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Why is CPAP not "prescribed" to treat snoring?
#11
That's like shooting insulin because your blood sugar gets high after eating a meal. Not high enough to be diagnosed as diabetic but heck, it works, right?

Snoring is the loose tissue and relaxed muscles in our throats literally vibrating in the breeze. The problem is when that loose tissue and relaxed muscle continue to loosen and relax until they collapse the airway, preventing breathing. Many, many, many people snore yet never have an apnea event. Many, many, many people have apnea events and never snore. There are other devices and stuff out there for people who "simply" snore.
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#12
Quote:Many, many, many people have apnea events and never snore.
That's me.
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#13
(08-14-2015, 01:29 PM)OpalRose Wrote: Not all snorers have Sleep Apnea, and snoring isn't a disease. It is only one of the symptoms of Sleep Apnea. Therefore, you won't find many insurance companies willing to pay for a condition that is not considered a disease. Plus CPAP therapy doesn't always elimate snoring, but does keep your airway from collapse.

Sleep Apnea is a serious condition, and the proven method of treatment for most people would be CPAP therapy.

That was my suspicion and I agree with you. A consequence of the insurance and reimbursement structure.

My point is that not all snorers have apnea. If a technique of applying air pressure to keep the upper airway passage open (and hence prevent snoring) helps, then why is this technique not used? I have been unable to locate a single **snoring treatment** using this solution. There are a lot more snorers than Apnea patients. Obviously we cannot expect this solution from the CPAP manufacturers for obvious reasons of cannibalization of their high margin market ($1000 / machine)


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#14
(08-14-2015, 05:50 PM)PaulaO2 Wrote: That's like shooting insulin because your blood sugar gets high after eating a meal. Not high enough to be diagnosed as diabetic but heck, it works, right?

Snoring is the loose tissue and relaxed muscles in our throats literally vibrating in the breeze. The problem is when that loose tissue and relaxed muscle continue to loosen and relax until they collapse the airway, preventing breathing. Many, many, many people snore yet never have an apnea event. Many, many, many people have apnea events and never snore. There are other devices and stuff out there for people who "simply" snore.

Understand. My discussion was not around trying to address Apnea but *snoring*. Several other devices on the market to "treat" snoring such a mouth inserts get mixed reviews on success.

If a technique of applying air pressure to keep the loose / relaxed tissue and muscles from fluttering works to address snoring (as it has for me), I was simply wondering why it has not been used.

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#15
(08-14-2015, 01:44 PM)AshSF Wrote: For a diagnosed AHI of 5, cpap seems like an overkill. You could probably get by using a dental device OR just elevating the head of your bed by a few inches.

Unless, you had a high RDI or high rate of EEG microarousals. You would need to look at your sleep study results to assess that.

In my case, I was trying to "treat" snoring (both for myself and my wife). I was given the option to try CPAP and so I took it. And in two months of use, I have found that I sleep better and don't snore. Happy wife, Happy life :-)

There are a lot many of us who snore and have bed partners who can't bear it. This is what made me wonder - why the CPAP technique was not used in any low cost appliance strictly for snoring.

Although CPAP is used to treat Apnea, the same technique may also be used to treat (at least) some of us snorers for whom other options do not work.
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#16
(08-14-2015, 03:59 PM)surferdude2 Wrote: I'd walk through hell barefoot to not have to do cpap and if I was given a 5 AHI on sleep lab I'd try sleeping on my side. It can make a huge difference for many people. Most sleep studies are performed in the supine position (to get worse case) so consider that and react accordingly. Snoring is one thing, gasping for breath is quite different. An alert and caring bed partner's opinion is worth as much as a sleep lab in many cases, sometimes more.

Tried it (sleeping on my side not walking through hell barefoot Smile). But it did not work. Snoring was still an issue. The CPAP machine in two months of use has treated my snoring every time I use it. I understand that this may be overkill in my case but that is exactly the source of my question.

If the CPAP technique works nicely to keep the upper airway open so that it also treats snoring, then why are there no devices on the market with a low enough price point and non-prescription option using this technique? Marketing by the CPAP manufacturer's aside, CPAP *does not* equate to Apnea treatment alone.
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#17
(08-14-2015, 03:32 PM)zonk Wrote: From: In conversation with Professor Colin Sullivan; Snoring kills
.....

Thanks. Interesting info Thanks
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#18
Firstly, there is a PAP solution for snorers, called epap, available as disposable nasal plugs under a few names, principally Theravent. if you don;t have apnoea, and your snoring is caused by a certain type of tissue laxity, it will work - but snorers snore for as many reasons as SA patients have SA, so a PAP device might not always be an effective treatment - nasal wall collapse, for instance can cause snoring, it is common and a PAP device won['t remedy it, although if you use nasal pillows it will do a lot to help, because of the increased local pressure - that is why you get nasal strips for snoring - it works on that particular type of snoring. So getting the right therapy for the type of problem is always the thing to do - there is no all in one solution, or I would be a rich and lazy doctor, instead of a hard working and middle waged doctor (I shoulda gone into private practice....).
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#19
(08-15-2015, 05:04 PM)DocWils Wrote: Firstly, there is a PAP solution for snorers, called epap, available as disposable nasal plugs under a few names, principally Theravent.

I looked into these but these did not work for me. They have received mixed reviews on success; most likely owing to different "point of failure" in the airway / nasal passage as you state correctly. I also do not buy into the physics of being able to create up to 4 - 6 cmH20 of pressure in the upper airway by adding resistance during expiration. In my case it seems that there was more pressure in my nasal passage (inflated nostrils) hence the slight suffocating feeling forcing me to breath through the mouth.


(08-15-2015, 05:04 PM)DocWils Wrote: but snorers snore for as many reasons as SA patients have SA, so a PAP device might not always be an effective treatment - nasal wall collapse, for instance can cause snoring, it is common and a PAP device won['t remedy it...

Exactly!! there is no single magic bullet. And there are a lot many of us who snore. Although EPAP may work in some cases, CPAP may work for many others but I see no solution using the latter. Hence my discussion post. It seems that CPAP treatment gets equated with Apnea even though it could help treat a percentage of snorers.

I am begining to wonder if a structure is in place so health providers are being incentivized to push CPAP machines and not really consider this solution for snoring (at least for a percentage of snorers)
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#20
None that I know of - if there is experimental evidence that it works for a certain type of snorer then it gets tried out. The problem is that not the right people are diagnosing and treating snorers. Usually it is a GP or a plastic surgeon, or an ENT, but a pulmonologist or another sort of respiratory physician would be a better choice. They have more experience with various forms of therapy for respiratory problems, although, that said, at the moment CPAP is really directed only at people beyond borderline SA. Insurance won't cover it for off-label Rx, and there is no proof that it works on most cases. it would take a series of studies looking into and defining where it WOULD work to get that into the pipeline. Something for you to suggest to your docs, perhaps, or better, to med students, if they are looking about for a graduate project. You never know....
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