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Steven B. Ronsen updated their profile
Sep 15, 2018
  • Male
  • New York, NY
  • United States
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Dave's Discussions

Sleep Apnea - Preventive Childhood Measures from A Parent
4 Replies

Started this discussion. Last reply by ZolliStar May 1, 2012.

New Study Shows Impotence and Erectile Disfunction link to Obstructive Sleep Apnea (OSA)
2 Replies

Started this discussion. Last reply by Mike C (at the Beach!) May 15, 2011.

Combination Therapy - Oral Appliance & Provent Nasal Device
3 Replies

Started this discussion. Last reply by Mary Z Mar 12, 2011.


NYC - The City That Needs Some Sleep!

Latest Activity

ZolliStar replied to Dave's discussion Sleep Apnea - Preventive Childhood Measures from A Parent
"     Lisa took the words out of my computer!  Breastfeeding helps in many ways know, unknown, and becoming known. Very likely the suckling action makes a difference in palate formation. Maybe a huge…"
May 1, 2012
Lisa replied to Dave's discussion Sleep Apnea - Preventive Childhood Measures from A Parent
"You are certainly not crazy, Dave. To give children the very best start, I would advocate breast feeding. For the best support and advice on breast feeding and good nutrition, I would recommend La Leche League. It was founded by breast feeding mums…"
May 1, 2012
Terry Vella replied to Dave's discussion Sleep Apnea - Preventive Childhood Measures from A Parent
"Dave, I agree with Mary, it's probably best one of the professionals try to answer your question, I would think just as a layman, it would be difficult to do anything. It's like saying how do I stop them getting cancer or any other…"
Apr 30, 2012
Mary Z replied to Dave's discussion Sleep Apnea - Preventive Childhood Measures from A Parent
"You're not crazy.  It's a great thought.   I'm no expert and I really don't know the answer to your question.  Hopefully one of our Professional members in the field of dentistry or anything related to oral…"
Apr 30, 2012
Dave posted a discussion

Sleep Apnea - Preventive Childhood Measures from A Parent

     I'm hoping to have children and if we are blessed with children I want to do as much as I can reasonably do to prevent the development of Sleep Apnea.  I have heard that proper palatal development to make sure the airway reaches its ideal size is key.  Is this correct?  Also, is anything else important besides the ever-important body weight?   I believe that part of the problem with proper airway and jaw development lies in all the easy-to-eat and processed food we all have been eating and…See More
Apr 30, 2012
Christine Underwood replied to Dave's discussion Deviated Septum Surgery (Septoplasty) - Helpful to OSA patients?
Mar 16, 2012
Ginny Edmundson replied to Dave's discussion Deviated Septum Surgery (Septoplasty) - Helpful to OSA patients?
"Dr. Park~ after this surgery how soon do your patients usually start back using their CPAP machine? Another post of this forum stated they could not use for 3-4 weeks.  The ENT I went to today mentioned one week.  I am scheduled for this…"
Jan 18, 2012
Dave replied to Bex's discussion Dental Devices Helpful?
"     I recommend being very scientific about any treatment you get.  Do a sleep study without appliance and then one with the appliance!"
May 18, 2011

Profile Information

My Interest in Sleep Apnea
I have Sleep Apnea, Someone I care about has Sleep Apnea
Treatment Being Used, if any
If Machine Being Used, What Type? (e.g., Respironics M Series with A-Flex Auto-Adjusting CPAP)
Oral Appliance - Somnomed

My Apnea Hell

Chapter 1 - Clueless (2002-2006)

In the year following 9/11, I started waking up with a choking feeling. Being in New York City post 2001, I thought it was panic attacks brought on by constant fears of terrorism and stressful feelings enhanced by the media and wartime politics. Also during this time, my work environment became very unhealthy when unnecessary stress, competition, and negativity were the norm. Total ignorance persisted for many years, until early 2006. A girlfriend, whose father has sleep apnea, watched me sleep and informed me I had sleep apnea. I talked to my doctor and he said I should go to a sleep center and get a Polysomnography. I wanted to go in right away, however, i had to wait a few months until May 2006.

Chapter 2 - Diagnosis - Polysomnography (May 2006)

In May 2006, I had a Polysomnography. According to the study, it seems I had an RDI of 33.2 (see below), although, in the professional opinion (see below), it said I had an AHI of 33.2. RHI is not the same as AHI, but in either case, I needed to get titrated for a CPAP.

Chapter 3 - Titration (May 2006)

I recall struggling with the constant positive airway pressure first used in the titration. The constant pressure was very confusing to my body and caused me to panic a bit. Although I can't speak from first hand experience, I have heard that people who scuba dive are used to the feeling and can acclimate more quickly. Eventually, after failing to get me comfortable with constant pressure, they switched to a BiPAP titration (also known as CPAP w/EPR - Expiratory Pressure Relief), which feels more natural when you are exhaling. The titration concluded with a recommended BiPAP setting of 9/5 cm of H20 which resulted in a 4.7 RDI. I believe an RDI<5 is considered successful. A few months after that, a Puritan-Bennett 425g BiPap machine was delivered. I preferred the Mirage Swift Nasal Pillows.

Chapter 3 - Ignorance and Medical System Neglect (May 2006-May 2008)

For about the next 2 years, I struggled to try to use the machine. I hated having to clean it and I felt like it wasn't doing all that much. I also would wake up with my mouth dry. I would also wake up with the pillows disconnected, with no recollection of what happened during the night. No one ever called me to ask me how I am doing. I have no idea how often I used the machine. Probably somewhere between 5%-60% of all days. I know it sounds ridiculous, but I honestly don't know.....

Chapter 4 - Apnea's Ugly Head & Re-Education (2007)

A close family member was diagnosed with diabetes, CLL (Chronic Lymphatic Leukimia), and Sleep Apnea all within a short period. It all kind of clicked. The snoring that seemed prevalent in all older males in my family was actually sleep apnea. The apnea then likely caused, aggravated, or sped up the development of Obesity, Diabetes, Depression, & Leukemia. With the help of a friend and the desire to help a loved one with the condition, a new level of understanding was approaching. I started to understand that these machines should be data capable to allow you to see if you are getting proper treatment. It also reminds us of the importance of having an advocate help you deal with this condition! Someone objective on the outside looking in - who cares. You really need understanding, constant monitoring, and effective evaluation. I went to the doctor, proud of what I learned and armed for the first time with the right questions. When I asked the doctor "Why don't I have a machine that monitors my treatment?" he responded "Well, How do you feel?". I said I feel a little bit better than the start of the treatment and he said...well, that's good then! He also seemed disturbed and thought I might start 'hacking' machines and doing undesirable things and so he believed there was no need for better machines. He said I could request another sleep I did!

Chapter 5 - Sleep Study Take 2 Failure (July 2008)

My 2nd sleep study said I needed a straight pressure of 5 cm of H20. That sounded nice, but I was shocked. My results for my 2nd sleep study seemed very confusing - I knew I wasn't getting good sleep yet. Hence, it made little sense to me, but I was really going to give it a shot. I purchased a Respironics m-series BiPap Auto. Finally, I would understand what's going on. I ran the BiPAP auto at a straight pressure of 5. I quickly found that my AHI was 11-21 with the machine. This was not was seen in my sleep study. I reviewed this other therapists outside of the ones I met through my doctor. They instantly saw that I was opening up my mouth when I sleep - making treatment ineffective. I suppose becuase sleep labs are not regular environments, they may produce unexpected results.

Chapter 6 - Fighting the good fight, but the struggle continues...

I purchased a Resmed S8 Autoset II which can function as both an auto adjusting (titrating) CPAP with or without EPR. Most importantly, it is data capable. Currently, I'm trying a full face mask and letting the machine titrate me. Soon we should see the result!

Quick Update - Jan 2008

After falling off the wagon after 3 colds in a row, I had my first night back on cpap. I had my lowest AHI of 7.0 according to the machine, but I still don't have the resmed smartcard reader...although, I did buy the software from a company in australia. It seems, however, that resmed now allows US distributors to sell it. I also called my DME to find out what I'm entitled to:

I'm entitled to a MASK every SIX MONTHS

Can't wait until April 2009! :) Change is in the air!
I will update fuller soon....

Comment Wall (6 comments)

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At 2:55pm on October 19, 2009, Renee said…
Hello Dave,

I am sorry you are hearing back from me so late. I am new to SG (and OSA) and you kindly replied to a posting I placed on the forum. I am still getting used to the website and today I noticed that the "Thank You" that I thought I sent to you, I had actually sent to myself ! So I am writing once again to Thank YOU for taking the time to respond, for your view on sleep study centers and for attaching the NYU's url. NYU was also recommended by two others who kindly responded to my query. I took the opportunity to click on the url you provided and checked out the site and NYU does seem to be professional, reputable and, even more so, staffed well and I went ahead and completed the Patient Registration form provided online. I thank you very much for thinking of sending the url because that simple thing prodded me right into action and I already have an appointment at NYU on 11-2.

Thanks much,
At 7:16pm on January 22, 2009, sleepycarol said…
Was just wondering how things are going with you.

I hope you are sleeping good!!
At 5:13pm on January 3, 2009, sleepycarol said…
The Quatro is one of the few mask that I haven't tried -- would love to. Maybe this summer when the heating bills go down.

I have used the Hybrid, Comfortfull 2, MoJo, Ultra Mirage Full Face, -- I really ought to dig them out and write a little review on them.

I have used the following which are not full face -- SNAPP X, Comfort Curve, Nasal Aire I and II, Comfortlite 1 & 2, Vista, Opus, Breeze, Simplicity, Aura/Headrest (my preferred mask), and some others.
At 11:41pm on December 31, 2008, sleepycarol said…
Love your avatar!! I have a mini dachsund and he is spoiled rotten!!
At 12:22am on December 30, 2008, sleepycarol said…
I, too, await the rest of your story!!
At 12:34am on December 9, 2008, Mike said…
Spencer, what a cliff hanger. . . let us know what happened next!

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