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Flipping the model presents a new way to treat sleep apnoea

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Re: Flipping the model presents a new way to treat sleep apnoea

#61

Post by ShakataGaNai »

elric wrote: post #36

The only reason why CPAP has such abysmal failure rates, is because followup is an absolute joke. Patients are titrated in a sleep centre, typically for one night, and are then sent home with a machine, probably the shittiest mask the sleep centre had on hand, and a kick out the door. With some luck, patients have to come in once a year, usually to prove that their therapy is compliant with whatever harebrained schem…

Yup. This was my experience, more or less. I was lucky enough to do an "at home" test, and so I wasn't given whatever they had on-hand. But when I was prescribed a CPAP the adventure began...

First the insurance adventure. They wanted to rent me a machine at rates that qualify at rates that would violate the geneva convention for war crimes. $327 for the 1st month. $50/mo for the next 10 months. Then I'd be eligible to buy the unit for some unspecified price. Total of AT LEAST $827 in rental fees PLUS whatever the sale cost was. Told them to fluff off and bought a top-of-the-line unit online for $499.

Did my research and got the mask that had the best reviews for someone like myself.

In advance, I had done a little research about CPAP's but I had no realidea what to expect. When I met with the sleep doctor, when he prescribed me the CPAP, he asked if I had any questions. I told him directly, "I don't really know much about them, what should I know?". You'd think whatever spiel he gave me would be a solid basis for life with a CPAP? Hah.

Did my own research on how to get comfortable and used to using it. First night I use it, I wake up in the morning and my chest is ON FIRE. Fortunately I didn't jump directly to heart attack, which apparently a lot of people do. Turns out my chest muscles were just sore - super duper common. A side effect almost everyone has the first few times they use a CPAP. Guess what my doctor DIDN'T Tell me about? And that about summarizes how useful my doc was.

My Primary Care was way more useful than the sleep doctor. But I never tolerated the CPAP well. Because I'm technical, I had OSCAR pulling data the very first night. Reviewed it every day, learned how to get into the CPAP service menu and make adjustments to the system. Still had problems with it and eventually gave up using it. (Note: I did have heated and humidified, played with those settings a lot. Tried several different masks. Putting the mask on or keeping it on wasn't the issue, my body would just freak out in the middle of the night - every night, when wearing it. Even after weeks of trying. My sleep was worse with the mask than without.)

You know who I never heard from again? The sleep doc. It's been 3 years (almost to the day) since I got the CPAP and they've never contacted me. Could I have reached out to them? Yes, but what good were they? They didn't set me up for success. They didn't follow up even one. Their use was to write me a prescription and that's it.

Re: Flipping the model presents a new way to treat sleep apnoea

#62

Post by elric »

2devnull wrote: post #57
elric wrote: post #36

The only reason why CPAP has such abysmal failure rates, is because followup is an absolute joke. Patients are titrated in a sleep centre, typically for one night, and are then sent home with a machine, probably the shittiest mask the sleep centre had on hand, and a kick out the door. With some luck, patients have to come in once a year, usually to prove that their therapy is compliant with whatever harebrained schem…

[flagged]

Ah this old chestnut. It's a load of garbage. CPAP is effective, as supported by many studies and many patients.

Obesity, as mentioned elsewhere in this discussion, is a tricky thing in relation to OSA. Having OSA can make you obese. As for allergies, they can certainly worsen symptoms, but they're only a small piece of the puzzle for many people.

TL;DR; the science supports CPAP.

Re: Flipping the model presents a new way to treat sleep apnoea

#63

Post by avivo »

fnordpiglet wrote: post #37
DrAwdeOccarim wrote: post #7

Totally agree. My journey started with TMJ disorder. Turns out bruxism (teeth grinding) is common in sleep apnea patients; I assume because it forces the lower jaw forward. I started with a mandibular advancement device and it was amazing. It completely relived my debilitating TMJ jaw pain and fixed my sleep apnea. I couldn’t believe how amazing I fet every morning. Unfortunately, and which was clearly communicated t…

I want to emphasize the importance of seeming an ENT. I also saw an ENT, but very early in my journey. I also had sinus surgery. After recovery was the first time in my life I could breathe fully through my nose. I had no idea - it was like being blind and being able to see for the first time, except I had no inkling others could see. That actually opened up a realization that the sinus issues they fixed had led to c…

It's worth knowing that, according to some recent research, taking a topical antibiotic like this might have permanent impacts on microbiome in your nose (and lead to drug resistance.)

Re: Flipping the model presents a new way to treat sleep apnoea

#64

Post by UncleOxidant »

When I was first diagnosed with sleep apnea I asked my doc about alternatives to CPAP because I didn't think I'd be able to sleep with that thing on my face. He sent me to a dentist who specialized in making those oral appliances for Oral Appliance Therapy. I did the adjustments for a couple of months (you move a screw just a bit further every few days which pulls your lower jaw forward in the device). After a couple of months he had me do another sleep test - it was actually worse than it was before without the device. Soon after I got a CPAP and after a 2 or 3 week adjustment period I was sleeping just fine with it.

Re: Flipping the model presents a new way to treat sleep apnoea

#65

Post by Klonoar »

UncleOxidant wrote: post #64

When I was first diagnosed with sleep apnea I asked my doc about alternatives to CPAP because I didn't think I'd be able to sleep with that thing on my face. He sent me to a dentist who specialized in making those oral appliances for Oral Appliance Therapy. I did the adjustments for a couple of months (you move a screw just a bit further every few days which pulls your lower jaw forward in the device). After a couple…

I’ve done the oral appliance route and it fixed it for me, so it might be a YMMV thing.

I really recommend everyone get tested for it tho, good sleep is the biggest game changer.

Re: Flipping the model presents a new way to treat sleep apnoea

#66

Post by UncleOxidant »

Klonoar wrote: post #65
UncleOxidant wrote: post #64

When I was first diagnosed with sleep apnea I asked my doc about alternatives to CPAP because I didn't think I'd be able to sleep with that thing on my face. He sent me to a dentist who specialized in making those oral appliances for Oral Appliance Therapy. I did the adjustments for a couple of months (you move a screw just a bit further every few days which pulls your lower jaw forward in the device). After a couple…

I’ve done the oral appliance route and it fixed it for me, so it might be a YMMV thing. I really recommend everyone get tested for it tho, good sleep is the biggest game changer.

This was about 15 years ago and I got the distinct impression that the oral device they gave me was still pretty experimental. I remember making a few suggestions to the dentist for ways it might work better and he thanked me for my feedback. Maybe they're better now?

Re: Flipping the model presents a new way to treat sleep apnoea

#67

Post by elric »

Maxious wrote: post #11
xnx wrote: post #6

Reduction is sleep apnea seems like a likely second-order effect of GLP-1 drugs.

We've known since at least 2016 that GLP-1 drugs would have a massive impact https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973216/

"Massive"? The intervention group went from a mean AHI of 49 to a mean AHI of 37. While the control group went from 49 to 43. It's something, but it's still very much in the "severe" category, and I wouldn't call it "massive".

Proper CPAP usage would reduce this group's AHI to <2 events/hour.

Re: Flipping the model presents a new way to treat sleep apnoea

#68

Post by fnordpiglet »

avivo wrote: post #63
fnordpiglet wrote: post #37

Earlier quoted context omitted.

I want to emphasize the importance of seeming an ENT. I also saw an ENT, but very early in my journey. I also had sinus surgery. After recovery was the first time in my life I could breathe fully through my nose. I had no idea - it was like being blind and being able to see for the first time, except I had no inkling others could see. That actually opened up a realization that the sinus issues they fixed had led to c…

It's worth knowing that, according to some recent research, taking a topical antibiotic like this might have permanent impacts on microbiome in your nose (and lead to drug resistance.)

Yes, but systemic antibiotics are substantially worse in this regard as they change your entire systemic micro biome, and a chronic sinus infection is a permanent highly negative micro biome in your nose. Sometimes it’s better to hit the reset button than endure misery for the rest of your life :-)

Re: Flipping the model presents a new way to treat sleep apnoea

#69

Post by micael_dias »

klyrs wrote: post #55
TheCapeGreek wrote: post #30

Earlier quoted context omitted.

>What has made a major impact was seeing an ENT [...] Turns out “negative pressure” is a major cause of airway collapse. The cause of snoring & apnea, from my own searching online and seeing various anecdata, is that there are several common causes but it can vary wildly. I've also tried many similar treatments to yours, short of CPAP, and including trying tongue & jaw exercises and mewing to try and get my default s…

Is "mewing" a typo? This sounds incredibly cute.

“ Mewing is a technique in which the tongue is placed on the roof of the mouth in an effort to make the jaw bigger and more square. This may be done for aesthetic reasons and/or to correct orthodontic, breathing, and facial structural issues.”
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