A new apnea patient's journey - starting with Provent

Gerald? wrote:If you can get the stickiness to work, it looks pretty good. Would you be able to post your Oximeter readings for both nights. I'm very curious as to how well Provent works.

Thanks.

I'll post the results from the sleep study when I get them tomorrow. I think this will be more helpful for everyone, especially to see it in comparison with the machine. I tend to think the machine won. BUT the Dr and I already discussed that if most of my events occured while I was on my back that a secondary use of either positional therapy or a fitted mouth appliance may do just as well as the machine, or that I may need one of these in addition to the machine.

The results will tell!

I abandoned Provent. I couldn't keep my mouth shut, even with a chinstrap, and the mouth openings were waking me. Considering it only works 50% of the time, it didn't seem worthwhile to continue banging my head against a wall trying to tolerate them (also the sleep aids I was using to help me tolerate them were giving me side effects). I am very jealous of anyone it works for, though. Boy, would it be nice to only wear stickers on my nose to bed.

SleepingUgly wrote:I abandoned Provent. I couldn't keep my mouth shut, even with a chinstrap, and the mouth openings were waking me. Considering it only works 50% of the time, it didn't seem worthwhile to continue banging my head against a wall trying to tolerate them (also the sleep aids I was using to help me tolerate them were giving me side effects). I am very jealous of anyone it works for, though. Boy, would it be nice to only wear stickers on my nose to bed.

Sleeping, I definitely admire how much you pushed through trying Provent as long as you did. The days without therapy SUCK. My doctor and I discussed that it appears when I sleep on my back my mouth is open. Based on the results of the previous study (and I get Provent results today!) we may add a mouth device or positional sleep therapy to the Provent. Do you know whether your mouth is open in general while sleeping or only when you were supine? I used my sleep study results, which included position, and the Snore App to isolate that the worst events occur when I am on my back. If I stayed off my back I have mild to moderate apnea.

I had been sleeping with Provent + a fanny pack on my back with tennis balls in it, to keep me off my back. I suspect my mouth issues are worse in the early am, when I hit lots of REM, but that perception could just be due to sleep aids wearing off and my becoming aware of mouth openings more. Is your mouth dry? You could try the fanny pack technique.

So the Bi-level did better than the Provent, but neither were very good when I was on my back. With Provent I had an AHI of 19 and with Bi-level it was 12, so room for improvement on both fronts. Due to the split nature of the study the tech didn't have the time to optimize the Bi-Level pressure. I spent half the time on Provent on my back, which inflated the AHI number - and only about 1/6 of the time on the Bi-level, where all of my Hypopnea events occured. If you normalize the time on my back they were kind of about equal.

So we are going to do two more studies, the first next Friday to optimize the Bi-level pressure. The 2nd with Provent plus a dental appliance. I like that my doctor is as open and experimental as I am. His eyes kinda lit up when I said I wanted to get the dental appliance with Provent based on the results. He hasn't had a Provent patient study done with an oral appliance, so I could see that he was excited as I am interested to see the results.

As soon as I can find the cord for my scanner I'll upload the results.

Why would you want to try Provent + MAD when you haven't tried MAD alone? What if MAD alone is enough to control your events and you didn't need to add Provent? Also, you're saying that your events are much worse supine, but none of the things you're suggesting would keep you off your back.

What kind of MAD is he proposing? Also, doesn't a MAD take weeks, if not months, to slowly move out to where you think your symptoms are better and then studied in the lab? (I am actually not sure about this, and am in the early stages of exploring MADs myself and trying to read about it.)

Hey,

I've just read through all 8 pages of the forum. I too have been diagnosed with mild sleep apnea. (supine ahi of 12, lower on side). I was only getting about 1/3 of requisite stage 3 NREM and Stage 4 REM sleep. Those are the importance metrics. Also, i'm 24, 150lbs. I've been questing for a solution to the problem for a long time, having worked through dozens of different variables: incline/ decline? left side/right side? prone/supine? soft or firm? supplements? nutrition? exercise? yoga? chin straps? special pillows? nasal strips and sprays? should i buy a didgeridoo? ( i did). I did not however, try CPAP. the doctors actually advised against it, surprisingly. They said the compliance rates are low and that I would hate it. I agreed.

To my understanding, the possible problem points for OSA are many-fold. The problem can be in the soft palate, nose, tonsils/adenoids, tongue, brain (central sleep apnea), jaw, etc. For me, according to mine and doctors observations, the problem was in my deviated nasal septum, my elongated soft palate, and my fat tongue. The deviated septum causes a lot of problems in plumbing. Sinuses can get congested and slight vacuums can be formed in the airway because it apparently can disrupt airflow. Also, PROVENT does not work nearly as well with a deviated septum. So i fixed my septum. Not such a big deal, just a few days of rest. It's a pretty common procedure. That still leaves my soft palate and tongue. To my observations, PROVENT does not create enough interior air pressure to displace a collapsed tongue. It only addresses a collapsed soft palate. Positional therapy is the opposite. It address the tongue obstruction but the soft palate still flops around. The only position that addresses both things is sleeping on my stomach. But that is nearly impossible for me to do. I've tried a lot of different strategies. Sleeping on your side, however, is easier. I bought a ZZOMA positional sleeper. For those who dont know what it is, ZZOMA is basically a foam block on a velcro belt that i wear around my chest. It looks like I bought it on clearance at walmart, but it actually is about $200 and does do its job. Tempurpedic pillows also make this more comfortable. So that takes care of the tongue problem. Pop on a couple PROVENT patches, and the soft palate is theoretically taken care of too. I've only tried this combo for a few days, and it seems to be promising, but fingers are still crossed. As to the application issues, I've had none really. As long as I wash my nose and lip and keep hair trimmed close to the skin, it works fine.

If it works, I'll get a sleep study again to get new metrics. I like this strategy because it's comprehensive, non-invasive, and mobile. Oral appliance therapy also mainly addresses the tongue and jaw, and only marginally the soft palate. Also, it sometimes leads to changes in the bite and tmj problems. Also no sketchy surgeries in the throat. I've also looked into voice lessons and speech therapy to strengthen my palate or tongue, but havent been motivated enough to follow through.

Hope this helps. Sleep well.

Hello, Is anyone still on this post? I noted the last posting was in June of last year. I was just recently diagnosed with mild OSA and don't even want to think about using a CPAP as I'm pretty sure I won't be able to tolerate it; nor do I want the added electricity usage. I did however research treatment alternatives to CPAP ran into Provent Apnea Therapy patches. After having to make several phone calls to find out the Procedural Code for the patches, I provided it to my health insurance representative and found that they are covered as a MED. I phoned my physician's nurse and asked if she would ask my Doc if he would be willing to prescribe a thirty day trial pack; she asked where would I get them. Being the studious, health conscience, economically challenged, internet researcher that I am I was ready with a pharmacy and a sleep lab in town that sold them. When I went to get them I found out that Ventus no longer makes them, Theravent Inc. does; also found that there is no longer a 10-day trial pack only the 30 day starter pack. This was news for the supplier I went to get them from; so I was given a regularly pressured 30 day pack to start with (supplier ordering new starter packs). Tonight will be my seventh night trying them, two nights ago I actually tolerated them and slept pretty good and have had less fatigue the last few days, but last night was the first night I had trouble getting them on right and eventually (adhesive no longer sticking after several attempts) had to open up a second pack. The biggest problem I am experiencing is that I have not breathed through my mouth while sleeping for a long time and am having problems doing it while trying to fall asleep and then last night staying asleep. So to make this long post longer..... Has anybody had long term satisfaction and therapeutic success with these? Can you give my some pointers on how to proceed with the breathing through my mouth until I fall asleep difficulties I am having? I really want these to work....

Good luck with that; just remember, there is no way except a PSG with the provent
to verify that you are getting any kind of positive results.

Guest,

I would try it in a heartbeat if I wasn't a mouth breather and in the severe range. I wish you all the luck in the world with it. Getting a sleep study is good advise.

49er

Guest wrote:Hello, Is anyone still on this post? I noted the last posting was in June of last year. I was just recently diagnosed with mild OSA and don't even want to think about using a CPAP as I'm pretty sure I won't be able to tolerate it; nor do I want the added electricity usage. I did however research treatment alternatives to CPAP ran into Provent Apnea Therapy patches. After having to make several phone calls to find out the Procedural Code for the patches, I provided it to my health insurance representative and found that they are covered as a MED. I phoned my physician's nurse and asked if she would ask my Doc if he would be willing to prescribe a thirty day trial pack; she asked where would I get them. Being the studious, health conscience, economically challenged, internet researcher that I am I was ready with a pharmacy and a sleep lab in town that sold them. When I went to get them I found out that Ventus no longer makes them, Theravent Inc. does; also found that there is no longer a 10-day trial pack only the 30 day starter pack. This was news for the supplier I went to get them from; so I was given a regularly pressured 30 day pack to start with (supplier ordering new starter packs). Tonight will be my seventh night trying them, two nights ago I actually tolerated them and slept pretty good and have had less fatigue the last few days, but last night was the first night I had trouble getting them on right and eventually (adhesive no longer sticking after several attempts) had to open up a second pack. The biggest problem I am experiencing is that I have not breathed through my mouth while sleeping for a long time and am having problems doing it while trying to fall asleep and then last night staying asleep. So to make this long post longer..... Has anybody had long term satisfaction and therapeutic success with these? Can you give my some pointers on how to proceed with the breathing through my mouth until I fall asleep difficulties I am having? I really want these to work....

Guest,

If you are firmly committed to trying all alternatives to CPAP, don't overlook the didgeridoo.

I'm serious:

http://www.sleepapnea.org/diagnosis-and ... ridoo.html

Regards, Nate