"please keep me updated about oximeters "
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ProVent: A New Way of Treating Sleep Apnea?
I've been waiting a long time for Provent to be available to the general public. I saw a pilot study about this device in one of my sleep medicine journals 6 months ago, and was intrigued by how this device works. Essentially, it's two nasal plugs that attach to your nostrils using adhesives. During inspiration, you can breathe normally, but during exhalation, it limits the amount of air that can pass through the device. The theory is that when there's more resistance when you exhale, at the end of exhalation, a slight positive pressure effect is created in the throat, keeping your relaxed muscles more open.
Looking at the raw data, it does seem to make a difference, but it doesn't really "cure" the problem. On average, it lowered the AHI by about 50%. In some people, the results were much better, and in others, it was actually worse.
Since it's so new, insurance doesn't cover it. A 30 day supply is about $135, but for a limited time, they're offering a 50% discount. It must be ordered through a prescribing physician and will be mailed to your house.
I got some samples and will offer it to select patients to test it out. I'll keep you posted on the results.
Looking at the raw data, it does seem to make a difference, but it doesn't really "cure" the problem. On average, it lowered the AHI by about 50%. In some people, the results were much better, and in others, it was actually worse.
Since it's so new, insurance doesn't cover it. A 30 day supply is about $135, but for a limited time, they're offering a 50% discount. It must be ordered through a prescribing physician and will be mailed to your house.
I got some samples and will offer it to select patients to test it out. I'll keep you posted on the results.
Views: 1674
Replies to This Discussion
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Permalink Reply by Judy on
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Thank you for making this generous offer, Dr Park.
I am going to be curious about the Provent. Not so much from the standpoint of "curing" or reducing my OSA as my OSA is mild and is well-controlled since I finally found the right pressure for me.
What has me curious is that years ago (1996-1998) when I was originally diagnosed I did try CPAP for about 2 1/2-3 months. I didn't have the support of my local DME supplier at all. They were terrible. And when they wouldn't let me exchange the only mask I was given despite I had a raw sore on the bridge of my nose I returned the equipment and didn't go near a sleep professional again until 2006. The mask was the only real problem I had.
I did have to put forth some effort to exhale against the pressure and that did contribute to problems acclimating to CPAP therapy but I did use that mask and CPAP every night faithfully at least 6-7 hours. Not that I slept the entire 6-7 hours. Anyway, one thing I did realize was that I did not exhale as strongly as I should and the CPAP actually encouraged and taught me to increase my exhalation even when I wasn't using it during the day. I was later told, in 2006, that that hadn't been a good thing since it would have interfered w/my sleep. Maybe so but I think it did my COPD lungs a world of good.
Pulmonary Rehab and two recent articles Rock Connor and jnk gave me links to reminded me that it was important for me to improve and maintain my exhalation strength. So far according to my PFTs I'm not yet a C02 retainer.
I will really be looking forward to the results you find w/the samples you provide!!!
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Permalink Reply by Steven Y. Park, MD on
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Judy,
Sorry if I wasn't clear, but I can only try out the Provents for patients in my clinical practice. It can't be done "virtual" patients. If you wanted to try them yourself, you can talk to your sleep doctor, who'll have to prescribe it. Or did I misunderstand your comment?
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I didn't make myself clear, Dr Park. I'm going to be VERY interested in the results you get w/your patients and was just explaining why the results would be of more than average interest to me. Heck, I can only use my VPAP Auto in auto mode as I'm not as "tough" as I was 10 years ago, the "puff" we can't seem to get rid of at the end of inhalation, start of exhalation in Spontaneous mode disrupts my sleep AND my getting to sleep. Now that I am sleeping goood in auto mode I really have no desire to disrupt my sleep again!!! But ... depending on the results you encounter w/your patients I might be interested in trying them for daytime "reminders" when from time to time I find myself exhaling too shallow.
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Permalink Reply by Daniel on
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Dr. Park,
This makes me wonder about the theory behind the Provent. The Provent only affects exhalation, but OSA happens during inhalation and exhalation. It sounds to me that it would only solve 50% of apneas. Then you report a 50% reduction in AHI. Could apnea during inhalation be the reason? Does this logic make any sense to you?
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The paper's explanation is that since obstructions happen as you begin to inhale, if the pressure inside your throat is slightly more pressurized at the end of exhalation, then during inhalation, it lessens the chance that you'll obstruct.
I have to admit, the explanation was a little technical, but you can't argue with the data. Don't think of it as a cure. Think of it as just another adjunctive tool in our big toolkit. For some, it may help significantly, but for others, it may not help at all.
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Permalink Reply by Mike on
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since first hearing about these Provent nasal devices, I've tended to think of them not only as a great option for folks who can't tolerate CPAP, but also for others in the third world (and the first world!) who can't afford a CPAP machine
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The rep did state that it takes a few days to get used to using. You have to start off breathing through your mouth.
Here's the link to the PDF of the original paper: http://www.proventtherapy.com/pdfs/pdf09_Abstract.pdf
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Permalink Reply by sleepycarol on
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Would it cause you to retain carbon dioxide levels? Medical stuff baffles me so I am not sure I understand how you would clear out the co2 and it would appear it would build up and you could have problems.
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