Provent Nasal Apnea treatment

[Mary Z]

Does anyone have any feedback about this device, whether first hand or through a friend? I have been unable to find any end user reviews of the product.
To find out more about it, just google Provent Sleep Apnea Device or something similar. Basically as I understand it, air on exhalation through the nose is restricted,
keeping the pressure in the upper airway positive and the airway open. It is prescription only and costs about $150/month.
I have written to them to ask if they would consider a one week trial package. If you tolerated it, seems like a good product for when the power goes out, or for camping.
Personally I can't imagine making it hard to breathe out of my nose.
Mary Z.

[jdm2857]

Ask them for any scientific clinical studies on the device. Not just anecdotal evidence. Without them, its snake oil.

[KC5cychris]

Mary

I saw this on the day time show Doctors, they talked about it feeling restrictive on exhale. But did not have any clinical proof one way or the other if it worked

[chunkyfrog]

No clinical data, no specs, equals voodoo, doo doo, or something similar.
Media coverage being substituted for good science.
Same tactic used by a couple of heavily advertised hearing aid companies that are about 20 years behind the ones people actually wear.
Consumers, like sheep being led to--aww, that's just WRONG.

[SleepingUgly]

One doc said that ~20% can benefit from it (in what way, I don't know). I would worry that if it's restrictive on exhale, it might cause mouth opening. But it's low risk, so I'd consider trying it.

[roster]

No clinical data, no specs, equals voodoo, doo doo, or something similar.
Media coverage being substituted for good science.
Same tactic used by a couple of heavily advertised hearing aid companies that are about 20 years behind the ones people actually wear.
Consumers, like sheep being led to--aww, that's just WRONG.

A good summary of the clinical results is posted on the Provent website.

http://www.proventtherapy.com/pdfs/pdf0 ... ctions.pdf

[Mary Z]

After looking at their clinical trial data, with an IPAP of 24 and an EPAP of 20 I still haven't reached under 5 AHIs/hr average during the night (machine LED data only), I'm going to ask my sleep doc about trying the provent with my mask for the ten day trial. Rooster, am I correct is assuming the Provent provides a pressure of 8 cm water?
I don't know if I gave contact information here. But your doc needs to call Debbie Heller for their special prescription form. Her phone# is 1-888-757-9355, option 2. A 10 night trial pack is about $15.00.
It costs about $150.00/month with discounts for orders of multiple months. Not covered by insurance. They have an expired rebate form on their site, but since it's still up there, perhaps they could be convinced to honor it (hate those expired rebate forms).
Thanks for the clinical data, Rooster.

[roster]

Rooster, am I correct is assuming the Provent provides a pressure of 8 cm water?

Mary, I don't see that on their website. It does say, "PROVENT Therapy is offered in two expiratory resistances to accommodate varying patient preferences."

I have no complaints against Provent. If it can bring the severity of sleep apnea down to a very low level for some patients, then they deserve accolades. However, I have to chuckle at their marketing guys who write the script for their literature:

Total sleep time, sleep efficiency and duration of the apneas were not significantly different, indicating that the PROVENT Nasal Device did not worsen sleep parameters and did not extend apnea duration.

The way to read this is there was no improvement in total sleep time, sleep efficiency and duration of apneas. So marketing writes, "If it does no harm, it is a good product."

[Mary Z]

Well, isn't the first rule of medicine "First do no harm"? Though it would harm the pocket book. The TNI device- transnasal insuflation, 20/L/min compressed, heated, humidified air via a nasal cannula type device sounds more interesting, though it's not available in the USA, and I haven't seen mention of any clinical trial except one with 11 subjects at Johns Hopkins in 2007.

Provent mentions using devices "with an 80 cm H20/sec/L expiratory resistance" (n=26), (I don't know how I translated that to a pressure of 8 except the difference in L and ml.)
and n= 32 using devices of 50 and 80.

[roster]

If you look at the Pressure vs. Flow Rate graph in the Patient Instructions PDF, you can see the resistance pressure of the Provent ranges from about 5 to 15 cm H2O depending on the flow rate.

[torontoCPAPguy]

So what's the difference between this stuff and just spraying your nose with Afrin in the morning and waiting for the rebound?

[roster]

In case you are not joking,

With severe congestion (rebound or otherwise) it takes extra pressure to breathe in or out through the nasal passages.

With the Provent device, additional pressure is not needed for inhalation through the nose.

[jdm2857]

I took a look at the studies and at their information for physicians. The device did reduce AHI and desaturations, but to a limited degree.

The website defines "significant improvement" as AHI reduced to < 10 or by greater than 50%. That's quite different from the medical standard of AHI < 5.

[roster]

So Jeff, You are criticizing the Provent studies because the "medical standard" is much higher?

How do you judge this part of the "medical standard":

CPAP compliance is often defined as using the therapy for an average of 4 hours a night for at least 70% of the nights. Studies show that somewhere between 29% and 83% of patients do not meet the criteria for compliance due to removing the CPAP early in the night and/or skipping use altogether.

http://www.sleepreviewmag.com/issues/ar ... -10_01.asp

If you do some math, that first statement means you only have to use the CPAP on average 2.8 hours per night (4 hours x 70%).

Then you have the second statement which says 29% to 83% of patients don't even use it 2.8 hours per night.

This makes the use of CPAP to treat sleep apnea look like an abysmal failure.

You and I may be aggressive in our CPAP therapy, but the great majority of patients are far from it.

[jdm2857]

Those stats on CPAP compliance are pretty dismal.

But Provent appears to offer few users the ability to really get their AHI down, regardless of how compliant they are.

Do you know if there are any studies on the health benefit of lowering AHI from say 60 to 30? Does dropping arousals from once a minute to once every two minutes benefit the patient. It's still pretty disrupted sleep.