alternative therapy stories

[Ariseal]

So as a technologist I know what the official word is on alternative therapies than PAP therapy for OSA. However I would love to hear a personal accounting both good and bad from site members that have tried things beside PAP. Please feel free to include any details you wish and your thoughts on the issue as well.

[Pugsy]

The only alternative I have ever tried is sleeping upright as much as possible and that was only mainly for emergency use when power outage happened or the one time I went on a trip and forgot the long hose and couldn't use the machine.

Sleeping upright...not much help for me. I assume still have a truckload of apneas because I still snore so much that I wake myself up with the snores and snorts and woke up feeling like crap.

Never really had any need or desire to try the alternative. I am fortunate in that cpap came easily for me and I adapted easily enough. My OSA is much worse in REM...like 50 something per hour compared to 12 in non rem.
I knew that while an other method might get the non rem down to an acceptable level it wouldn't likely help enough in REM and in my case I was experiencing desats to the low 70s and I simply didn't want to risk it.
Supine sleeping not much of a factor..mainly its REM no matter what sleeping position I am in.

I have always thought that if I was going to try an alternative it would probably be some sort of oral device as first alternate trial. I always say that some therapy is better than no therapy even if it isn't ideal therapy.

This is a cpap help discussion forum. We don't have many people hanging around here that opted for one of the alternatives to cpap but we do have a few who have or maybe use one of the alternatives in conjunction with cpap.
It's not so much a help forum for other alternative treatments.

We do have several people who opted for some sort of surgery (either full UPPP or partial) and maybe it worked for a while but they are back here using cpap because the surgery either eventually failed or never really helped in the first place.

The only surgery I would ever consider would maybe be tonsil removal if the tonsils were big...mine aren't at all. In fact I essentially have no tonsils. They long ago atrophied to the point they are non existent. So that was never an option for me anyway.

[greatunclebill]

For me, it's CPAP or nothing. In the early days when i couldn't adjust to the old straight cpap brick or the m-series straight cpap and had a doc that said keep trying it was in fact nothing. then as a last resort after 10 years the doc reluctantly got me a 550 apap and it was still a struggle. A new more modern doc that would work with me got me the current s-10 and it works great with numbers very seldom above 5. I never once seriously considered the popular alternatives.

[jnk...]

I used an oral appliance to move my jaw forward immediately after my diagnostic NPSG, since I knew it would take weeks to get my titration appointment and then my PAP equipment. Then I continued using the OA in conjunction with PAP because I had been a lifelong mouth breather and the OA use trained me to keep my mouth closed during sleep. It took many months before I could sleep with my mouth closed without the OA, but once I could, I discontinued the OA. I consider the OA to have been instrumental in keeping me alive before PAP and in making my PAP use successful in the early months.

[Goofproof]

There are many alternative therapys for Sleep Apnea. They can be found in the Public Library, in the fiction section, most of the Authors are dead, it seem they drown in De-Nile. Jim

[Mogy]

Welcome Ariseal.
I have been using Weight Management, Tongue/Throat Exercise, and Cardio Exercise as my alternative therapy for OSA. I feel that using the 3 approaches will give me a better result than using just one. So far, so good.
I was diagnosed in Feb 2017 with moderate OSA, AHI of 19.5. The first week with my Resmed Autoset was not good. I had treatment emergent CSA and with my machine my sleep apnea was considerably worse than without. I was lucky in that my treatment emergent CSA settled down after about a month. I had already started on a weight reduction plan before my diagnosis so I continued with it. I continued using my APAP but I was non-compliant. Over the year that I used my machine I averaged 3.5 hrs per night.

Where I live it is common to use Level 3 Home Sleep Studies, and I was diagnosed using a Resmed Apnealink Air HST. Since then I have used it twice more(getting requisitions from my PCP and Pulmonologist). The first time in May 2017 was after I had lost about 30lbs and the Pulmonologist wanted to see how my oxygen levels were doing, they were very poor during the original study, but had improved a lot with the weight loss. My AHI was still at approx 15 so I found that a bit disappointing.

I did well with keeping the weight off for the remaining part of 2017, but my compliance with my APAP didn't really improve. I had been reading about other alternatives and decided in Jan to give the Myofunctional/Oropharnygeal exercises a go, along with upping my cardio workouts. After 3 months I decided I wanted to see how I was doing so got a requisition from my PCP at my yearly medical. The Apnealink Air now reported my AHI at approx 5, so this time I was pleasantly supprised. I used the HST over the weekend so that I was able to get a couple of nights with the tester.

What do you think about using the Apnealink Air HST in this fashion? I am using it to monitor how well my alternative therapy is working. Some posters here have told me that it is illogical and dangerous to use it and to post my results.
In this study about the accuracy of Level 3 portable devices as compared with level 1 sleep polysomnography they state in their conclusions:
"Level 3 sleep studies are safe and convenient for diagnosing obstructive sleep apnea in patients with a high pretest probability of moderate to severe forms of the condition without substantial comorbidities."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883848/

In your opinion, are Level 3 studies not to be used to monitor mild cases of OSA?

[Julie]

A couple of things you may run into out there are... playing the didgeroo (it may actually work, but only if you play it nonstop for months ), and using the Buteyko breathing exercises... proven to be a scam years ago, though questions about it still show up here on occasion.

[Okie bipap]

After my first sleep study around 1997, I opted for surgery in an attempt to treat my sleep apnea. Since I had a very badly deviated septum, I chose to consult with an ENT to see if surgery would help with my problem. After a thorough check by the doctor, he said I would probably do well with the surgery. I had a septoplasty, UPPP, and turbinate reduction. At the same time, he cleaned out all of the sinus cavities since I was having a slot of breathing problems during the day. This relieved my major symptoms for several years. I no longer snored and I did not wake up gasping for air. By 2014, I had started exhibiting the classic symptoms of sleep apnea. When I had a knee rep.laced, the nurses noted my blood oxygen was dropping quite low when I slept. The day I left the hospital, my doctor sent an oxygen concentrator to the house for me to use when sleeping. I used that for almost 10 months until I was finally able to get a machine. I was started with a bi-level machine with IPAP of 20 - 25 cm. My current pressure is 17 - 20 cm IPAP, but I seldom go over 17.5 cm.

[Ariseal]

Thank you everyone for your replies in this thread.

Clinically the analysis of alternative methods is not enough conclusive data. It works for some and not for others and the closest rule of thumb they have is the more severe your apnea the less likely alternative methods will get you off the cpap. They can help reduce the severity of the apnea sometimes but still no guarantee to get someone off Cpap. Pap therapy is still by far the most clinically trusted method to treat Apnea.

Concerning HST I am not a fan from a personal stand point. They are highly inaccurate and insurance companies constantly use them to screw people over. I couldn't say for sure how well their data compares to the diagnostic aspect of the cpap machines for home use themselves. Neither have a method to tell if you are awake or asleep. Concerning your use, if you feel it works for you then I am not an expert enough on the subject to tell you not to. I think that mild apnea could easily be inaccurate and mishandled when concerning an HST though.

[Pugsy]

Concerning HST I am not a fan from a personal stand point. They are highly inaccurate and insurance companies constantly use them to screw people over.

There is the type II HST that could be used that is more comprehensive than the others but it's not used as often because it costs more money. It does do EEG leads for sleep status and can be fairly accurate if a tech who knows his stuff is reading it. I don't know if it does limb electrodes (I forget) for evaluating possible PLMD issues.

[Mogy]

Concerning HST I am not a fan from a personal stand point. They are highly inaccurate and insurance companies constantly use them to screw people over.

There is the type II HST that could be used that is more comprehensive than the others but it's not used as often because it costs more money. It does do EEG leads for sleep status and can be fairly accurate if a tech who knows his stuff is reading it. I don't know if it does limb electrodes (I forget) for evaluating possible PLMD issues.

Shin Ryoku got a Level II sleep study done by this site:
http://axgsleepdiagnostics.com/product/ ... nattended/

It cost $459 but didn't include leg sensor for PLM.

[Jay Aitchsee]

So as a technologist I know what the official word is on alternative therapies than PAP therapy for OSA. However I would love to hear a personal accounting both good and bad from site members that have tried things beside PAP. Please feel free to include any details you wish and your thoughts on the issue as well.

Please see:
Mars-Given-OK-On-Positional-Sleep-Apnea-Therapy
N=1

[chunkyfrog]

In orthodontia, experts have finally identified unnecessary removal of healthy teeth as a contributing factor;
and have been investigating arch expansion as a strategy to PREVENT apnea.
A nice smile--WITHOUT lousy sleep. What a concept!

[Ariseal]

Yea that type two therapy does look to be pretty comprehensive just missing legs they even have EMG chin covered for teeth grinding. Seems kinda similar to a ambulatory eeg concept for sleep. That is a home study I would much rather see the insurance companies use than a type 3 HST. Also since it is actually staged and scored by a person instead of software reliant.