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ZolliStar posted a discussion

New mouth device on the market

I've been hearing advertising for this product over the past few days.  It's sold as something to help snoring, but as I look at the information it seems to me that it would work just as well as my mandibular advancement device (MAD).In other words, this could help some of us with sleep apnea.Read about it here.Anybody have any thoughts about this?  See More
23 hours ago
99 replied to Mary Z's discussion AHI finally under five.
"Hi Richard I mainly use an empty humidifier as it reduces noise"
Feb 16
richard graham left a comment for richard graham
"When I can afford it I'd like to get New machine with heated tube"
Feb 10
richard graham replied to Mary Z's discussion AHI finally under five.
"I would like to see this forum active again as well. I will be more aware of what's going on"
Feb 10
ZolliStar posted a discussion

If you have trouble falling asleep....

I thought that when I got my sleep apnea diagnosis, that -- at last! -- all my sleep problems had come to an end.Ha!I have trouble falling asleep. Indeed, I rarely feel sleepy at night although I do feel tired. I even cut back on computer at night, etc., etc. (and installed f.lux on my computer) but I still had trouble. Now I'm doing something different: wearing special glasses (Uvex S1933X Skyper Safety Eyewear glasses). They block out the blue -- and they're making a difference! First I tried…See More
Feb 1
99 replied to 99's discussion colloidal silver
"i have purchased some silver the make my own colloidal silver"
Dec 21, 2014
99 replied to 99's discussion colloidal silver
"just add to the distilled water it is antimicrobial eg cleans your machine and is beneficial for keeping you healthy  from bugs germs viruses you get the picture and when you need to clean the humidifier out, put water on your plants the silver…"
Dec 21, 2014
Mary Z left a comment for richard graham
"If the heated tube works with your machine I would try that.  They also make covers for your tubing which may help some.  I think the heated tube may be your answer.  Keep us posted."
Dec 21, 2014
Mary Z left a comment for richard graham
"Richard, some folks just use the humidifier in a Passover mode.  They just don't turn it on, but let the air pick up moisture without heat."
Dec 21, 2014
Mary Z replied to 99's discussion colloidal silver
"99, where have you been?  Do you add the colloidal silver to your humidifier?"
Dec 21, 2014
Mary Z replied to Andy's discussion Resmed S8 AutoSet II - No Longer Collecting Data??
"I Andy, I realize I'm months behind your post.  I have no idea why your S8 would stoop collecting data.  I'm glad to hear  you're having such improvement with your apnea.  I have made great strides since I changed…"
Dec 21, 2014
Mary Z replied to Andy's discussion Resmed S10 AirSense - Anyone have one? Any feedback?
"Andy, just found your post.  I don't know anything about this new machine.  How are you liking your new ResMed?"
Dec 21, 2014
Mary Z left a comment for Kay Day
"Kay, I haven't been around myself and miss the old, active forum."
Dec 21, 2014
Mary Z left a comment for richard graham
"Hi Richard,  I don't bother with a humidifier.  Someone on the forum suggested not using it and I'm a lot less congested without it.  A good AHI is under 5.  I use the Wisp and have been since it came out.  I think…"
Dec 21, 2014
hifay replied to Mary Z's discussion Sleep apnea increases risk of osteoporosis
"Always something. Thanks for the information."
Dec 21, 2014
99 posted a discussion

colloidal silver

a humidifier can be used with colloidal silverthis can keep the humidifier clean for day maybe weeks or longer without the need to clean the humidifiersilver colloidal is antimicrobial and you could just top up your humidifier without cleaning and at the same time treat your bodyor you just put silver on it own into the humidifierSee More
Dec 20, 2014
richard graham posted a status
"I feel like the humidifier is making me feel yucky and I'm waking up hacking and having to clear my throat a lot for a while."
Nov 3, 2014
richard graham posted a discussion

what's a good AHI?

I've been using and auto and it says my AHI HAS been between 4 and 6 and wondering what's a good range.
Nov 2, 2014
Andy posted a discussion

Resmed S10 AirSense - Anyone have one? Any feedback?

Hi All,I've just ordered a new Resmed S10 AirSense, and I was wondering if anyone here has used one?Any information or input would be appreciated!See More
Sep 29, 2014
Andy replied to Andy's discussion Resmed S8 AutoSet II - No Longer Collecting Data??
"Hi All, Well, I went to the sleep doc today, and he ordered a new S10 for me! I still don't know why my S8 is not tracking data anymore. Anyone have any ideas?"
Sep 29, 2014

7 Habits of Highly Successful Sleep Apnea Patients

from Dr. Park: Some patients with sleep apnea do remarkably well, despite all the hurdles and obstacles that arise. Then there are others that procrastinate, or refuse to take any action at all. I've noticed 7 commonalities amongst the ones that do succeed in the end:

1. They take responsibility for their own health, and not rely on doctors alone. They surround themselves with a team of medical professionals, constantly reading and learning, asking questions, and staying up to date on the latest in new sleep apnea treatments and research. They are willing to make major changes their lives, daily habits and diets to achieve set goals.

There are some people who are unwilling to make any changes, such as with eating late or going out 2-3 times per week and drinking alcohol. These are the same type of people who say they don't have time to read an important book to help them along. These are the people who want only a quick fix. They are unwilling to commit to a life change.

2. They are willing to pay extra. Unfortunately, insurance will typically cover only the bare essentials for sleep apnea treatment. Most durable medical goods vendors will give a basic model, and typically won't cover any additional add-ons or extras or a more full-featured CPAP machine. Depending solely on insurance to cover for everything will lessen your chances for achieving success. Sometimes, you have to pay for a new mask, or a dental device. Yes, you should maximize your insurance benefits, but you should also not hesitate to go outside of medical insurance to invest in your health.

Successful people also are willing to invest in gym memberships, yoga classes, books and information products that complement standard sleep apnea treatments.

3. They take action. The people that succeed typically have tried multiple different options and have failed more often than once. But because they are persistent and take massive action, eventually, they find something that works for them.

There are many patients research everything but can't make up their mind. This is called paralysis by analysis.

4. They do everything possible to breathe well through the nose. Being able to breathe well through the nose, although not a cure for sleep apnea, helps every other form of treatment option. Whether it's with CPAP, dental devices or surgery, not being able to breathe well through your nose will ultimately diminish the quality of your results. Through trial and error or by working with your doctor, you can usually figure out what's causing your stuffy nose, and take care of it in one way or another.

Many successful CPAP patients get into the habit of irrigating their noses with nasal saline. There are various ways of getting saline into your nose, so you'll have to try different options to see which one you like.

5. They set aside time for regular exercise or relaxation. Paradoxically, exercise is a great form of relaxation. When you take the time to exercise, you have to focus on your exercise activities, which forces you not to stress about work, life and other distracting things. Not to mention the cardiovascular benefits. The more advanced people discover that active forms of relaxation or meditation helps to calm the overstimulated stress part of the nervous system, or the sympathetic nervous system. They routinely practice yoga, meditation, tai chi, which are all disciplines where proper breathing techniques are stressed.

6. They join a community of other sleep apnea patients. There's a saying in business, "Teamwork makes the dream work." Surrounding yourself with other successful people's perspectives will help you to grow, learn. There are live groups such as AWAKE, or various internet forums and support groups.

7. They accept sleep apnea rather than fight it. At a certain point, all these habits will be a regular part of your life. If you're constantly resisting it and fighting it, always looking for a "cure," you're in for a long and frustrating battle. Unless you undergo a tracheotomy, you'll never be cured. Your ultimate goal should be to reach a point where you're able to function normally, gain satisfaction from the work that you do, and ultimately, to be able to enjoy life.

(excerpted from http://ezinearticles.com/?id=2528115)

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I think that numbers three and seven are the most important things for people with sleep apnea to accept.

Number one is important, but I take exception to "They surround themselves with a team of medical professionals". I am not sure that number six is all that important, although it may help some people.
I agree with most of what Dr Park says, but I would say never accept sleep apnea, not even an AHI of one. Continue to fight it until it is conquered. For most, it's APAP (or Auto CPAP) with a smart card. If you are truly APAP resistant then the question is: can ENT make you an APAP success? If so, have a tracheostomy first, then undergo whatever ENT surgical procedure (e.g.removing nasal polyps, etc) that will resolve your nasal problem. Now that your nasal problem is resolved, go back to APAP and if it is successful, close the tracheostomy.

But you might say, "a tracheostomy, are you kidding? Why a tracheostomy?" The reason is simple.You are continuing to obstruct your airway nightly while you are experimenting with ENT surgery which can go on for months. Apneas are not good, they are bad for you. They will kill you. Stop the Apneas.
j n k,

I think everyone has different experiences in different parts of the country. There are some insurance carriers that contract with only one DME vendor. If you have a choice between different DME vendors, then by all means do your research and look around. But for most people, they go with whichever one the sleep doctor sends them to. As you may know, there's wide variability in the quality of the DME vendors. Most are honest, but there are some that do practice less than ethical tactics. The entire system is so complicated that even if you've educated yourself about these issues, you'll still come across many frustrating situations. Maybe all the bright minds on this forum can come up with a CPAP/DME checklist and questions to ask before selecting a DME vendor. I'm also talking about paying for non-covered accessories, such as CPAP cheek pads, sleep position positioners, extra machines for travel, all within reason. Any other option to improve or optimize your sleep apnea treatment experience. Yes, different people have various levels of financial resources, but some people refuse to shell out even $10 if insurance doesn't cover for it.

Tim,

I'm just speaking from my experience with patients that I deal with. I'm sure there are plenty of people who do fine with minimal physician involvement.

Mack,

Conceptually, I totally agree with you that even one apnea per hour is not a good thing, but to try to reach that goal for everyone with sleep apnea is unrealistic. Due to the law of diminishing returns, we'd had to spend enormous time and resources to get everyone with sleep apnea under one. I'm willing to bet that many people on CPAP or aPAP at their best are hovering above one. Most CPAP titration studies I see end up being over one at the final pressure.

Tracheotomy is a great option for some people, but most won't ever consider it for obvious reasons.

As I point out in my book, most modern humans are susceptible (to various degrees) to sleep-breathing problems due to our smaller jaw anatomy. It's just a fact of life. I know I have some it as well. We all are prone to upper airway narrowing from the tip of the nose down to the voice box. It only gets worse as we get older.

Also, different people react differently to different levels of apnea. Some people are very sensitive to apnea indexes of even one, whereas I know some people who have numbers in the 60s who feel just fine.

Lastly what about all those people who have AHIs of 0, but wake up due to short breathing pauses anywhere from 5 to 25 times per hour and are miderable? What do you do with these people with upper airway resistance syndrome?

This is why I don't have a blanket recommendation for everyone. Yes, there are some basic medical guidelines that you must follow, but everyone has to have an individualized treatment approach.
Dr Park, I agree with everything you have said about sleep apnea and the need for patient compliance. However, as said before, not all cpap patients are internet savy as we are! and not all patients are comfortable enough to discuss anything with their doctor - they rely on the doctor telling them the info rather than getting it themselves - these are mostly older adults who, because of being raised in a different generation, where their doctor was the one with all the answers or they felt the doctors were much smarter, or whatever the reason - relied on the doctor to have the expertise. If a doctor wrote them a prescription to "go join a gym or yoga class or tai chi" they would fill it like a prescription for a drug - knowing that the doctor knew best. Today, many of us are more than capable of being our own advocate, however we are not privy to the information
that is most helpful to us. Sleep apnea is a fairly new "disease" so we are all learning as we go along. Thank goodness for websites like this one - where we can all interact and find some solutions.

I would like to know more about MY sleep apnea which as of today is determined to be both obstructive and central but mostly central. This is a SERIOUS diagnosis and I take it seriously. Unfortunately, I have to sleep my day away because my nights are spent waking up and adjusting a mask, readjusting a mask when I turn over, just plain waking up and not knowing why, etc. etc. I have a wonderful machine with all the latest for central sleep apnea, however because my BRAIN is not getting the signal to tell me to BREATHE I feel that this is only a somewhat helpful device, although as far as I know there is nothing else for me.

Does anyone know of a trial or program I could become involved in that would address CENTRAL sleep apnea. I'll go to
Alaska if I have to, but I doubt there is such as program or trial. You see, doctors haven't gotten to the point of having the answers yet. Doctors are just like us, except they have gone through 8 years of highly intensive training to be MDs - they are taught to diagnose and treat. Right? Doctors don't know everything! They are human beings just like us -ONLY WITH TRAINING. Yes, I know I sound frustrated - because I am. I know there is nothing more I can do except follow the doctors advice - do everything they say and hope for the best. Sitting back and doing nothing is not an option. Ron
Steve, One explanation for the seemingly contradictory symptoms can be attributed to the unseen white matter infarcts demonstrated by Paul Macey and collegues in their report in the Journal Sleep July, 1 2008 (http://www.journalsleep.org/ViewAbstract.aspx?pid=27202). Click on Full Report to see the MRI- DTI colored images. All 41 OSA patients (ages 32 to 52) had multiple white matter strokes scattered through out their brains. It's no wonder that some of these patients don't feel better right away after going on PAP. These areas of brain damage may take weeks, months or years to recover, if at all. Denial of symptoms, as you well know, is common in OSA, the assumption being that haven't experienced one of these lesions yet (or if he has it hasn't occurred in an area of the brain that manifests itself in feeling like crap).

Notice I said "yet." The point I wanted to stress is that the way you feel after going on PAP may not necessarily be a true indication of how well the machine is actually working. (The smart card is going is going to come to the rescue here). The guy who feels like crap with an AHI of less than 5 may have a brain loaded with infarcts, whereas, the guy with an AHI of 60 may have few or none (yet). Or the ones he has are in a relatively silent area of the brain thus far. Oh, by the way, you probably wouldn't be far off if you guessed that most of your OSA patients, at least in the age group mentioned in the study, have similar lesions. At 73, I wouldn't be surprised if my brain lit up like Christmas tree on an MRI-DTI scan.
Ron,

Part of the issue is the generic "doctors" term. The avergage primary care physician has little or no training on sleep medicine during medical school, probably no more than 2-3 hours according to research. I've educated my primary physician to a point, but while he has asked me about other apnea patients of his, he has never really asked me about my own apnea. That may be because he knows I see a sleep specialist, though, since my primary doc does dialogue with me on other health issues.

I always recommend that a person with moderate to severe sleep apnea see a sleep specialist at least once a year, just like you would see a cardiologist if you have a heart problem. Unfortunately, most people I talk to say "what's a sleep specialist?" because they've never been referred to anyone to discuss their sleep apnea diagnosis.

Dave

Ron Sowell said:
Dr Park, I agree with everything you have said about sleep apnea and the need for patient compliance. However, as said before, not all cpap patients are internet savy as we are! and not all patients are comfortable enough to discuss anything with their doctor - they rely on the doctor telling them the info rather than getting it themselves - these are mostly older adults who, because of being raised in a different generation, where their doctor was the one with all the answers or they felt the doctors were much smarter, or whatever the reason - relied on the doctor to have the expertise. If a doctor wrote them a prescription to "go join a gym or yoga class or tai chi" they would fill it like a prescription for a drug - knowing that the doctor knew best. Today, many of us are more than capable of being our own advocate, however we are not privy to the information
that is most helpful to us. Sleep apnea is a fairly new "disease" so we are all learning as we go along. Thank goodness for websites like this one - where we can all interact and find some solutions.

I would like to know more about MY sleep apnea which as of today is determined to be both obstructive and central but mostly central. This is a SERIOUS diagnosis and I take it seriously. Unfortunately, I have to sleep my day away because my nights are spent waking up and adjusting a mask, readjusting a mask when I turn over, just plain waking up and not knowing why, etc. etc. I have a wonderful machine with all the latest for central sleep apnea, however because my BRAIN is not getting the signal to tell me to BREATHE I feel that this is only a somewhat helpful device, although as far as I know there is nothing else for me.

Does anyone know of a trial or program I could become involved in that would address CENTRAL sleep apnea. I'll go to
Alaska if I have to, but I doubt there is such as program or trial. You see, doctors haven't gotten to the point of having the answers yet. Doctors are just like us, except they have gone through 8 years of highly intensive training to be MDs - they are taught to diagnose and treat. Right? Doctors don't know everything! They are human beings just like us -ONLY WITH TRAINING. Yes, I know I sound frustrated - because I am. I know there is nothing more I can do except follow the doctors advice - do everything they say and hope for the best. Sitting back and doing nothing is not an option. Ron
I like # 6, particularly the mention of A.W.A.K.E. groups. I've led two A.W.A.K.E. groups for years and am the Past Chairman of the American Sleep Apnea Association which fosters the A.W.A.K.E. Network. This is a good place for those who are not internet savvy to go, to get information in person, that they are not receiving from their DME or physician.

I do agree with #7. When someone asks "do you really have to use that machine and mask the rest of your life?" my quick response is " Yes, but with that mask and machine I actually have a 'rest of my life' and the quality of that life is very good compared to what I had before I was treated." CPAP reduces my 82 events per hour down to about 1-2 events per hour and I feel good because of it. Sleep apnea IS a chronic disease, like diabetes or COPD, or even heart disease, and you have to learn how to accept your diagnosis, find the best treatment for yourself, and then stay compliant with that therapy, whether it's wearing eyeglasses, using CPAP, or taking your medications.
Great points as a apnea client I always find KNOWLEDGE IS POWER and also enpowering ourselves is the ticket to our success. i find that I do my machine a sleep at a time I agree we must wear ur machines eac sleep even if for 1/ 2 hour. The consistency is and will always be the key to our progression. Thanks for your 7 tips I loved the article look forward to the next.... Nurse lori
Wish all doctors were as enlightened as Dr. Park about the plight of the apnea patient.
My primary care physician has absolutely no interest in my sleep apnea or my CPAP usage. At physicals I tell my PCP that I am still on CPAP and tell him my average AHI for the past week -- and he totally ignores it. The last time I saw a sleep specialist was about 14 years ago when he performed what is now called an MMA.

My most recent sleep study was about three years ago -- I told a PA in my doctor's office that I have sleep apnea, that I use a CPAP, and I needed a new sleep study; she then ordered the blood tests and a sleep study. Other than the blood tests, she didn't do any sort of exam or ask me any questions.

I never saw or talked to a doctor at the sleep clinic; a clerk called me and asked me which DME she should fax my script and sleep study too. The clerk also faxed me a copy of my script and sleep study. The sleep study techs gave me CDs of my polysomnograms the morning after each study. If I hadn't been on CPAP for the previous several years, I would have been totally lost.

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