Can Sleep Apnea be treated with a cannula alone?

[Pad A Cheek]

I ran across this article while surfing the web.

Perhaps this could help some folks. What do you think?


http://www.medpagetoday.com/Pulmonary/S ... rs/dh/6160

Karen

[Guest]

The study was partly supported by Seleon GmbH. Dr. Schneider receives consulting fees from Seleon and is entitled to royalty payments on the future sales of products described in the study. Co-author Alan R. Schwartz, M.D., of Johns Hopkins, also has financial links with Seleon.

I wonder how a person can get "qualified" to do these "studies"?
I think many of us should be able to get on some "gravy train" (research grants) if some of the studies I've read today are any indication of what's being put out for information (theories) these days.
ELEVEN subjects in that study? Oooooh I'm impressed!
About the time they blew WARM air up my nose, I'd be mouth-breathing because my nasal passages would swell shut.

And then......how are they or who is going to determine the patients' progress? (More sleep studies? "How do you feel?") We've got the same problem NOW......NOBODY......other than the patients themselves. (and we're being shut out of having access to the software to monitor our therapy)

Educate the medical profession and the caregivers first.

Den

[andyomega]

The study was partly supported by Seleon GmbH. Dr. Schneider receives consulting fees from Seleon and is entitled to royalty payments on the future sales of products described in the study. Co-author Alan R. Schwartz, M.D., of Johns Hopkins, also has financial links with Seleon.

I wonder how a person can get "qualified" to do these "studies"?
I think many of us should be able to get on some "gravy train" (research grants) if some of the studies I've read today are any indication of what's being put out for information (theories) these days.
ELEVEN subjects in that study? Oooooh I'm impressed!
About the time they blew WARM air up my nose, I'd be mouth-breathing because my nasal passages would swell shut.

And then......how are they or who is going to determine the patients' progress? (More sleep studies? "How do you feel?") We've got the same problem NOW......NOBODY......other than the patients themselves. (and we're being shut out of having access to the software to monitor our therapy)

Educate the medical profession and the caregivers first.

Den

I agree !

[Slinky]

Well the article I read on this cannula bit it only reduced the apneas (or the AHI ??) to 10 per hour from the 50s and higher. Whoopeee. 10 per hour still "ain't" good enough. Back to the drawing board, guys!

[split_city]

I think many of us should be able to get on some "gravy train" (research grants) if some of the studies I've read today are any indication of what's being put out for information (theories) these days.

These are just theories. Sometimes you need to think outside the square when it comes to research

ELEVEN subjects in that study? Oooooh I'm impressed!

They stated this was a 'proof of concept' study. Why recruit 100s of subjects and waste heaps of money on something that may not work?

They went on to say:

"While the finding is promising, they said, it still requires further clinical testing. Dr. Schneider said a larger clinical trial is currently under way in Germany and another is planned for the U.S."

[split_city]

Well the article I read on this cannula bit it only reduced the apneas (or the AHI ??) to 10 per hour from the 50s and higher. Whoopeee. 10 per hour still "ain't" good enough. Back to the drawing board, guys!

It's a start. I'm sure the intital CPAP trials didn't get rid of OSA.

A drop from 50 to 10 would be classified as a 'success' by many ENT surgeons

[ZZZCPAPZZZ]

I belive I read the the drop to 10 was only in 4 of the 11 subjects. That is less then 50 percent how can it be even remotely considered a success.

[split_city]

I belive I read the the drop to 10 was only in 4 of the 11 subjects. That is less then 50 percent how can it be even remotely considered a success.

Reduced the apnea-hypopnea index to fewer than 10 events per hour in eight of 11 volunteers

It was a 'proof of concept' idea. The results aren't conclusive enough to say it's a 'success,' but it probably was good enough to go on to conducting a larger trial. Let's just wait and see what the full trial brings to the table.

[birdshell]

<snip>
ELEVEN subjects in that study? Oooooh I'm impressed!
About the time they blew WARM air up my nose, I'd be mouth-breathing because my nasal passages would swell shut.

And then......how are they or who is going to determine the patients' progress? (More sleep studies? "How do you feel?") We've got the same problem NOW......NOBODY......other than the patients themselves. (and we're being shut out of having access to the software to monitor our therapy)

Educate the medical profession and the caregivers first.

Den

Den, I understand your comments and concerns. You make many good points, as usual. A small number of participants and the method of determining effectiveness are pretty serious; plus, researchers with a financial interest in the outcome are rather suspect, aren't they?

However, I would like to point out 2 things about research studies, remembering it has been about 10 years since my last stats class:

1. There are legitimate studies done with small numbers of subjects using APPROPRIATE statistical methods--it depends on the design of the study. Even a very large study has a tiny chance of being inaccurate, but is better than a small number;

and

2. This was a pilot, or proof-of-concept, study: meaning, the concept has merit for conducting a full-out study, which is currently being done in Germany and is planned for the US.

So, that study is merely a speculation that there MIGHT be a possibility of using the canula instead of the whole mask. It really doesn't make much sense to me, either, that this could work. As Slinky has said:

... it only reduced the apneas (or the AHI ??) to 10 per hour from the 50s and higher. Whoopeee. 10 per hour still "ain't" good enough.

BTW, doesn't Dr. Sullivan (inventor of the flow generator) own a significant part of ResMed? Maybe I am mistaken, but it seems that I read that somewhere. That was around the time when ResMed dramatically elevated the price of its products sold via Internet companies.

However, my memory isn't always reliable.

That said, I'm not exactly sure that the medical community can afford to do research studies without the support of some of the drug or medical equipment, etc., companies. We do have some people who know more than I about medicine and research--are you all more aware of the realities of medical research?

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, AHI

[split_city]

1. There are legitimate studies done with small numbers of subjects using APPROPRIATE statistical methods--it depends on the design of the design of the study. Even a very large study has a tiny chance of being inaccurate, but is better than a small number;

This is common in my field. A majority of our (physiology-type) studies generally only require between 12-15 subjects based on sample size calculations. On the otherhand, clinical trial-type studies require a lot more subjects.

[Goofproof]

I belive I read the the drop to 10 was only in 4 of the 11 subjects. That is less then 50 percent how can it be even remotely considered a success.

Reduced the apnea-hypopnea index to fewer than 10 events per hour in eight of 11 volunteers

It was a 'proof of concept' idea. The results aren't conclusive enough to say it's a 'success,' but it probably was good enough to go on to conducting a larger trial. Let's just wait and see what the full trial brings to the table.

Maybe if they had learned to tape, the success rate would have been higher. First you must learn about the problem, then apply a solution. Jim

[Slinky]

... BTW, doesn't Dr. Sullivan (inventor of the flow generator) own a significant part of ResMed? Maybe I am mistaken, but it seems that I read that somewhere. That was around the time when ResMed dramatically elevated the price of its products sold via Internet companies.

However, my memory isn't always reliable.

You read it about the time all the pooh hit the fan about Resmed's new pricing and software sales policy. BUT - the business relationship between Resmed and Dr Sullivan .... DSM can best clarify that as it was info (posted at his site, I think) he provided about his "tour" of the Resmed facility in Oz. I don't think you are remembering it correctly - but my memory is too vague to swear on that.

I read just a couple of years ago that the US government spends less of its GNP on health/medical research than any other of the industrialized nations. I don't expect that anything has changed in the last 10 years ago and 10 years ago there had not been ANY independent (of food manufacturers) nutritional research done since 1948!

And did you read just within the last month that our Supreme Court has just voted 5-4 to allow manufacturers to set minimum prices?

[dsm]

<snip>
BTW, doesn't Dr. Sullivan (inventor of the flow generator) own a significant part of ResMed? Maybe I am mistaken, but it seems that I read that somewhere. That was around the time when ResMed dramatically elevated the price of its products sold via Internet companies.

However, my memory isn't always reliable.

<snip>

Birdshell,

The founder of Resmed went to Colin Sullivan while working with another medical field company. He talk Sullivan into letting them have a go at commercializing his invention. The company involved wasn't really committed so this person founded Resmed & is today their CEO. I would only guess that Sullivan has and always did have, shares in Resmed. Also I have been told by a few people who I asked (Respiratory Surgeon who worked with Sullivan & a Resmed RT) if Sullivan did any work for Resmed these days & both said they believe not.

DSM

[birdshell]

Thank you, DSM. I had no desire to make Dr. Sullivan seem to be a mercenary inventor, just to point out that this may happen when one is a pioneer and believes strongly in an idea.

If I offended Dr. Sullivan or ResMed, I apologize. I also apologize to any Aussie members of the forum, anyone who has done or is doing research on apnea and its treatment, and all who have been affected by this information.

OK, that last paragraph was a bit tongue-in-cheek toward the end, but I think you all get the gist. We are all benefited by the participation of our Forum Folk from around the world. Thanks to all of you.

____________________________

Warning: Off Topic (OT)

BTW, where is blarg these days, since moving to Oz? (Oz=nickname for Australia.

[rem700pss]

There is a point - but you have to know the details or else the point is pointless - so read on or skip this one but its back on topic of canula delivery.

It took me over 3 weeks to get booked for an "IN HOUSE" sleep study after the "AT HOME" study kaiser did showed 140+ events per night and 70% SPO2 saturation. My primary care doc got the results and immediately re-enrolled me in the "IN HOUSE" study so medicare would pay for the equipment which took quite a while as they only have 4 beds. At the same time he did not like the 70% SPO2 at all. I read around on the internet and the only reference I could find to 70-80% SPO2 is that cadavers for organ harvesting should be kept on a respirator and not allowed to drop below 79% SPO2 until everything of value is gone. How comforting this was to know I was sleeping with less O2 than dead people.

So given that he WAS an MD but not a respiratory therapist and COULD Rx O2 but not the CPAP for Medicare, he Rx'ed an O2 generator and tanks until I got my cpap machine setup so he would not loose a patient in the meantime. I used a canula to deliver the O2 (96% 4LPM) I got the O2 system in 4 hours from his phone call.

I also wanted some sort of alarm in case something broke during the night (I have a german shepherd who sleeps in my room). I found a good deal on ebay for a used Nellcor 595 pulse oximeter which graphs your SPO2 all night in 5 second increments. I was dropping down into the 70's w/o anything (when the oximeter alarms very loud to wake you). With the O2 I was pegged at 100%, so even if I stopped breathing I'd still be saturated above 90 for a while (and way above 70).

Well now I have the Vantage S8. I still put the finger clip on and set the alarm for anything under 90% which is recommended. It's alarmed a couple times when I knocked my nasal pillows off and the Nellcor will wake the dead in that case. It also graphs my pulse so I can see how much dreaming I am doing.

Now the point - I've used both O2 by oxygen generator and canula and from cpap - both of them peg my SPO2 at 100% saturation if everything works all night long. I'm running about 6.4 cm pressure after it settles. It makes me wonder if people who can't stand the cpap (81st day now for me with it and I tolerate it fine) would benefit from the O2 canula system.

Has anyone known about this alternative - they seem identical in the Nellcor plots of night activity from the finger clip. (you get detailed heart rate and SPO2 down to 4-5 seconds of resolution all night long stored for 48 hours and graphed on the display)

Rem700Pss[/img]