Alternatives to CPAP

[Tom]

Over the years, I've read about various alternatives to CPAP machines for dealing with sleep apnea. One acquaintance had surgery, and declared he was "a new man". I recently became aware of this option offered by a dentist. Anyone have experience with this or similar devices?

[DearMissMermaid]

I don't use a CPAP. When I was told I might need one, I was freaked out because I didn't think I could sleep with that contraption. I know other folks love their CPAP but I was searching for alternatives.

I cured my snoring and apnea through sheer luck.

1-Eliminated alcohol
2-Gargle with salt water several times a day (exercises that flap in the throat and as a bonus reduces the chance of choking on food, another problem I used to have)
3-Sleep on side instead of back, even when I do sleep on back, I am told I do not snore anymore. YAY!

I am one of the lucky ones!

I think gargling has been the biggest help for many cures. I used to sometimes start choking while eating and that was scary. Also I snored. Once I started gargling every day, both problems went away.

I use these stemless plastic wine glasses for mixing salt and warm/hot water. They swirl around fast and easily dissolving the salt without spilling the contents. The ones I have are unbreakable so no worries in the bath or kitchen.

The ones I use are from Amazon:

https://www.amazon.com/gp/product/B0178GUY8Q/

I also use pure pink Himalyan sea salt, I love the flavor (I use it for cooking and eating too) and it gargles up nicely.
 
https://www.amazon.com/gp/product/B005MER0RA/

This has also helped chronic sinus problems I used to have that also went away. I figure the salt gargle may have helped that too as sometimes after gargling I have to blow my nose and then I breathe nicely all night long and my sleep is much improved.

This worked for me, and it might work for you, might not. But gargling is fast and quick. 

[Tom]

Thanks. I have another reason(s) I should gargle, so I'll give it a try.

[John From Detroit]

When I was in hospital with heart issues the Cardiologist and my Primary both insisted I had Sleep Apnea and needed a CPAP.. Well we went for the sleep study and they found.. NOPE.

(The pulmonologist did not think I had that problem. I mean it's his jurisdiction. but the others did not listen to him so.._)

They explained the problem as this. When you sleep and your muscles relax your tongue falls back and blocks your air passages...  (Much simplified version).. Well I can not sleep on my back due to other issues. So i sleep face down and to the side... Gravity works great

[Tom]

Aye John, whatever works to keep the flap from closing the airway. I can't sleep face down.

[Koodog]

With Healthcare now being a business it's easy to see how CPAP is just another money making product.
Outrageous costs for equipment and supplies. An ongoing money stream just in replacement components.
Interesting how it's stressed to replace filters, hoses, masks, ect.
We no longer treat the illness, only the symptoms.
Can't make money is one fixes the problem.
As I'm getting older and the machine breaks more often it's been a real eye opener !

[Rene T]

This is garranteed to work:   

https://www.google.com/search?source=hp&ei=Hk7cW8L3N4uSzwKdtKjgCg&q=tracheal+tube&oq=trachea+tube&gs_l=psy-ab.1.0.0i10l10.1123.5163..7695...0.0..0.142.1240.8j4....2..0....1..gws-wiz.......0j0i131.qB0G3nXNcpY

[TandC]

oops.  delete

[Gizmo100]

Over the years, I've read about various alternatives to CPAP machines for dealing with sleep apnea. One acquaintance had surgery, and declared he was "a new man". I recently became aware of this option offered by a dentist. Anyone have experience with this or similar devices?

I worked for a medical supply company and I can tell you that at least 1/3 of the C-Pap PT's. would not have needed a C-Pap if they would have made some life changes.

I think it will all depend on the root causes of the sleep apnea. I would consult with your doctor. Some of the PT's need for a C-PAP were very real and life saving. A good measure of this was the prescribed pressure settings.

DearMissMermaid listed some good advise. I would also add weight loss (If needed).

All of that said..in the D.M.E. business C-PAP's can generate profits but we made more money on hospital beds and oxygen concentrates.

[Punomatic]

Tom, I am a retired dentist. I have both made and used appliances similar to the one you linked to. So, FWIW:

• This appliance will help to keep the airway open, i.e., reduce snoring/sleep apnea.
• The biggest problem I have had with this style was with one I purchased. It had a hole in the front for you to breathe through. Unfortunately, I ended up with a very dry mouth every night.
• I made a simple one out of two athletic mouth guards bonded together back to back with no air hole. That solved the dry mouth problem.
• Finally, because this appliance displaces the condyle of the mandible in the Temporo Mandibular Joint (TMJ=lower jaw joint), you will probably find that your upper and lower teeth don't seem to come together properly in the morning for some time after you remove the appliance. If you have had any problems at all with your TMJ, I would recommend you have this type of appliance custom made by a dentist who specializes in treatment of snoring/sleep apnea, rather than buying OTC.

[Tom]

... I am a retired dentist. I have both made and used appliances similar to the one you linked to. So, FWIW:

A big thanks for that info. I'd put this on the back burner after receiving an input from from one dentist that "nothing can replace your CPAP machine". In the last week, I received a flyer from another dentist (here at our winter retreat in the MidWest) specializing in these devices, and did some research on his web site before making a planned phone call. I was directed to some reviews of 3 types of appliance, including the one you mentioned, and came away convinced that none of the three options would work for me.

I threw away the flyer, didn't make the phone call, and resigned myself to continuing use of the CPAP machine, until seeing your post. Now I'm confused 

[Bill N]

Another educational thread.  I have learned that because I am a side/face down sleeper my chances of needing a CPAP are probably pretty slim. As it is I would have to figure how to use it AND the oxygen cannula that I currently use.  Thanks Tom and all others who contributed.

Bill

[Molaker]

I may have to get a new laptop. I read the subject line as "Alternatives to CRAP".

[garyb1st]

Sorry if I missed it but can someone tell me what health condition causes difficulty breathing at night and the need for a C-pap machine.  I've seen it come up numerous times on the forum and am thinking maybe I need some help.  If I'm not able to sleep with a window open and fan blowing directly on me it can be difficult to get enough air to breath.  This is more of a problem traveling when we can't open the bedroom slide.  Also much more of a problem during the summer when the temps are higher. 

Never connected it with drinking but MissMeraid may have something regarding alcohol.  I quit drinking 8 months ago for financial reasons.  I'm cheap and was drinking almost a bottle of wine a night.    Actually It was like taking a sleeping pill.  Only problem I'd wake up after a few hours with a headache.  Long story short, my sleeping has improved quite a bit since.  I quit candy about a month ago since I'm trying to lose some of the 35 lbs I've gained since RVing.  I quit smoking more than 35 years ago.  Relatively easy as was quitting alcohol.  But quitting sugar, that's a huge problem.  The craving is less but I'm still thinking of my favorite candy and ice cream.  Aside from sleeping, I'm pretty sure the extra weight is contributing to my growing back problems.  Then again I never connected the weight with difficulty breathing.  So maybe another benefit from losing weight.  Time will tell.

[Lowell]

What prompted me to go in for the sleep test is that I would come awake in my bed and my heart would be beating very fast.  I first went to a cardiologist and after a EKG, sonogram and stress test showed no problems with my heart, the cardiologist suggested I get a sleep test. He said perhaps if one stopped breathing, the brain sent a shot of adrenaline to the heart that was causing the rapid beating.

When I went to the sleep lab and spent the first night, I was told that I had stopped breathing 49 times in one hour.    The sleep lab scheduled a second test and this test was with a CPAP machine hooked up the whole night.  I was told that I was prescribed a CPAP machine but am still awaiting the place to call me to schedule a time to pick up the machine and be taught how to use it.

[Punomatic]

Sorry if I missed it but can someone tell me what health condition causes difficulty breathing at night and the need for a C-pap machine.  I've seen it come up numerous times on the forum and am thinking maybe I need some help.  If I'm not able to sleep with a window open and fan blowing directly on me it can be difficult to get enough air to breath.  This is more of a problem traveling when we can't open the bedroom slide.  Also much more of a problem during the summer when the temps are higher. 

Never connected it with drinking but MissMeraid may have something regarding alcohol.  I quit drinking 8 months ago for financial reasons.  I'm cheap and was drinking almost a bottle of wine a night.    Actually It was like taking a sleeping pill.  Only problem I'd wake up after a few hours with a headache.  Long story short, my sleeping has improved quite a bit since.  I quit candy about a month ago since I'm trying to lose some of the 35 lbs I've gained since RVing.  I quit smoking more than 35 years ago.  Relatively easy as was quitting alcohol.  But quitting sugar, that's a huge problem.  The craving is less but I'm still thinking of my favorite candy and ice cream.  Aside from sleeping, I'm pretty sure the extra weight is contributing to my growing back problems.  Then again I never connected the weight with difficulty breathing.  So maybe another benefit from losing weight.  Time will tell.

Hey, Garyb1st, DISCLAIMER: I am not a sleep expert! OTOH, I am a retired dentist and have struggled some with sleep issues. The primary concern in this problem area is sleep apnea (lack of breathing). Some of the things you mentioned can definitely contribute to sleep problems.   

• Excessive weight contributes because the tissues in the head and neck region become enlarged. When that happens the spaces surrounded by those tissues become smaller. CPAP, jaw-repositioning appliances and other breathing aids are designed to help open those passages mechanically. CPAP forces air through the passages under pressure rather than the body drawing air into the lungs via vacuum pressure, which tends to close the relaxed airway. The appliances reposition the jaw, which advances the tongue so that it doesn't close off the airway when it relaxes and drops back during sleep.
• Alcohol contributes to sleep apnea (and snoring, which is my main problem...or perhaps, I should say it is DW's main problem!) in that it relaxes the tissues surrounding the airway, making them flabby and more likely to block the airway. DW (a life-long non-sleeper) also finds that, whereas a little wine helps her go to sleep, she awakens later either with headache or restlessness that prevents her falling back to sleep.
• Smoking contributes by irritating the tissues along with all the other negatives associated with it.
• I have never seen any references in the literature to sugar intake directly leading to sleep apnea, but there are enough problems associated with refined sugar intake that I applaud your efforts to reduce your intake. Indirectly, of course, excessive sugar intake can exacerbate the weight problem.

Your description of needing the window open and a fan blowing on you sounds suspiciously like an indication that your are experiencing compromised air flow during sleep, if not sleep apnea. I would recommend you continue your weight loss plan and look into having a sleep study done. Be aware that sleep apnea contributes to heart disease, so it is well worth exploring. BTW, I have lost 45 lbs in the last year using a phone app called Lose-It. If you don't already have a specific weight loss plan underway, you might check it out. Good luck, and congrats on giving up cigarettes and alcohol.

[Punomatic]

Now I'm confused 

Oh, no! I hope I didn't throw a monkey wrench in the works. PM me if I can help clarify something I wrote or otherwise shed some light on the subject.

[garyb1st]

Punomatic, I thought I had sleep apnea 25 years ago and went to UCLA for testing.  Interestingly, the technician thought I might have it, but the Docs said no.  Don't recall what followed but for most of my life, I've had problems sleeping. 

By the way, I was married to a Dentist for almost 10 years.  She was educated in South America, then certified as a DDS after attending classes at USC.  Aside from being a real bear to live with, she was probably the best dentist I ever went to.  Continued to work on my teeth for many years after our divorce. 

[Daffy]

With Healthcare now being a business it's easy to see how CPAP is just another money making product.
Outrageous costs for equipment and supplies. An ongoing money stream just in replacement components.
Interesting how it's stressed to replace filters, hoses, masks, ect.
We no longer treat the illness, only the symptoms.
Can't make money is one fixes the problem.
As I'm getting older and the machine breaks more often it's been a real eye opener !

This ^^^^^
ten fold.
Try still being a working stiff, I can tell many on here are not.. God bless you.

Keeping a DOT Medical Card has become a challenge.

If you go to the sawbones with an issue I'm sure when they ask you what insurance you have it lights up the list of available testing that can be performed via the ins company. Battling to get my blood pressure under control to keep my card right now and even though I had a clear "OSCOPY" 2 years ago they want further testing in that area.

You really have to become your own patients advocate anymore and stay educated to the ever changing methods.

[catblaster]

Another educational thread.  I have learned that because I am a side/face down sleeper my chances of needing a CPAP are probably pretty slim. As it is I would have to figure how to use it AND the oxygen cannula that I currently use.  Thanks Tom and all others who contributed.

Bill

   I was also a face down or to the side sleeper until my first heart attack and they realized I stop breathing several times depending on conditions. My CPAP machines are continually improving from a CPAP to a BIPAP, next an AVAP and finally an IVAP.  No testing necessary for the new IVAP, it senses pressures and wave fluctuations and adjusts, also has remote monitoring so the first night a tech goes over the information and make manual adjustments to the machines parameters.
    Before xplant I was on oxy (15L) and the solution is very simple, there is a tee fitting added to the hose at the machine and the oxy line attaches there. If you get up in the night you detach the hose and connect to your cannula. I quickly learned that too much oxy at night can cause a person to stop breathing since the body sees its oxy level as satisfactory and slows down breathing too much. This is where an IVAP comes into play. When it sees no breath being taken it will sent a pulse of air to remind the body it needs to breath.....so far it works every time.  Best solution for this is to follow advice and cut back on oxy flow at night when the need is not as great.Also a water tank and heater is a necessity since the oxygen will dry out sinuses to the point of bleeding.

What prompted me to go in for the sleep test is that I would come awake in my bed and my heart would be beating very fast.  I first went to a cardiologist and after a EKG, sonogram and stress test showed no problems with my heart, the cardiologist suggested I get a sleep test. He said perhaps if one stopped breathing, the brain sent a shot of adrenaline to the heart that was causing the rapid beating.

When I went to the sleep lab and spent the first night, I was told that I had stopped breathing 49 times in one hour.    The sleep lab scheduled a second test and this test was with a CPAP machine hooked up the whole night.  I was told that I was prescribed a CPAP machine but am still awaiting the place to call me to schedule a time to pick up the machine and be taught how to use it.

    When there are times I use my old BIPAP machine the same thing happens. Waking up in a panic with my heart pounding.  After two or three times in one session I refuse to sleep and stay awake until I can get to my other machine (IVAP).

   If you are eligible for VA benefits they will provide a state of the art machine and consumables.

[Gizmo100]

   I was also a face down or to the side sleeper until my first heart attack and they realized I stop breathing several times depending on conditions. My CPAP machines are continually improving from a CPAP to a BIPAP, next an AVAP and finally an IVAP.  No testing necessary for the new IVAP, it senses pressures and wave fluctuations and adjusts, also has remote monitoring so the first night a tech goes over the information and make manual adjustments to the machines parameters.
    Before xplant I was on oxy (15L) and the solution is very simple, there is a tee fitting added to the hose at the machine and the oxy line attaches there. If you get up in the night you detach the hose and connect to your cannula. I quickly learned that too much oxy at night can cause a person to stop breathing since the body sees its oxy level as satisfactory and slows down breathing too much. This is where an IVAP comes into play. When it sees no breath being taken it will sent a pulse of air to remind the body it needs to breath.....so far it works every time.  Best solution for this is to follow advice and cut back on oxy flow at night when the need is not as great.Also a water tank and heater is a necessity since the oxygen will dry out sinuses to the point of bleeding.


    When there are times I use my old BIPAP machine the same thing happens. Waking up in a panic with my heart pounding.  After two or three times in one session I refuse to sleep and stay awake until I can get to my other machine (IVAP).

   If you are eligible for VA benefits they will provide a state of the art machine and consumables.

Catblaster you are the type a person I was referring to way up at the top of this post..I'm glad you are able to get the equipment you need. In the private sector insurance companies fight very hard with anything over a C-PAP's
Are you still using 15L OF O2...That's a VERY high level. In-fact We only had a few people that used 5L.

[catblaster]

Catblaster you are the type a person I was referring to way up at the top of this post..I'm glad you are able to get the equipment you need. In the private sector insurance companies fight very hard with anything over a C-PAP's
Are you still using 15L OF O2...That's a VERY high level. In-fact We only had a few people that used 5L.

No more supplemental oxygen for me !! A double lung transplant on 29 Aug 2012 solved that problem. But I still have two bottles of it sitting beside me now, seems hard to get rid of it. A reminder of how things used to be.

Because regulators max out at 15L the PT nurses would tie two tanks and regulators together with the cut off ends of a stethoscope to make 30L so I could get on the treadmill for therapy.

[Bill N]

   I was also a face down or to the side sleeper until my first heart attack and they realized I stop breathing several times depending on conditions. My CPAP machines are continually improving from a CPAP to a BIPAP, next an AVAP and finally an IVAP.  No testing necessary for the new IVAP, it senses pressures and wave fluctuations and adjusts, also has remote monitoring so the first night a tech goes over the information and make manual adjustments to the machines parameters.
    Before xplant I was on oxy (15L) and the solution is very simple, there is a tee fitting added to the hose at the machine and the oxy line attaches there. If you get up in the night you detach the hose and connect to your cannula. I quickly learned that too much oxy at night can cause a person to stop breathing since the body sees its oxy level as satisfactory and slows down breathing too much. This is where an IVAP comes into play. When it sees no breath being taken it will sent a pulse of air to remind the body it needs to breath.....so far it works every time.  Best solution for this is to follow advice and cut back on oxy flow at night when the need is not as great.Also a water tank and heater is a necessity since the oxygen will dry out sinuses to the point of bleeding.


    When there are times I use my old BIPAP machine the same thing happens. Waking up in a panic with my heart pounding.  After two or three times in one session I refuse to sleep and stay awake until I can get to my other machine (IVAP).

   If you are eligible for VA benefits they will provide a state of the art machine and consumables.

More good info to educate me.  But I need to comment on the dry sinuses and bleeding.  I have been on oxy at night for over one year (2L) and have not had this problem but I can easily see how 15L would cause it.  I was amazed when I first read your Oxy levels but see that your lung transplants have solved that problem and am happy for you.  Health is everything but breathing is the first step in good health.  Thankfully the Medicare and Tricare for Life cover 99 percent of my health expenses.  I have empathy for those who are younger with health problems now.  Just the deductible is enough to bankrupt many folks.  Again, thanks for that info.

[catblaster]

More good info to educate me.  But I need to comment on the dry sinuses and bleeding.  I have been on oxy at night for over one year (2L) and have not had this problem but I can easily see how 15L would cause it.  I was amazed when I first read your Oxy levels but see that your lung transplants have solved that problem and am happy for you.  Health is everything but breathing is the first step in good health.  Thankfully the Medicare and Tricare for Life cover 99 percent of my health expenses.  I have empathy for those who are younger with health problems now.  Just the deductible is enough to bankrupt many folks.  Again, thanks for that info.

    Thank You Bill, I think that by now they have billed close to $2M. I added up the billing shortly after transplant and it was at $1M then and that was a little more than 6 years ago. This year the Photopheresis sessions were billed at just under $10K each and there were 25 of them, medicare doesn't cover it so therefore neither does my supplemental but when I got several statements and the balance was $0.00, thats a beautiful thing. I dont know who or what group paid it but I sure am thankful. 
    Some people cant get their transplant because of the financial burden, the inability to pay for it. I was fortunate with the right insurance at the right time, met my deductible in Jan/12 and haven't paid anything since.....good insurance and good fortune.

[99dart]

I started out on a CPAP, but after 3 months I gave it up. I just couldn't sleep with it. I am now using one similar to the one I linked. It is adjustable, so you can pull the lower jaw forward as much or little as needed. My wife swears by it!


http://www.empowereddoctor.com/wp-content/uploads/2018/03/herbst_acrylic.jpg

[J32952]

“Sorry if I missed it but can someone tell me what health condition causes difficulty breathing at night and the need for a C-pap machine”
   Simple explanation:  during sleep your muscles relax and soft tissues in back of throat “collapse”, thus blocking your airway.  The CPAP creates a pneumatic splint holding your airway open.  Prior to PAP most common solution was a surgery (maybe 50% effective) where they cut out some of the soft tissue. Dental appliances can adjust your jaw position, again the goal is keeping your airway open.  Sleeping position, often sleeping on side, may help as soft tissues doesn’t “fall” into airway.
   Most common is “obstructive sleep apnea” (OSA), obstruct - the soft tissues blocking airway. Apnea: to stop breathing.  There are other causes of apnea, however much less common. Simple PAP generally not effective solution when cause is other.
    Weight loss can help. Alcohol does play a factor (even using PAP, your prescription may be fine most of the time, but not enough pressure at times you over indulge).
   Snoring is an indication, but does not mean OSA. However, if while snoring your bed partner gasps for air, startles awake to breathe, that should be tested. 
   In addition to disrupting your sleep (patients report always feeling tired), lack of breathing (getting rid of CO2) puts excessive strain on your heart.  PAP is simple, generally effective, one of those few treatments that can change your life for the better “overnight”.  The masks / interfaces can be a PIA, so try different types till you find one that works.
    Someone asked about using O2, you can bleed it into your pap mask with a simple valve. Ask your provider.
   Adding humidification can reduce dry mouth. Keep your mask/tube clean!
   I am not a Dr, spent 20 plus years involved in the HME industry with a lot of time around PAP ..so this is layman’s view.
   

[Tom]

Adding to J32952's explanation, with sleep apnea, when you stop breathing, the brain eventually signals you to wake up and start breathing. You may not fully wake, but you come out of the deep recuperative sleep. After some period of breathing, you fall back into deep sleep, muscles relax, and the process starts all over. This can happen many times a night, meaning that you don't get the prolonged deep (restful) sleep that the body needs. The net result is that the following day you feel very tired and are likely to fall asleep at inopportune/unexpected times.

[Rene T]

Adding to J32952's explanation, with sleep apnea, when you stop breathing, the brain eventually signals you to wake up and start breathing.

Or my DW would kick me. 

[Gizmo100]

Or my DW would kick me. 

Rene that wasn't a kick...That was a love tap.

My first wife swore up and down that I would stop breathing at night...One night I'm laying in bed WIDE AWAKE. Had a lot of things on my minds and just couldn't sleep. All of sudden she smacks me in the chest..I about had a heart attack...She insisted I stopped breathing...I promised her that not only was I breathing but I was awake the whole time and I think I would have noticed.....

[SargeW]

I am a huge proponent of exercise, and it's never too late to start. Anything you do in the way of aerobic exercise or weight bearing exercise will make a significant difference in your overall general health and mobility. Dozens of studies have been made with participants in their 80's, and after 4-6 weeks of minimal exercise, all reported better mobility and over all general health. 

I have a buddy that was using a CPAP and was on diabetic and blood pressure meds. He got mad, changed his diet and started a regular exercise program. Not excessive, just regular.  When I saw him again he had lost 50 pounds, and his doctor had just taken him off of the meds.  He quit the CPAP 2 months prior. He will be 70 in a few months, and feels way better than he had in years.  I am a believer.