using an ace bandage - but how else am I going to know if the Provent works? If you've tried another sleep monitor app and liked it I'm willing to try it too.

When I figure out to upload an image here I will post the baseline graphic. And each night's subsequent graphic. I joined just today to kind of journal this and share it with you. I've seen a mix of love, indifference and hate toward those using trying Provent in the forums. I'm just going to post my experience as there are a lot of people who, like me, came here trying to get some idea what Provent is like and someone's experience. I realize this is a "CPAP" forum so if anyone knows of a better Sleep Apnea site to post this on I'll do it there instead.

Well, here's hoping for a restful night. Wish me luck!

Welcome to the forum.

I do wish you luck and success with this alternative therapy. If your untreated OSA was mild you stand a good chance of having significant reduction in your events and it might help..
Please do keep us posted because we really haven't known anyone who has actually tried this except fly by night spammers coming by touting the wonders of it all and we can't trust them to tell the truth.

Sounds like you educated yourself and you are aware of its limitations and are willing to give it a try.
You know the odds so I won't go into all that. Instead I will wish you luck and hope that you get the results that you want.

There has been some talk among a few members of trying it but it hasn't been done yet that I know of.
So do keep us posted.

neurotony wrote: I joined just today to kind of journal this and share it with you. I've seen a mix of love, indifference and hate toward those using trying Provent in the forums.

Forums like?

I realize this is a "CPAP" forum so if anyone knows of a better Sleep Apnea site to post this on I'll do it there instead.

Hmmm, when I googled "sleep apnea forum" cpaptalk wasn't even on the first page of the results...many other "sleep apnea forums" on my google page. I have to admit I didn't check them for the "mix of love, indifference and hate" that you found "in the forums". Which forums were you reading on which you saw that aforementioned mix? What in the world kept you from posting on them? What in the world made you post in a cpap forum, and ask forum members for "better sleep apnea forums"?

neurotony wrote:When I figure out to upload an image here I will post the baseline graphic. And each night's subsequent graphic. I joined just today to kind of journal this and share it with you.

It's very easy to figure this out -- here's an explanation from pugsy:

Pugsy wrote:You have to put the image on a website to then create a link to that image.
Here is how I do it.

Open the image to full size so it is easily read.
I use Vista snipping tool to create a screen shot and crop the image at the same time.
Prt/scr key will also take a screen shot if using XP. If laptop is used sometimes the Fn key has to be pushed at the same time as the prt/scr key

I think windows 7 Home Premium has the snipping tool, Basic may not.

Once the screen shot is created save it in jpg format.
Upload the image to a host site. I use Photobucket it is free, there are others.
Once the image is uploaded then copy the ENTIRE IMG address. Be sure to include the opening and closing IMG in brackets. Paste that copied address into a post here.
Use the preview button. If you can't see the image try again because if you can't see it we can't.

Eagerly awaiting to view your results.
Wishing you lots of luck with your therapy. I mean that. I wish you much success in solving your sleep apnea in the simplest, easiest way you can.

edited to add the "k" I dropped from "ask"

You might consider getting an oximeter to monitor yourself as well because snoring doesn't give the whole picture about how well such a treatment may be working for you.

Good luck, it will be interesting to hear how it goes.

Janknitz wrote:You might consider getting an oximeter to monitor yourself as well because snoring doesn't give the whole picture about how well such a treatment may be working for you.

Good luck, it will be interesting to hear how it goes.

Great idea.

Thanks Pugsy and Janknitz for the positive reinforcement! I thought of getting an oximeter too and will check into it today. I am hoping my local pharmacy will have it.

[quote="Pugsy"]
If your untreated OSA was mild you stand a good chance of having significant reduction [quote]

Pugsy - Why do you think Provent only treats mild apnea? Rapaports results (the video link in my 1st post) show it worked across the board from mild to severe, though he didn't know WHY it worked across the board. Heh. I've heard the "mild-to-moderate" for Provent from my sleep tech and here in the threads but am not sure where that take comes from. Is it from medical guidelines, a study or is it your personal perception? The research seems to show it works on all forms, but no one knows why yet.


[quote="ozij"]
Forums like?

Hmmm, when I googled "sleep apnea forum" cpaptalk wasn't even on the first page of the results...many other "sleep apnea forums" on my google page. I have to admit I didn't check them for the "mix of love, indifference and hate" that you found "in the forums". Which forums were you reading on which you saw that aforementioned mix? What in the world kept you from posting on them? What in the world made you post in a cpap forum, and as forum members for "better sleep apnea forums"?
[quote]

It's this kind of animosity I'm talking about. It stops people like me from posting information I came here looking for in the first place. Admitedly this isn't as bad as some of the posts here I've seen - but it is equally accusing. Why do you guys feel the need to criticize so much? Is your CPAP not working and you're just cranky? (wow - look! actual proper use of "your" and "you're"!)

OZIJ: By forums I meant threads here - search them for Provent and you'll see the mix of love, hate and indifference. The hatred is usually from trolls who are constantly questioning the validity of every poster and they appear to do this across the site for any topic. For someone searching for Provent information it gets tiresome and comes across as mean-spirited. I spend more time reading these troll's posts discussing whether someone is real rather than reading the information the poster is trying to provide - and, as I would, they stop posting from the bullying on this site.

I rarely post in forums so please forgive the mixing up of the words "forum" and "thread". I am sure if I read through your posts they wouldn't be letter-perfect either. Stop being so nit-picky looking for a chink in the armor of my personhood. There are plenty of chinks, believe me, but they aren't going to lead you to the path that I am not a real person posting this for others like himself who came here trying to find an answer.

I didn't search for "sleep apnea forums", but thanks for assuming I did. Next time just ask me. I searched for"Provent review" which is how I got here. Try it yourself and see.

I mention the term "mild" because of Provent's own shown 50% reduction numbers.
I looked at this for myself but my AHI was 53....and even with a 50% reduction of events that leaves me with 25 AHI...I just don't see it getting me down to where I would want to be. Even on the cpap machine when my AHI was 8 and felt like total crap and saw zero improvement.

If a person has AHI of say 20...rather mild...if they get the 50 % reduction then they are down to 10 AHI.
The 50 % number was theirs...if you look at the reduction numbers charts.

Also we have to bear in mind that mild, moderate and severe categories are just related to the number of events per hour. If I only had an AHI of 12....but those events were super long and I had drops in oxygen to 70%...while the classification is mild base on numbers....it is really a rather significant drop and pretty ugly when looking at it from that standpoint.

Of course a 50% reduction is better than no reduction (when someone just can't tolerate the machine)..

I am not going to give you the "you should try cpap" speech. I figure you are a grown up and quite able to make your own decisions and you know yourself better than anyone else. I truly do wish you success and if your AHI happens to respond positively to Provent...I am very happy for you.
Based on numbers alone...the lower anyone's pre treatment AHI..the greater chance to have marked improvement. Hence my comment about mild. Meant nothing else by it.
Just statistical probability thing based on numbers alone.

Oh... I second the suggestion about a recording pulse oximeter. It is a better indicator than recording snores I think. Since it is the desats that actually do the most damage to our body.
Absence of snores...really just means absence of snores. Not everyone with sleep apnea snores like a freight train. Doesn't mean zero apnea events when there are no snores.

I got this one and it is quite decent. There are other models but this one was sufficient for my needs.
http://www.pulseoxstore.com/Downloadabl ... anchor_107

1st night quick-results

So I overall slept well with the Provent. Of course within seconds of putting them in, my nose itched. Typical. heh. But I didn't have the feeling of being smothered like I did with the CPAP. It was pretty easy to put in and wasn't uncomfortable. I did breathe through my mouth as the video instructed before I feel asleep. Though I kept waking myself up as my body made the normal shift from mouth to nose breathing. I was kind of hyper-aware of that "magic moment". Besides that, I fell asleep pretty normally.

I woke up a couple of times throughout the night but otherwise tolerated it well. Well as in I didn't really feel it at all. I have to admit I've already spent a lot of my morning reviewing the logs from the sleep monitor app. And I figured out how to upload images - huzzah!

Here is the baseline I took during a nap:


I scheduled the baseline to start tracking 30 minutes after I laid down, so I am in full-snore here. And you can hear it in the audio. Note that I am constantly on or over the baseline here. And it's LOUD.


Here's from one of the hours of the first night:


I scheduled the recording to start about 45 minutes after I laid down to catch me while I was sleeping. I am way below the baseline for this hour and that kinda rocks. I wish there was some way to upload the audio here. It's snore-free! How cool is that on your first night? Srsly.

I'm taking a closer look at the data throughout the day and will give an update later. There is about 7 hours of data to poke through and I see some spikes, but some appear to be me turning over and some appear to be my cats mewing for food.

neurotony wrote:some appear to be my cats mewing for food.

I have a little Pug dog. He sleeps with me. He snores something fierce. For the longest time I kept seeing these really bad snores on my software reports..I was wondering what the heck..then one night it dawned on me when he was up on the pillow with his little chin resting on my shoulder...Pug snores...my machine was recording his snores. When he sleeps at my feet...I don't have any snores on my reports.

@Pugsy - Now you see why I asked the question. 50% success doesn't mean it only works on mild - it means 50% across all apnea severities. It may work for you, though it sounds like you have issues with even CPAP working for you so not sure how well Provent would or wouldn't work. My take is it's only $20 bucks to try it and potentially a new life. We'll see.

And I am a freight-train snorer as you can see from my baseline recording. I will go ahead and get an oximeter too. You're absolutely right, lack of snoring doesn't imply lack of apnea or an increased oxygen supply. Since the provent works on restricting outflow I kind of wondered if it would have a negative impact on oxygen levels.

Thanks for the oximeter link and support! I'll keep going!

Your pug-tale is too cute. The Sleep Monitor app actually records every noise so I can hear what caused the spike.

neurotony wrote:50% success doesn't mean it only works on mild - it means 50% across all apnea severities. It may work for you, though it sounds like you have issues with CPAP working for you.

No, 50% reduction in my case wouldn't be enough reduction. My AHI was 53 and my oxygen levels dipped to 73%. Cutting it in half to 25 would not be acceptable to me. I left out part of my story though. When I said a reduction in AHI to 8 left me still feeling horrible...I just meant that to explain that even with 8 per hour..I felt horrible so 25 per hour...I would still feel horrible.
The missing part..I adjusted my pressure just a bit and that 8 per hour...is now normally less than one per hour and I feel great (well about as great as any other 60 year old with arthritis) and I routinely sleep 7 to 8 hours without interruption and I have zero issues sleeping with the cpap machine.

So I am a happy cpap machine camper. I have no need to try alternative therapy because I am having zero problems with using the machine. Been on the cpap machine 3 years the end of this month. Never missed a night with it except one night when I had the stomach bug and I slept on the bathroom floor so I would be near the toilet since I was puking and pooping so bad.
While I would rather not have to use the machine..I really have zero issues with it and thus I have no need to explore alternative therapies.

Now if I just absolutely couldn't use the cpap machine..sure I would try the Provent and gladly accept whatever reduction in AHI that I got. Any reduction is better than no reduction.

So, I don't think I missed it in any of your posts - what was your AHI from that sleep study? In fact, might be good info for this journal to post the results of that split study to give a good, concrete baseline to work from. (Of course blanking out the personal info first...)

Pugsy wrote:
No, 50% reduction in my case wouldn't be enough reduction.

Ah - here's where we're misunderstanding each other. The Rapaport study showed it worked in 50% "of patients", not a 50% reduction. I'll have to review the video again but I'm sure it was a pretty significant drop over 50%. I'll see if I can find the studies on PubMed (the NIH article database). But that's besides the point that we needed to clear up what "50%" meant for us. Heh.

Ugh - that must have been a serious bug to sleep on the bathroom floor. I'm glad the CPAP is working for you and it may be where I wind up. If last night is "beginner's luck" and the Provent doesn't work out in the end I'll try the mouth guard next. It seems the CPAP is the 1st treatment anyone tries and the sleep tech mentioned it was the only one covered by insurance so was kind of my only choice. That bothered me since it almost seems like CPAP has a monopoly on apnea, especially if you can't afford to pay for the other treatment options. I don't mind trying the other therapies first. They may even prep me for the day when I have to use the CPAP machine.

I am opening my medical expense account today. Heh.

@jaybee72 - I haven't had my post-sleep study consultation yet and won't for a couple of weeks. It's why I asked the Dr if I could try it in the interim, just to start some form of treatment and to have some results using Provent since I think we both view it as experiemental in nature. If it all goes well, I'm hoping that I can do another sleep study with the Provent to see how effective it is overall. I think adding the oximeter to my measurements is going to be more helpful than the results from the snore monitor app. Though it is cool to hear me NOT snoring.

I'll gladly post the sleep study results when I have them.