Posted on 08/10/2023 5:38:37 AM PDT by ConservativeMind
Professor Danny Eckert says his research team has examined shortcomings in some people's response to the popular continuous positive airway pressure machine (CPAP) and found that adding combinations of therapies gets impressive results in those who are unable to tolerate CPAP.
Oral appliance therapy (OAT) is an effective treatment for many people with obstructive sleep apnea (OSA) but does not fully control OSA in about 50% of cases.
This study aimed to control OSA in individuals who have an incomplete response to using only OAT, with the solution being to use additional targeted therapies informed by each individual's specific causes of OSA known as "endotype" characterization.
"Rather than everyone first trying CPAP—for whom we know at least 50% will fail—we flipped the model on its head and gave everyone a dental split in the first instance," explains Professor Eckert. "This tends to be much better tolerated than CPAP, though it is less efficacious overall, as it works in about 50% of people."
"However, we found that if the dental device alone was insufficient, we added extra treatments—and this combination of therapies fixed almost all the 50% of the remaining patients.
"We then added alternate and emerging therapies such as oxygen therapy, and novel medications informed by the findings of a detailed sleep study that we did which tells us exactly why each person gets their OSA.
"If this combination approach didn't fully work, we then gave CPAP, but only as a last resort.
"Using this new approach, we were able to treat almost all participants and only a few required CPAP.
"Essentially, we believe this outlines a whole new way of treating sleep apnea."
(Excerpt) Read more at medicalxpress.com ...
From the abstract, in order:
1. Detailed physiology review 2. Oral appliance therapy (OAT) 3. Expiratory positive airway pressure valve (EPAP) 4. Supine-avoidance device therapy
Then, potentially adding one or more of the following:
- Oxygen - 80/5mg atomoxetine-oxybutynin - OAT combined with EPAP and CPAP therapy.
sounds like a pita. I’ll stick with my cpap. Tried a dental appliance instead of cpap and it didnt’ work for me. The cpap just works.
I used to have a problem with Sleep Apnea.
I tried a dental device for a while, and it did help, but it was also making my lower jaw stick out and I was developing an underbite. Plus, it made my jaw ache all day long.
I had another sleep study done and they noticed that I have sleep apnea really bad if I sleep on my back, but I’m OK if I sleep on my side. So now, I just sleep on my side and don’t have sleep apnea.
I snore when I sleep on my back but not on my sides. I used to prefer to sleep mostly on my back but I have learned to side sleep. It’s just gravity in action when you think about the physiology. There is more pressure on mandible and throat tissue to collapse down when you are on your back.
The dental devices are for sleep apnea caused by excess weight which c.oses off the throat at night when sleeping, but there is another form of sleep apnea where the brain shuts off the “need to breath” briefly- I think it’s called central sleep apnea? Whatever it’s called, that is the kind I have supposedly, but I have my doubts as I’ve recorded my breathing throughout the night a couple of times and I hear no disruptions in breathing or gasping for breath.
Me too. I can sleep on my stomach, no problem. I work with a guy who had his throat lasered & that helped for a couple years & then you have to have it done again. They have a new device that’s like a pacemaker with a wire up to your tongue. When it senses it closing, it gives it a jolt.
Used to scare my wife because I’d stop breathing, especially after drinking. Haven’t drank in 12 years but still use mine. Was missing a part to my cpap machine a month ago & woke up the next day miserable so I drove to a pharmacy to get the part. It makes that big of a difference & I never travel without it, even for one night.
I wen5 on a machine for a couple of months ths, and felt no difference at all- which is another reason I suspect I didn’t have apnea- went for the sleep study and the tech said “yep, you have it bad. A cpap will make up feel amazing”- only it never did. I thunk my sleep recordings pretty much confirmed my suspicion too. My dad on the other hand will fall asleep in a chair, and he will snore and stop breathing quite often- he definitely has it, and needs his cpap.
Husband snored so loud I would relocate. After years of this he discovered that the snoring stopped when he discontinued his nightly glass of whole milk. He also found that side sleeping stopped the Apnea. In addition, sleeping on the left side stopped acid reflux. This is because of the way the esophagus enters the stomach.
Irish whiskey and ________??
I love my CPAC.
I have successfully used a CPAP for 25 years. It works well for me and the results were immediate the first night I slept with it. I’m interested in the new technologies, but am content to use my CPAP. I have traveled with my CPAP to Europe and as far away as Australia without any issues ….just be sure to have the right adapter for your electric plug. Most CPAPs will run on 220v 50Hz electric systems found in many foreign countries, but will need an adapter to accommodate the various wall sockets. Customs and airport security are generally quite familiar with CPAP devices so you need not worry about traveling with your CPAP.
APAP (which automatically adapts to needed pressure) works the best, but only if the lower pressure in the range is set at the titrated level, not 0, and the higher pressure is set no more than 5 cm above that.
From there, nightly readings can allow the patient to modify the pressures to obtain the lowest AHI (apnea hypopnea index).
This procedure was developed my patients communicating on online forums. For some sad reason, machine makers fight the notion that patients can take responsibility for their own therapy.
When I first got it ~15 years ago, my son’s baseball team travelled to Kansas City for the weekend so I figured I wouldn’t bring it. Driving back to Omaha I almost fell asleep 1/2 dozen times to the point it scared me. I’ve only slept one night without it since & that was because because I threw a piece away & didn’t have a spare. That next day I drove to the pharmacy to get the piece because it would have taken a couple days via mail.
If you’re not having those types of experiences, I would agree a machine prolly wouldn’t help.
Been sucking on a hose for over 15 years. The first 7 were frustratingly spent educating my self and trying every thing that was out there and finally finding the dental appliance/nose pillow anchor some folks were raving hard about it on one of the many blogs. ~~BOOM~~ No leaks AT ALL. It moves with you, no head gear. You rinse it clean every night because you have to warm it up with hot water so it will slip right on your upper teeth. Now my VA carries them for me. (Gigantic victory!) 100% no leaks. 100% compliance!
Oh I do get extremely tired driving even just say 60 miles or so. And yep, I begain to nodd off quite a few times to point it scared me too. That was why they thouhgnt I had sleep apnea- and why they told me I’d ‘feel amazing’ after a few nights sound sleep. It never happened for me though. I just kinda suspected from the beginning that I never had it.
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