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Somnics iNAP experience after 1 week
Somnics iNAP experience after 1 week
I've recently started using the Somnics iNAP negative pressure device after 4 years on a CPAP. While the CPAP has been great, I have never loved the mask, so I decided to give this new device a try. 

It works by pulling your tongue and soft palate forward using negative pressure from a tiny pump, opening up the airway. 

Here's my experience so far.

All the sources I've seen (Jason Sazama did a trial on himself, and I had an onboarding call with Somnics) have said that the first couple of weeks can be tough - there's a learning curve and adjustment period. I've been using it for a week now, and I think my body must still be in the adjustment phase. The app that goes along with the iNAP has one main measure - "seal time" which is the amount of time the device does not have to pump because your mouth and palate is sealed, meaning the airway should be open.

Well, over the past week my seal time has gone down significantly, I've had a lot of excess saliva, and my wife says I've started snoring again. This could be because my body is adjusting from being on CPAP for 4 years, as well as my brain still trying to expel the mouthpiece. I'm still going to give it another few weeks to see if I adjust, but if by the 4 week mark I'm still having problems, I will likely go back to CPAP.

Anyway - just thought I'd share - anybody else trying this?
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RE: Somnics iNAP experience after 1 week
Thanks for the update. Please continue to report your progress.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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RE: Somnics iNAP experience after 1 week
UPDATE: Week 2 was a disaster. The sealing time on the device kept getting worse and worse (it's the only stat you get from the machine). The company suggested I get permission from my doctor to change the pressure - apparently because it's "off label" to change the pressure to anything but the approved level.

So after having my doctor give permission, this past week I've been working with the company to move the pressure up and down, at first with little success - I was getting leeks in the back of my mouth. But then their support person shared a video with me about managing those kinds of leaks, and at the same time I had them max out the pressure (-120) - and for the past 2 nights I've had excellent seal time, and I feel that my sleep quality has been very good.

I'll give another update in a couple weeks.
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RE: Somnics iNAP experience after 1 week
Thanks for the update!
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RE: Somnics iNAP experience after 1 week
Thank you joshielevy for updating your use of the Somnics iNAP.

Hope this ends up being a positive experience. Either way, this information will be helpful to others that might want to consider trying it.
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RE: Somnics iNAP experience after 1 week
My doc has written a prescription for me to try it.  Did you do a rental or buy it ?
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RE: Somnics iNAP experience after 1 week
I did the rental...still evaluating btw...I highly recommend getting one of the supported pulse oximeters - or at least a pulse oximeter that has bluetooth that lets you monitor your sleeping spo2. I'm finding that even after almost a month, the iNAP is giving me ~12 min of SPO2 < 90...not great.
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RE: Somnics iNAP experience after 1 week
Thanks for the feedback.
I'm interested in any updates, too.
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RE: Somnics iNAP experience after 1 week
OK so here's my update after maybe 4 weeks or so. 

First off - I just want to say that the customer service from the company has been very good. They've been helpful and responsive for the most part after a bit of an initial communications glitch. After that, they've been very responsive via email, and I also had maybe 3 calls with them.

Finally, about a week ago, I felt like I could get my tongue pulled forward to the proper position where it was almost impossible to even try to make a snoring sound. But during the night - according to the app - I was still having only 20-30% seal time. This was due to leaks mostly from the back of the mouth. I have a uvuloplasty (no uvula) so I wonder if that's affecting the seal from the soft palate?

In any case - I finally got the Wellue pulse ox and did some comparisons, and here's what I found:

1 - (control test - about 3h) during the day, SpO2 avg 95%, never falling below 90%, 0.7 drops > 4% per hour
2 - on the iNAP (about 8h at night), SpO2 avg 93%, ~12 minutes with SPO2 < 90% (lowest SpO2 86%), 2.1 drops > 4% per hour - overall not feeling rested the next day
3 - on CPAP (about 8h at night), SpO2 avg 96%, 0 time < 90% (lowest SpO2 90%), 0.8 drops > 4% per hour, generally feeling rested and mentally very sharp

So I'm not sure if I'm going to continue with the experiment with the iNAP due to the clear results after a month...my failure with the device might be due to my anatomy - that is, uvuloplasty, generally narrow airways, low palate. I did have them adjust the pressure down and up over about a week, and settled on the highest - which at least kept my tongue in place, otherwise I had a lot of saliva which allowed my tongue to move back and open a leak in the back.

I am sure that given different anatomy the iNAP would be a great alternative to CPAP - though even so, expect to take a few weeks for your mouth to adjust and to properly be able to get your tongue consistently in the right position.

Anyway - I kinda feel like a failure - I was really hoping it was gonna work for me, given how portable the device is - but at least I was able to objectively evaluate performance.

Hope this helps y'all!
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RE: Somnics iNAP experience after 1 week
Yes, thanks.  That's a tremendously helpful writeup.
I've had more than one palatal surgery.  And, like you, had the uvula removed.  I may have similar problems.
I see on their website that they're working on having the system eligible for insurance reimbursement.  Kaiser Senior Advantage (my medicare linked plan) isn't paying for the device at this time, but I think it should.  Maybe Inap will give me some feedback on progress along that line.
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