AlaxoStent new Hybrid version: Anyone tried it?

[imposterdroids]

Curious if anyone has tried the new AlaxoStent since the original 6" was discontinued? I'm debating whether to try it or to try the nastent/back2sleep stents available in the EU.

[lazarus]

Won't.

Air belongs in my nose and throat.

Other stuff don't.

It is well known that "fixing" only one possible area of collapse in the upper airway does not usually effectively treat OSA in the long term for anyone, since negative pressure from narrowing and diaphragm movement simply causes the point(s) of collapse to then migrate to another location in the upper airway. The only possible exception to that is the removal of outright airway deformities, such as tumors.

That is why optimized PAP treatments are so successful--stabilization of the entire upper airway, not just one location.

So I personally consider AlaxoStent to be a bad design for implementing a flawed approach to a problem based on a misunderstanding held by makers who don't understand the subtle nature and progression of sleep-disordered breathing.

Medical research and experimentation are all well and good. Science requires we try stuff. But I say don't willingly allow people to trick you into putting weird stuff in your nose and throat without their paying you very handsomely to do so.

Hey, just me.

[chunkyfrog]

LOL
I second the feeling.

[imposterdroids]

Won't.

Air belongs in my nose and throat.

Other stuff don't.

It is well known that "fixing" only one possible area of collapse in the upper airway does not usually effectively treat OSA in the long term for anyone, since negative pressure from narrowing and diaphragm movement simply causes the point(s) of collapse to then migrate to another location in the upper airway. The only possible exception to that is the removal of outright airway deformities, such as tumors.

That is why optimized PAP treatments are so successful--stabilization of the entire upper airway, not just one location.

So I personally consider AlaxoStent to be a bad design for implementing a flawed approach to a problem based on a misunderstanding held by makers who don't understand the subtle nature and progression of sleep-disordered breathing.

Medical research and experimentation are all well and good. Science requires we try stuff. But I say don't willingly allow people to trick you into putting weird stuff in your nose and throat without their paying you very handsomely to do so.

Hey, just me.

Well and good when CPAP fixes the problem. But what do you suggest when people struggle with palatal prolapse, which CPAP doesn't seem to treat? What do you do when your sleep doctors are at a loss on how to treat you?

[lazarus]

As a self-optimizer of my therapy, it took a combination of simultaneous (1) mandibular advancement, (2) positional therapy [avoiding back-sleeping], (3) nasal mask [not FFM, but nasal pillows], along with (4) very careful pressure titration of PAP.

That combination allowed, over time, the swelling to heal in that area of the airway (as snoring and irritation were lessened) so that mandibular advancement and positional therapy eventually were no longer necessary for me, but it took many months.

The slight tendency is still there, of course, but sufficient pressure from nasal delivery of PAP is now sufficient alone for me to keep AHI below one most nights. Even during the day I can now recline fully supine for the dentist and dental hygienist without my airway closing on me.

I don't claim it will work for everyone. But effective long-term airway solutions for most require finding a way to continue PAP, in my opinion.

BTW, similar combination-approach findings have been observed for related outright epiglottis collapse too:

"Interestingly and unexpectedly, CPAP normalized PIF [peak inspiratory flow] and Vi [median inspiratory flow] in all patients regardless of its effect on the epiglottis. This finding challenges the notion that epiglottis collapse is a contra-indication for CPAP therapy. . . . Other treatment strategies that are known to be effective, such as oral appliances and positional interventions, should be considered as well in patients with primary epiglottis collapse."--https://respiratory-research.biomedcent ... 23-02452-z

I sincerely hope you find what works best for you for the best breathing and health long-term.

[SleepyCPAP]

I’m using the original version of the 6” stent. I got a replacement after 18 months of the first (and a broken strand), I guess just before their changeover.

I don’t know if I’ll like trying the newer nose/throat combo when the time comes. I’m open to the idea, but because I have PAP pressure as well as the stent I don’t feel a need for the nose part. If it annoys my nose, or reduces the flexibility of placement (I have a particular target area behind my soft palate that works best), then “new” won’t be “better”.

By the way, I keep my old stent in its box in the trunk of my car. Just in case I’m stranded someplace unexpectedly.

Sorry for the time lag in responding. My treatment is going so well, I’m rarely on the forum anymore.

- SleepyCPAP