CPAP Basics - 14 - CPAP Alternatives

palerider wrote: ↑

Sat May 25, 2019 12:22 pm

Peony wrote: ↑

Fri May 24, 2019 5:32 pm

LSAT wrote: ↑

Fri May 24, 2019 5:25 pm

Peony wrote: ↑

Fri May 24, 2019 12:25 pm

Wow! Thank you for these links! Turns out that the Dr in the first video has his office very close to where I live! May go see him- so again, thanks.

He's a Chiropractor...not an MD

Yes, I know. Still call them "Dr".

You might call someone that teaches math at the university 'Dr' too, but I wouldn't go to them for medical advice.

Wasnt thinking of going to him for medical advice! I was thinking of seeing him for chiropractic treatment for pain, which is what he does.

Peony wrote: ↑

Sun May 26, 2019 11:31 am

palerider wrote: ↑

Sat May 25, 2019 12:22 pm

Peony wrote: ↑

Fri May 24, 2019 5:32 pm

LSAT wrote: ↑

Fri May 24, 2019 5:25 pm

Peony wrote: ↑

Fri May 24, 2019 12:25 pm

Wow! Thank you for these links! Turns out that the Dr in the first video has his office very close to where I live! May go see him- so again, thanks.

He's a Chiropractor...not an MD

Yes, I know. Still call them "Dr".

You might call someone that teaches math at the university 'Dr' too, but I wouldn't go to them for medical advice.

Wasnt thinking of going to him for medical advice! I was thinking of seeing him for chiropractic treatment for pain, which is what he does.

My point was that you still call them 'dr' like you call that math professor 'dr'.

Has *nothing* to do with medicine.

Can't even prescribe you a cpap.

palerider wrote: ↑

Fri May 24, 2019 1:30 pm

camper wrote: ↑

Thu May 23, 2019 1:51 pm

I snore quite loudly. The noise comes from my vocal cords

That's not where snoring comes from.

If you look it up, there is no single place in the airways where snoring is generated. Vocal cord snoring is less common than some other places - e.g., the back of the mouth is very common, as is part of the nose - but there are a fair number of other people who do vocal cord snoring too. If everyone was the same, it might be a lot easier problem to solve. Instead, solutions and devices that work for one person, don't work for many other people.

To figure out where I snore from, I recorded myself sleeping. Figured out how to make the same sound while awake - basically, relaxing the part of my throat just above the vocal cords. I could feel my vocal cords vibrating, while breathing out. To verify, recorded that too, since sound conduction inside the head changes sound quality. (Try this: record yourself singing, using a GOOD quality recorder or smartphone. Play it back. You sound substantially different to a recording device, or to other people, than to yourself.) The result is identical, including timbre, duration and pitch. Vibration somewhere else in the airways might match duration and perhaps timbre fairly well, but pitch is a fairly unique signature.

palerider wrote: ↑

Fri May 24, 2019 1:30 pm

camper wrote: ↑

Thu May 23, 2019 1:51 pm

. I'm using the Respironics DreamStation, ...- supposedly one of the quietest combinations available.

Not really, dreamstation produce a variable audible whine that's annoying to people with good hearing.

[/quote]

I have no problem hearing the Dreamstation. Once I put the Dreamstation farther away, on the floor, the whine was less noticeable, though it is still an annoyance- but the Darth Vader-like air noise coming through the tubes into the mask is still very noticeable. The respiratory therapist told me to play with tube configuration - e.g., to mount the tubes from a high point, but that didn't seem to help much.

Are you saying there are machines that make less annoying noises? The website reviews I looked at claimed that Dreamstation was the quietest, though the claim that it is "whisper quiet" is not accurate IMO - unless they mean a "stage whisper".

camper wrote: ↑

Sun May 26, 2019 3:16 pm

Vocal cord snoring is less common than some other places - e.g., the back of the mouth is very common, as is part of the nose - but there are a fair number of other people who do vocal cord snoring too.

Some parts of that statement are weak at best.

Snoring is the sound produced by vibrating structures of the upper airway, typically during inhalation. Any membranous part of the airway lacking cartilaginous support, including the tongue, soft palate, uvula, tonsillar pillars and pharyngeal walls, can vibrate.

https://www.scientificamerican.com/arti ... redirect=1

First, I wasn't endorsing any of those videos, or the people who made them. They were just examples of what I found in a very quick search. A lot of them are trying to market their services, which could bias what they claim.

palerider wrote: ↑

Fri May 24, 2019 1:37 pm

All of these "muscle 'tone' exercises" fail to take into consideration one important point:

No matter how strong or "toned" a muscle is, when it relaxes, as in sleep, it is then floppy.

AFAICT from non-authoritative sources, people only partially relax various muscles while asleep. Perhaps there could be sufficient muscle tone to stop snoring?

If I thought a few hundred hours of preliminary exercise, maintained by an hour or two more a week, would stop or significantly reduce snoring and/or sleep apnea, I would do it.

I wasn't asking whether people thought it would on a theoretical basis. I was asking whether anyone here has tried it, or can point to clinical data regarding such trials.

I just did a quick search for applicable medical studies at Google scholar. Selecting for specific exercise type, and for the fact that my BMI is 25 - only a little overweight, and am not sedentary, I found:

Positive results of exercise on snoring or apnea
https://www.sciencedirect.com/science/a ... 9900903765
https://www.sciencedirect.com/science/a ... 369191651A
http://medind.nic.in/daa/t11/i1/daat11i1p133.pdf
https://link.springer.com/article/10.10 ... 009-0311-1
https://link.springer.com/article/10.10 ... 014-3382-y
No positive results on snoring or apnea
http://www.scielo.br/scielo.php?pid=S18 ... ci_arttext
https://europepmc.org/abstract/med/17417165

I could look up the full text of these studies, and the other studies they reference, at a university library, but I don't have the expertise to evaluate how well they apply to me, or if they are biased. Incidentally, improving muscle tone isn't the only exercise effect some of them suggest might help.

In a second (titrating) sleep study, CPAP was only partially successful in solving MY sleep apnea. However, I'm not sure the test was very well done. I'm a mouth breather, especially at night, but they insisted on using a nasal mask, despite my request for something else - one that I found quite physically painful to wear. They used fairly high air pressures, in an attempt to close my mouth, which I doubt succeeded completely. Between the painful mask, all the wired and tubed connections, and the ventilation system noises, I felt like I got almost no sleep. Some of their results are not consistent with my own impressions - e.g., they said I fell asleep within 15 minutes, which I'm quite certain is untrue.

Also, that test did not report the affects of CPAP on snoring.

I've had a bit more luck at home with a CPAP machine and a nominally full-face mask, though I have no way to detect apnea events - but I still sometimes snore a little, while using CPAP.

So, apnea and snoring -specific exercise seem like a reasonable option - if and only if they have a high probability of working.

P.S. One article does not constitute a complete scientific literature search. If you search for "snoring" and "vocal cords" or "vocal folds" at Google Scholar, you will find instances of vocal cord snoring mentioned in refereed journal articles. So I am not entirely unique.

camper wrote: ↑

Sun May 26, 2019 4:29 pm

I've had a bit more luck at home with a CPAP machine and a nominally full-face mask, though I have no way to detect apnea events

Too bad you ended up with a brick.

camper wrote: ↑

Sun May 26, 2019 3:16 pm

palerider wrote: ↑

Fri May 24, 2019 1:30 pm

camper wrote: ↑

Thu May 23, 2019 1:51 pm

I snore quite loudly. The noise comes from my vocal cords

That's not where snoring comes from.

If you look it up, there is no single place in the airways where snoring is generated. Vocal cord snoring is less common than some other places

Nothing found. If you have a *credible* reference, I'd be interested.

camper wrote: ↑

Sun May 26, 2019 3:16 pm

To figure out where I snore from, I recorded myself sleeping. Figured out how to make the same sound while awake - basically, relaxing the part of my throat just above the vocal cords. I could feel my vocal cords vibrating, while breathing out.

A *parrot* can make the same sound as your snoring, but it does not have the same origin.

camper wrote: ↑

Sun May 26, 2019 3:16 pm

Are you saying there are machines that make less annoying noises? The website reviews I looked at claimed that Dreamstation was the quietest, though the claim that it is "whisper quiet" is not accurate IMO - unless they mean a "stage whisper".

I'm saying that Resmed machines are quieter than Respironics machines, because of the radical differences in the blower.

Whatever you're reading that says that the dreamstation is the quietest, is simply wrong.

camper wrote: ↑

Sun May 26, 2019 4:29 pm

AFAICT from non-authoritative sources, people only partially relax various muscles while asleep. Perhaps there could be sufficient muscle tone to stop snoring?

And, just how would 'partially relaxed' "toned" muscles (and what is 'toned', anyway), differ from partially relaxed non-toned muscles?

camper wrote: ↑

Sun May 26, 2019 4:29 pm

If I thought a few hundred hours of preliminary exercise, maintained by an hour or two more a week, would stop or significantly reduce snoring and/or sleep apnea, I would do it.

Come back in a few hundred hours and lets us know what happened.

camper wrote: ↑

Sun May 26, 2019 4:29 pm

I wasn't asking whether people thought it would on a theoretical basis. I was asking whether anyone here has tried it, or can point to clinical data regarding such trials.

Just a quackpot or two... and no, no reputable clinical data.

camper wrote: ↑

Sun May 26, 2019 4:29 pm

but I still sometimes snore a little, while using CPAP.

Raise the pressure to alleviate snoring.

Parrots can make snoring sounds? How interesting.

And they can create human speech sounds too.

I wonder why they need to be so versatile.

As far as snoring and vocal cords, I'm obviously not an expert, but:

https://www.ent-surgery.com.au/ent-resources/snoring says

"Snoring is a sound made by vibrations of the soft palate and other tissue in the mouth, nose and throat (upper airway). Snoring is caused by turbulence inside the airway during breathing. The turbulence is caused by a partial blockage that may be located anywhere from the tip of the nose to the vocal cords."

www.britannica.com/science/snoring (text requires subscription) includes
"Snoring: Snoring, a rough, hoarse noise produced upon the intake of breath during sleep and caused by the vibration of the soft palate and vocal cords."

Needless to say, I found those after specifically searching for "snoring" and "vocal cords", so my search was biased.

camper wrote: ↑

Sun May 26, 2019 5:21 pm

As far as snoring and vocal cords, I'm obviously not an expert, but:

https://www.ent-surgery.com.au/ent-resources/snoring says

"Snoring is a sound made by vibrations of the soft palate and other tissue in the mouth, nose and throat (upper airway). Snoring is caused by turbulence inside the airway during breathing. The turbulence is caused by a partial blockage that may be located anywhere from the tip of the nose to the vocal cords."

And I'd wager that your vocal cords causing the snoring noises is JUST as unlikely as the tip of your nose.

camper wrote: ↑

Sun May 26, 2019 5:21 pm

www.britannica.com/science/snoring (text requires subscription) includes
"Snoring: Snoring, a rough, hoarse noise produced upon the intake of breath during sleep and caused by the vibration of the soft palate and vocal cords."

Needless to say, I found those after specifically searching for "snoring" and "vocal cords", so my search was biased.

You should be suspicious of very 'high level' texts.

Regardless, seems like you've made up your mind about what you want to think.

Yes, I know that there are published texts which are incorrect - in fact, almost every textbook in almost any subject has some things wrong, or only presents approximations applicable to a limited set of circumstances. This used to bother me a lot - I felt classes and textbooks should teach the absolute truth, but finally had to realize that the absolute truth is elusive.

As far as making up my mind, well... I just asked my ENT. She is not familiar with any exercise programs of this nature, but she says my obstructions are at the base of the tongue and the soft palate. She has appropriate qualifications - she specializes in throat surgery and sleep disorders.

Yet I cannot figure out how to imitate the recorded snore sound using the tongue and soft palette. So... I'm not completely convinced.

I don't know whether it is worth putting in the time to try out these exercises.

Right now, I have a lot of trouble getting to sleep using the CPAP machine, whereas I have little trouble with no machine - but it I've only had it for less than two weeks, so I don't know if that will remain true.

And it has major practicality issues in the outdoors.

My machine may also be too noisy for social purposes, though that might as much to do with the mask as the machine - e.g., I'm about to try a Resmed Airtouch F20 mask which has "QuietVent technology", as well as potentially doing a better job of covering my mouth and nose than the Dreamware "Full Face" Mask I am using, and the nasal masks I tried before that. (I'm clearly not alone in thinking these machines have noise issues. A lot of posts in this forum relate to noise problems noticed by bed partners.)

But, a simple passive valve that increases pressure while breathing out, along the lines of the two passive nasal devices I mentioned (Theravent and OptiPillows), but that attaches to a CPAP mask, or other mouth-covering device, along the lines of those in the study I mentioned, instead of applying to the nose, might be an improvement, for my purposes. It would it eliminate the weight, bulk, power and battery issues, and I bet it could be much more quiet than most active electric pump CPAP machines. It is obvious that it could theoretically be a lot cheaper than a full blown CPAP machine - so I would expect the CPAP industry to fight it - though the fact that those two mentioned passive nasal devices are FDA approved suggests that fight may not be completely successful. And of course, I don't know if such a device can work for me.

And, I still want to know why parrots, etc., are so versatile in the sounds they can produce, be it snores or speech... Is there an evolutionary need that such versatility satisfies, that justifies how sophisticated the brain needs to be, along with the weight and energy requirements that such sophistication requires? E.g., do they have a reason to imitate the sounds of predators or prey, or do have a good reason to need unusually sophisticated communications with each other? Though that is off-topic.

camper wrote: ↑

Tue May 28, 2019 1:47 pm

Right now, I have a lot of trouble getting to sleep using the CPAP machine, whereas I have little trouble with no machine - but it I've only had it for less than two weeks, so I don't know if that will remain true.

If you want help with CPAP, start a new post to discuss your CPAP therapy. You can get plenty of help here.

If you are just looking for excuses to give up CPAP this early in the game, you won't get much sympathy here.

ChicagoGranny, I'm not trying to get into an argument with you. I believe that one should always seek alternative treatments, for any condition, if the current treatment has costs, inconveniences, or side effects.

Some of my negative side effects were eliminated last night by the methods described in another thread,
viewtopic/t175967/Respironics-Dreamstat ... ation.html

But some negative side effects, costs, and inconvenience remain. So I will continue to search for alternatives.

BTW, I found a dissertation at
https://osu-slam.github.io/doc/Music-In ... tation.pdf
that, among other things, summarizes evidence supporting the use of voice exercises to reduce snoring and sleep apnea.

However, some classically trained singers snore and/or have sleep apnea. So such exercises are not a complete universal cure, even at high training levels. Nor are CPAP, APAP, EPAP, surgery, or weight reduction. But perhaps they could complement each other.

Also, it occurs to me that strength and muscle tone are not the only possible mechanisms for exercise-induced change. It is widely accepted that general strength and endurance training shortens muscles, unless countered by flexibility training. Any changes to the size or shape of the relevant muscles could carry over into the periods of muscle tone relaxation induced by REM-sleep.

camper wrote: ↑

Thu May 30, 2019 2:48 pm

But some negative side effects, costs, and inconvenience remain. So I will continue to search for alternatives.

I suggest that you purchase and take lessons on the use of the didgeridoo for sleep apnea.
They say that it has good results for some and, as far as I can see, no one here on cpaptalk has as yet contributed a report on their personal experience with it as an alternative remedy.

https://www.youtube.com/watch?time_cont ... Ynzw4AUwxA

https://duckduckgo.com/?q=didgeridoo+sl ... 3-1&ia=web

https://www.sleepapnea.org/treat/sleep- ... digeridoo/

https://www.verywellhealth.com/learn-to ... ea-3015177

https://didgeproject.com/sleep-apnea/di ... cal-study/

It sounds as if you have the drive and the determination to try out an alternative like this one, and the rest of us would look forward to getting your full report. After you have given it a reasonable trial period of a few months use.

Best wishes, Nate

NateS wrote: ↑

Tue Aug 27, 2019 3:02 pm

camper wrote: ↑

Thu May 30, 2019 2:48 pm

But some negative side effects, costs, and inconvenience remain. So I will continue to search for alternatives.

I suggest that you purchase and take lessons on the use of the didgeridoo for sleep apnea.
They say that it has good results for some and, as far as I can see, no one here on cpaptalk has as yet contributed a report on their personal experience with it as an alternative remedy.

https://www.youtube.com/watch?time_cont ... Ynzw4AUwxA

https://duckduckgo.com/?q=didgeridoo+sl ... 3-1&ia=web

https://www.sleepapnea.org/treat/sleep- ... digeridoo/

https://www.verywellhealth.com/learn-to ... ea-3015177

https://didgeproject.com/sleep-apnea/di ... cal-study/

It sounds as if you have the drive and the determination to try out an alternative like this one, and the rest of us would look forward to getting your full report. After you have given it a reasonable trial period of a few months use.

Best wishes, Nate

Best played in a desert setting or deserted island. Or use XPAP correctly and make everyone Happy, even your own body! Jim