New Technology Could Replace CPAP For Some

[feeling_better]

OK, I will bite! Beneath all the facade, this is what one is supposed to read: This has been approved for clinical trial by FDA. If it passed phase I, then that means it did not kill any participants and they did not have any serious side effects like trees growing thru the nostrils after the trial. Usually phase I is just for testing very bad side effects, not effectiveness.

I predict they would compare in this study this device against other 'nasal keep open' devices.

Some portion of obstructive sleep apneas are indeed caused by the obstruction just in the nasal area. For these people, during inhaling, the nose closes even though they may not have any problem with obstruction in the throat area at the beginning. But as the nose closes, and the vacuum builds up, the deeper airways would close. After the fact now I know that with my AHI of 30 before treatment, the cause was primarily nasal. I had allergies (had not realized how bad it was all these years), and the claritin, sudafed, and fluticasone propionate nasal sprays I used regularly every night all thru my 9 mo. of cpap use have cleared up / enlarged my nasal passages so much, I breath much better now. That is why I have ahi ~1.5 with pressure 4.2cm average thru the whole night. The steadily kept open nasal passages with cpap, also keeps it that way now.

I had found out that during the few weeks I was waiting for the cpap machine, a special nasal clip I designed, which had a better pull out than the commercial one, almost got rid of my snoring completely! The device here is a tube like thing inserted in the nose, instead of a strip on the outside pulling the wall open.

Here is my fictional future outcome: Barring other problems, this probably will be marginally more effective than nasal clips. If the indications of the past few years where 0% to 2% more effective drugs which cost 20 to 100 times more got approved all the time, they would get this one approved too; and some doctors would certify it (later some investigative reporters would allege that they had major income thru this company directly or indirectly), and it would become yet another marginally more effective, but practically useless device. They would price it at about the same or higher annualized cost of cpap use, for this special disposable item they provide. Eventually this would be another dud. Remember the pet rock too was sold, rather successfully.

BTW, if they try two soft tubes (slightly larger in diameter than straws) inserted in, they would be more effective!! But it would not be an easy sell.

So that is my predictive evaluation of this product. In a few years we will find out

[WearyOne]

<snip> Some portion of obstructive sleep apneas are indeed caused by the obstruction just in the nasal area. For these people, during inhaling, the nose closes even though they may not have any problem with obstruction in the throat area at the beginning. But as the nose closes, and the vacuum builds up, the deeper airways would close. After the fact now I know that with my AHI of 30 before treatment, the cause was primarily nasal. I had allergies (had not realized how bad it was all these years), and the claritin, sudafed, and fluticasone propionate nasal sprays I used regularly every night all thru my 9 mo. of cpap use have cleared up / enlarged my nasal passages so much, I breath much better now. That is why I have ahi ~1.5 with pressure 4.2cm average thru the whole night. The steadily kept open nasal passages with cpap, also keeps it that way now.

I had found out that during the few weeks I was waiting for the cpap machine, a special nasal clip I designed, which had a better pull out than the commercial one, almost got rid of my snoring completely! The device here is a tube like thing inserted in the nose, instead of a strip on the outside pulling the wall open.

I didn't realize the OSA could start in the nose for some people. I was wondering how in the world this device could be helpful when everything I had ever seen showed the obstruction as occurring in the throat. Breath Right strips do nothing for me. I could wear two of them and still wake up with at least one side of my nose completely closed. My steroid spray would probably help, if I could get in the habit of using it every day. (I know they don't work unless you use they every day.)

Hey, got blueprints on the nasal clip you created. I thought about straws, but the plastic is kinda hard on the inside of the nose. (And not as a substitute for cpap.)

Pam

[san_fran_gal]

My doctor gave me a few samples of the Provent product several weeks ago. I was excited, thinking this might be the answer to my not-having-to-do-CPAP prayers. Well, instead of Provent, I now call it Prevent -- as in, it prevents you from breathing because you can't exhale! At least I couldn't. Inhaling is a piece of cake. But it would take a very long time and lots of effort to fully exhale, and toward the end of each breath I kind of opened my mouth to catch my breath. It felt like someone was plugging up my nose and barely letting any air escape. I thought maybe I just have weak nose power or something, so took them off and put the center of one in my lips and inhaled nicely, and once again, was met with tremendous pressure on the exhale.

I really wanted to like this product. But it made my CPAP look good, and to a newbie who was having problems adjusting, that's saying something. I hope it works better for other people, because it sure would be a simple and portable solution.

[miggity]

i'd like to try it myself to see whether this new technology would work for me, but my doctor has never heard of it --- guess it's too new/experimental... any idea how i can get it online or elsewhere?

[san_fran_gal]

Miggity, I threw away the little instruction pamphlet that came with the samples, and there's not much online about it. But on the packet of my remaining sample it says it's manufactured for Ventus Medical, Inc, in Belmont, CA. Here's a website I found for them: http://www.ventusmedical.com/company/contact.html. Hope that helps.

[sepool]

It sounds to me like little pressure regulators in the nostrils - one you are "pressured up", it should feel like straight CPAP on exhale with absolutely NO exhale relief. I wonder how many breaths it takes to pressure up - shouldn't be too many, but it sure would feel weird. And I'd worry about the restrictions in general - see how the trial forbade anyone with stuffy nostrils (even one)?

[DreamStalker]

This new gadget sounds like one of those nifty nose hair trimmers made in China

[Needsdecaf]

Rather vague, but this gives the general idea: http://www.fda.gov/cdrh/pdf7/K071560.pdf

Hard to believe this wouldn't impact O2/CO2 balance in a bad way, but I'm sure we'll learn more later.

That was my thought exactly.

In order to act as a "splint" for holding airways open you have to utilize the pressure of exhaled air.

Exhaled air contains lots of CO2, not much O2.

Sounds like several people earlier in the post have figured out the way that it MUST work...must trap some of the exhaling air, thus having your lungs force the airway open.

What I want to know is:

1) What does this do to your O2 / CO2 balance.

2) How does this differ from, say, a stuffy nose? Having just gone through a week long cold, I can say that my nasal interfaces were quite useless, and that sleeping sans cpap with a cold just forces air out your mouth. It certainly does NOT keep your airway open, as evidenced by my wife's observations about snoring, snorting and breathing cessation throughout the night.

I'd love to say that I thought it could work....but I can't.

[-SWS]

I think I agree with jnk's and sepol's take on this device.

Normally when we exhale the lungs (especially) and upper airway deflate. For those who experience apneas, that upper airway deflation at the very end of expiration is where the problem occurs. So when adequate "back pressure" is applied throughout exhalation only, that "back pressure" keeps the upper airway from completely deflating. That's your "human powered" airway stent that covers those apneas most common at the end of expiration. Then the human inspiratory cycle begins, where the airway is naturally re-inflated as we breathe in.

I'm thinking that should theoretically work for easy-to-stent cases of apnea that are largely limited to expiratory end phase. However, I don't think this product can do anything for obstructive hypopneas and flow limitations that tend to plague the inspiratory phase of respiration. And, as the article mentions, the product won't be able to do anything for central events.

However, I don't suspect the slight CO2 skew would be problematic for purely obstructive etiologies. Homeostatic adaptation should handle that part well in my way of thinking---at least for purely obstructive patients.

[DreamStalker]

... snip ...
I'd love to say that I thought it could work....but I can't.

That was my thought exactly re: OSA treatment ... but if they put tiny blades that spin upon exhalation pressure, they could keep the nose hairs trimmed.

[Needsdecaf]

I think I agree with jnk's and sepol's take on this device.

Normally when we exhale the lungs (especially) and upper airway deflate. For those who experience apneas, that upper airway deflation at the very end of expiration is where the problem occurs. So when adequate "back pressure" is applied throughout exhalation only, that "back pressure" keeps the upper airway from completely deflating. That's your "human powered" airway stent that covers those apneas most common at the end of expiration. Then the human inspiratory cycle begins, where the airway is naturally re-inflated as we breathe in.

.

Except that problem of breathing out is going to cause to you to naturally open your mouth.

And there goes all your "back pressure".

As I said above, no different than sleeping with a moderately to severe clogged sinus. And that sure doesn't help.

[-SWS]

Except that problem of breathing out is going to cause to you to naturally open your mouth.

And there goes all your "back pressure".

As I said above, no different than sleeping with a moderately to severe clogged sinus. And that sure doesn't help.

I'm not so sure that physiologic assessment will be universal, Needsdecaf. Those two restrictions are not identical after all.

Clogged sinuses restrict inspiration and expiration. Inspiration, is where mouths tend to drop in order to get that next breath of air in. This medical device is not restricting inspiration. Now let's perform a litmus test of logic on whether this device will cause everyone to open their mouths during moments of exhalation back-pressure. If it were universal that everyone would open their mouths to that pressure, then the statement would stand true that PAP-provided pressure during exhalation causes every mouth to open as well. Doesn't always happen. Right? On that basis I don't see how back-pressure provided during exhalation will cause everyone's mouths to open. I agree it's a caveat for some, however. So add that to the already-substantial list of other caveats.

[Needsdecaf]

I'm not so sure that physiologic assessment will be universal, Needsdecaf. Those two restrictions are not identical after all.

Clogged sinuses restrict inspiration and expiration. Inspiration, is where mouths tend to drop in order to get that next breath of air in. This medical device is not restricting inspiration. Now let's perform a litmus test of logic on whether this device will cause everyone to open their mouths during moments of exhalation back-pressure. If it were universal that everyone would open their mouths to that pressure, then the statement would stand true that PAP-provided pressure during exhalation causes every mouth to open as well. Doesn't always happen. Right? On that basis I don't see how back-pressure provided during exhalation will cause everyone's mouths to open. I agree it's a caveat for some, however. So add that to the already-substantial list of other caveats.

I will accept that for those people who can use nasal only masks without mouth breathing or leaking while not running exhalation relief or APAP. If you can do that, this device may work for you.

[jnk]

If they work at all, and are dirt cheap, they might come in more handy than a battery in a longterm power outage or something. Might be good to put a pair in your go-bag.

[DreamStalker]

I'm not so sure that physiologic assessment will be universal, Needsdecaf. Those two restrictions are not identical after all.

Clogged sinuses restrict inspiration and expiration. Inspiration, is where mouths tend to drop in order to get that next breath of air in. This medical device is not restricting inspiration. Now let's perform a litmus test of logic on whether this device will cause everyone to open their mouths during moments of exhalation back-pressure. If it were universal that everyone would open their mouths to that pressure, then the statement would stand true that PAP-provided pressure during exhalation causes every mouth to open as well. Doesn't always happen. Right? On that basis I don't see how back-pressure provided during exhalation will cause everyone's mouths to open. I agree it's a caveat for some, however. So add that to the already-substantial list of other caveats.

I will accept that for those people who can use nasal only masks without mouth breathing or leaking while not running exhalation relief or APAP. If you can do that, this device may work for you.

Hey ... I fit that description completely. How do I become a trial patient?