Alternatives to PAP therapy

[chunkyfrog]

When large amounts of money are present, expect those only interested in money to be involved.

[jnk...]

The best treatment for obstructive sleep apnea is a system known as continuous positive airflow pressure (CPAP). . . . The American Academy of Sleep Medicine recommends dental devices for patients with mild-to-moderate obstructive sleep apnea who are not appropriate candidates for CPAP or who have not been helped by it. (CPAP should be used for patients with moderate-to-severe sleep apnea whenever possible.) . . . Few randomized clinical trials, the gold standard of medical research, have been conducted to verify the long-term efficacy of sleep apnea surgery. -- http://www.umm.edu/health/medical/repor ... leep-apnea

[Mogy]

Hi Josiah,
No one has mentioned weight loss. If you are overweight, studies have shown weight loss helps to reduce sleep apnea. Everyone is different, it is not a guarantee, but in my mind it is worth a shot.
Also, a study has shown that general weight training and cardio exercises also helps to reduce sleep apnea, even if you don't lose weight. Again, it is not a guarantee, but worth a shot IMO.
Both losing weight and exercise help with many other areas of health.
And last but maybe not the least, mouth, tongue and throat exercises. Or if they are too tedious, playing the didgeridoo.
I don't know much about your situation but I think you have moderate sleep apnea and are probably a good candidate for any of the alternative treatments, with the caveat that you should stay on xPAP till you are tested to show it is not needed.

[chunkyfrog]

I do not believe a "cure" exists, so I will keep on as I have for immediate results.

[Josiah]

The forum has spoken loud and clear and the answer is NO.

[jnk...]

The forum has spoken loud and clear and the answer is NO.

No to what?

. . . CPAP forum and not just and OSA forum . . .

I would like to believe that this place is about any subject related to sleep and that those not using PAP therapy are as welcome here as those who do.

. . . how often OSA sufferers have success with surgical or other alternatives to CPAP . . .

As has been stated, about 50% of those who use alternatives to PAP are able to have their AHI reduced by 50%. So for anyone who tries the gold-standard approach of PAP but is unwilling or unable to make it work, it is a real blessing to him that there are other approaches that have a possibility of helping him. The biggest problem with that, though, is related to your next question . . .

. . . who the best candidates are . . . ?

No one knows. It is a 50-50 coin toss, since no easy, workable criteria have yet been established. And that is compounded by the fact that alternatives, unlike PAP, tend to lose effectiveness over time. Which is a real shame, since there is no way to assess effectiveness of those approaches for a patient over time other than the hassle and expense of yearly NPSGs. Not to mention that some who get palate surgery, for example, may not be able to get effective treatment from APAP algorithms once the time comes that they have to go on PAP, since their flow curves may no longer provide standard indications of impending obstruction/narrowing.

[klv329]

Surgery, nah, but if you have the money you could try a hypoglossal nerve stimulator like Inspire for your obstructive apneas, and for your central apneas you could try a diaphragm pacemaker to stimulate your phenic nerves like an Avery Biomedical implant.

Your spouse could play with the remote controls, and you could acquire other fun devices. Just make sure the contol frequencies aren't the same as the remote control garage door openers in your neighborhood.

[Goofproof]

Surgery, nah, but if you have the money you could try a hypoglossal nerve stimulator like Inspire for your obstructive apneas, and for your central apneas you could try a diaphragm pacemaker to stimulate your phenic nerves like an Avery Biomedical implant.

Your spouse could play with the remote controls, and you could acquire other fun devices. Just make sure the contol frequencies aren't the same as the remote control garage door openers in your neighborhood.

And you don't have a de-fib or pacemaker! Jim

[Goofproof]

The forum has spoken loud and clear and the answer is NO.

No to what?

. . . CPAP forum and not just and OSA forum . . .

I would like to believe that this place is about any subject related to sleep and that those not using PAP therapy are as welcome here as those who do.

. . . how often OSA sufferers have success with surgical or other alternatives to CPAP . . .

As has been stated, about 50% of those who use alternatives to PAP are able to have their AHI reduced by 50%. So for anyone who tries the gold-standard approach of PAP but is unwilling or unable to make it work, it is a real blessing to him that there are other approaches that have a possibility of helping him. The biggest problem with that, though, is related to your next question . . .

. . . who the best candidates are . . . ?

No one knows. It is a 50-50 coin toss, since no easy, workable criteria have yet been established. And that is compounded by the fact that alternatives, unlike PAP, tend to lose effectiveness over time. Which is a real shame, since there is no way to assess effectiveness of those approaches for a patient over time other than the hassle and expense of yearly NPSGs. Not to mention that some who get palate surgery, for example, may not be able to get effective treatment from APAP algorithms once the time comes that they have to go on PAP, since their flow curves may no longer provide standard indications of impending obstruction/narrowing.

Wow, a whole 50% less chance of dying gasping in your sleep, I rather take a chance on a Indian Blanket. Jim

[klv329]

I use a custom mouth piece, periodically, a MAD, and it helps a little because i have a very narrow air passage way, but my obstructive apneas are lower in my throat where the muscles collapse when I'm asleep.

I am hoping the MAD will help keep my jaw steady when I try an FFM.

The nasal burn helped a little when it comes to using nasal pillows because it opened the canal a bit.

And of course I have breathing issues that only a resmed ASV can address.

I will be talking to a neurologist this week about other developing neurological issues, but I know there won't be any ready surgical remedies there either.