I’m using AlaxoStent with PAP therapy for Palatal Prolapse

[SleepyCPAP]

Hi all,

I’m on my second night of using my 6” AlaxoStent, added to my VAuto therapy. Yes, it can work!

This thread is so folks can ask about my use of the stent, etc.

Last night I had 0.0 AHI.
Last night, with the stent, there was no Palatal Prolapse!* That hasn’t happened since the Palatal Prolapse started. That’s amazing.

*Before the stent, expiratory Palatal Prolapse was messing with the rest of my breathing at night even at low AHI (Palatal Prolapse appeared in my CPAP, APAP and VAuto OSCAR results since summertime). PAP alone was treating Flow Limitations, and should have eliminated apneas except for my Palatal Prolapse leading to apneas. Worst night this month (before AlaxoStent) was 11.75 AHI - all during Palatal Prolapse. Even on a good AHI night I could see the Palatal Prolapse waveforms (before stent arrived), they just hadn’t become scored events on the machine.


Here is the closest I came to Palatal Prolapse breathing with the stent in place:

AlaxoStent seems to have prevented Palatal Prolapse

Stent preventing Palatal Prolapse 2021-12-17.png (211.64 KiB) Viewed 10652 times

[ChicagoGranny]

1. Which country?

2. Which mask?

3. Without the stent, did you ever try higher pressures with less PS?

4. Do you think the use of CPAP is necessary when the stent is used?

[SleepyCPAP]

Hi ChicagoGranny,

I’m in the USA.

I’m using the Bleep Mask with Bleep Dreamports stuck to my nose. Extra tape (I’m using KT brand tape) helps, as the end of the stent comes out of the nose and has to be affixed to the upper lip or cheek, creating a place of potential leak at the nostril. I had no leaks last night, and only minor ones the first night (disturbing noises sometimes, but didn’t register on the VAuto or OSCAR).

I have tried many different pressures and PAP modes. Before the Palatal Prolapse began this summer I was doing just fine on straight CPAP 10cm with nasal pillows (PRS1 450 or 460 machines, now recalled) and no CFlex (my sleep study said 11cm, but that was before I switched to nasal pillows which needed less). Then I got a replacement ResMed machine and tried APAP and APAP “for Her” modes in various ranges. At first I had no EPR, but then tried 1, 2, and finally stayed on 3 EPR. Then got a suggestion to try straight CPAP again, 8, 9, 10, 11 and 12 cm. Palatal Prolapse was not affected by pressure, it just happens. Sometimes it seemed EPR might make it worse, but then not. Then I switched to VAuto, mostly 4 or 4.4 PS to eliminate flow limitations, and narrow range of pressure (EPAP 6 or 6.4 minimum, set to be near my old CPAP pressure when PS is added).

Maybe use of PAP isn’t needed for other people using the stent, but YES, I believe PAP is still required for _me_ to eliminate flow limitations and opening the rest of my airway consistently. I may need to re-titrate once I’ve had longer experience with the AlaxoStent - at the moment my nose fills the whole stent with gooey mucus all night, so it is taking up some of the airway. Maybe that mucus will go away in time, and I’ll see pressure needs reduced. The main study that the company quotes gives the impression that PAP therapy is still the gold standard, and the stent doesn’t cut out all AHI events for people. They imply AlaxoStent is great for people who have failed or can’t tolerate PAP - that’s not me. I’ve been masking up for 11 years now, usually averaging <1 AHI, but PAP doesn’t fix this new-since-summer expiratory Palatal Prolapse which leads to its own apneas. So I figure combining the two is the best in my case.

[ChicagoGranny]

Maybe use of PAP isn’t needed for other people using the stent, but YES, I believe PAP is still required for _me_ to eliminate flow limitations and opening the rest of my airway consistently.

I do fine with CPAP. For a long time, I have thought it would be nice to have a stent for

1) 15-minute afternoon naps and

2) emergency backup in case of CPAP failure while traveling.

Which size stent is typical for an average person?

[SleepyCPAP]

Hi Chicago Granny,

I might try it for naps down the line, or napping in the passenger seat on long rides, or on a plane. First I want to get used to good results combined with PAP at nighttime, and maybe someday put my VAuto on 3cm and see how much is treated (as close to nothing as possible, but still reading breaths).

They make 2” and 3” versions for people who just have nasal constriction and no narrowing at the palate. Then it jumps to the 6” stent for those like me who have to deal with the palate, or even placing it to go behind the tongue. I figure I don’t need all that length, but that just means I have more hanging out my nose.

Here is a picture from an online article showing two placement positions

AlaxoStent 6” with two placement positions

4EDC75EA-7C02-4EEF-8F13-F6252B768542.jpeg (49.88 KiB) Viewed 10617 times

[ChicagoGranny]

maybe someday put my VAuto on 3cm

The accepted way to do this is to drop it down 1.0 cm each night and check for good results the next day. Maybe that is what you planned.

napping in the passenger seat

Good idea. You might want to avoid doing this in the driver's seat.

[SummerTime]

Good idea. You might want to avoid doing this in the driver's seat.

Why? It's worth at least trying.

[SleepyCPAP]

Another night of Zero AHI and no Palatal Prolapse with the AlaxoStent and my VAuto.

As far as being in the driver seat… 11 years ago I was so desperate to get treated, before my sleep study, before titration, before finally getting a machine (from August when I told my doctor about my apnea at night, to late November when a machine was in my hands). I was so sleepy in the daytime, I was turning up the radio with my CD player on repeat to an upbeat song that would keep me alert. Ugh. Sooo much better after CPAP.

ChicagoGranny, when you say go down 1cm at a time, I’m assuming you mean to figure out the new pressure levels (titration). When I said 3cm I was thinking “Finding baseline AHI without PAP, just stent” (like a sleep study).

[SleepyCPAP]

Wow. I’ve never had a perfect “10” score on my O2Ring software before.
Using the AlexoStent along with PAP therapy is really working. Palatal Prolapse is vanquished!
I’ve posted this on another forum too.

4th Night of 6” AlaxoStent combined with VAuto & Bleep mask

876124BE-05FA-4AFF-B9CF-B4FB194D3767.jpeg (74.35 KiB) Viewed 10526 times

[palerider]

, added to my VAuto therapy.

You really should change your avatar

[SleepyCPAP]

, added to my VAuto therapy.

You really should change your avatar

I’m pretty sure my avatar is (and always has been) a snapshot of my very first PRS1 450 (generation 1) from 2010. It wasn’t in my possession for very long, due to noise, and got warrantee replaced with what Pugsy nicknamed “the anniversary edition” (which had a backlit screen and other features). I notice the photo had the old style sparkling clear humidifier tank too, which was later tested and found to have those bad chemicals in it (so the smoked/grayish ones came out later). I like the photo it because it reminds me of how much relief I experienced when I started dealing with my obstructive sleep apnea.

[chunkyfrog]

When you mention KT tape, I presume you mean the cotton tape,
as opposed to the polyester "PRO" tape, which could damage skin
if removed within 24 hours.

[SleepyCPAP]

When you mention KT tape, I presume you mean the cotton tape,
as opposed to the polyester "PRO" tape, which could damage skin
if removed within 24 hours.

Yes, I looked at the box. It says “Original” and the comparison chart on the back says original is all-natural cotton. The tape holds well, and is breathable for skin (and tiny lip leaks, which is why I use a Poligrip strip between my lips, and blue tape over the KT Tape). I’ve also used “Hampton Adams Premium Kinesiology Tape” which is similar cotton, but holds the blue tape better than KT Tape. Hampton is cheaper online than KT is in my pharmacy, but it had a tendency to pull at my skin as I removed it (mostly taking the scabs off of razor cuts, and leaving me vulnerable to more) so I’m not sad about switching to KT.

The box says 1-3 days of wear, and that “Pro” KT Tape is 4-7 days. I wouldn’t wear the tape on me for more than overnight anyway. “Pro” is supposed to be water resistant, but drool doesn’t dislodge the “original”, it just soaks through and unsticks the blue painters tape.

[chunkyfrog]

I found the best price for KT tape is in sporting goods at Walmart,
Pharmacies are way more spendy.

[SleepyCPAP]

I do fine with CPAP. For a long time, I have thought it would be nice to have a stent for

1) 15-minute afternoon naps

ChicagoGranny,
I tried it for a two hour nap, just the stent without masking up for PAP, and my O2Ring said I had only five brief and slight (less than 4%) SpO2 desaturations, none lower than 93%. I figure that means some RERAs or brief Hypopneas, but otherwise well controlled sleep apnea. My sleep study was 33 AHI so I haven’t wanted to sleep without PAP therapy, even naps, but I think this AlaxoStent can be a good alternative for naps.

- SleepyCPAP