Experience with Provent?

[Galactus]

The way it works is to create pressure in the airway, whether during inhalation or exhalation it accomplishes the same thing, to keep the airway pressurized thereby not allowing it to collapse. Think of it this way, it doesn't matter how you pressurize the straw or from which direction, just so long as it remains pressurized. I am not saying they work I am just saying that is what they are purported to do.

I just felt it would have been nice to test them, and as so many manufacturers and drug companies are now giving away free samples one would think this would be a perfect product to give away free samples of.

The Sleep Apnea industry Worldwide is huge and growing. Every man and his dog wants to get a piece of the action, even if it involves marketing something that looks good with a glossy brochure.

They will sell enough to the curious to make a lot of money even if it doesn't work. Then people will simply conclude it "didn't work for me" rather than it just doesnt work at all.

There are no free samples for that very reason. They don't want to be found out too soon before the gravy train stops. While they get good sales there will always be a % of people who will "try" it and keep sales going.

I totally agree with you, anything that a profit can be made of will be marketed and sold, and most especially anything that looks good on a sales gloss.

Just keep in mind though that many things work for small subsets of people, even if they do not work for the majority. Surgery, singing lessons, sleep positions, weight loss, who knows what else. Depending on the severity, and or the conditions this thing could work for a small subset of people as well. Those people alone could be enough to make a company like this profitable. I mean think about it, not all meds work for all people and that is why there are so many free trial coupons out there for various meds. This just seems like a very high profit item that could benefit some individuals, and could easily and cheaply be given away. It is easier to believe that there are no free samples simply because it doesn't work. But I think it's equally as easy to believe no one there has considered it even if it could be a good idea.

I doubt highly it would work for me, I have a pretty severe case of apnea, but I think I still would have liked to try it, just to see what it did if anything. It might have been interesting.

[Sleepster]

I believe there were successful clinical trials. Without them I doubt the FDA would allow the product to be released in the US. Last I heard Provent works for a limited number of people with mild sleep apnea, but I thought I'd also heard that the company had gone out of business.

Regardless, like dental appliances, it's a possible alternative for folks who can't tolerate CPAP therapy.

I count myself as lucky to be able to sleep at all with the CPAP machine attached to my face. If it weren't for the fact that it's a successful treatment I wouldn't be doing it.

[Galactus]

I believe there were successful clinical trials. Without them I doubt the FDA would allow the product to be released in the US. Last I heard Provent works for a limited number of people with mild sleep apnea, but I thought I'd also heard that the company had gone out of business.

Yes, there were clinical trials, they were bashed by some because of course Provent paid for them. To some people that mattered, to others it didn't.

They did go out of business, and they are back, not sure if they were bought out or what, but they did go out for a time, and now back.

Regardless, like dental appliances, it's a possible alternative for folks who can't tolerate CPAP therapy.

That wasa my thought. I still want some free trials though lol.

I count myself as lucky to be able to sleep at all with the CPAP machine attached to my face. If it weren't for the fact that it's a successful treatment I wouldn't be doing it.

Agreed

[Jim Bronson]

LankyLefty's explanation makes sense. The Provent doesn't pressurize on inhalation. The patient inhales normally, almost as if the devices weren't there. The manufacturers claim the airway is only pressurized on exhalation when the lungs are trying to expel CO2, but they can only do so at a reduced rate due to the partial blockage of the Provent one-way valving. If there's an OA, the Provent can't do anything about it during inhalation, so the result would be snoring and gasping for air (sounds familiar). On exhalation, the airway might be partially opened by the pressure that the lungs exert trying to expel the CO2, but that's not the usual issue with apnea sufferers. The concept appears backwards to me. I want a clear airway both directions, and CPAP type devices provide this. It bothers me that it is apparently approved by the FDA.

[TyroneShoes]

LankyLefty's explanation makes sense. The Provent doesn't pressurize on inhalation. The patient inhales normally, almost as if the devices weren't there. The manufacturers claim the airway is only pressurized on exhalation when the lungs are trying to expel CO2, but they can only do so at a reduced rate due to the partial blockage of the Provent one-way valving. If there's an OA, the Provent can't do anything about it during inhalation, so the result would be snoring and gasping for air (sounds familiar). On exhalation, the airway might be partially opened by the pressure that the lungs exert trying to expel the CO2, but that's not the usual issue with apnea sufferers. The concept appears backwards to me. I want a clear airway both directions, and CPAP type devices provide this. It bothers me that it is apparently approved by the FDA.

(emphasis mine)

Thank you for saving me the time, as this was exactly my point.

The way it works is to create pressure in the airway, whether during inhalation or exhalation it accomplishes the same thing, to keep the airway pressurized thereby not allowing it to collapse. Think of it this way, it doesn't matter how you pressurize the straw or from which direction, just so long as it remains pressurized. I am not saying they work I am just saying that is what they are purported to do

"Purported", indeed. Put your finger over the far end of a straw and try to suck the air through it. What happens? A flat straw, with no air movement, due to negative pressure. The "Ps" in XPAP stand for "Positive Pressure". If this device has one capability, which is to restrict airflow in one, the other, or even both directions, your airway would collapse on inhale, just like the straw. Inhalation against something restricting it, whether your airway or a device, creates comparative negative pressure, and the airway collapses.

That is the exact polar opposite of what is needed. Provent can create EPAP positive pressure, but to what end? That would be as stupid as the US invading a different foreign country that had no part in the terror act that P*ssed them off in the first place. We know something that stupid could never happen.

To keep the airway from collapsing, you either need an airway not prone to collapse (not suffer from OSA), or positive air pressure. What a concept...somebody should try to invent something that does that.

The only difference in pressure this thing creates, is on exhalation. It can't possibly be of any value to the OSA patient, unless he is a major share-holder in this fly-by-night company.

[Sleepster]

It bothers me that it is apparently approved by the FDA.

I think it might actually work. The theory behind it makes sense to me and I think that in some cases it was proven to work.

As you sleep you only partially fill your lungs when you inhale, then nearly empty them when you exhale. They never get more than, say, half full. You are putting air in and out of the "bottom half" of your lungs. What Provent does is keep those lungs half full, so that as you breathe you are filling and emptying the "top half" of the lungs.

Keeping the lungs partially filled with air at all times keeps the pressure in your airway elevated so that possibly an airway that would otherwise collapse remains open.

The thing is, why bother with a technology that might work when you've got a technology that does work. The same argument applies to dental appliances. These are treatments for people who would otherwise leave their CPAP machines in a closet.

[Galactus]

LankyLefty's explanation makes sense. The Provent doesn't pressurize on inhalation. The patient inhales normally, almost as if the devices weren't there. The manufacturers claim the airway is only pressurized on exhalation when the lungs are trying to expel CO2, but they can only do so at a reduced rate due to the partial blockage of the Provent one-way valving. If there's an OA, the Provent can't do anything about it during inhalation, so the result would be snoring and gasping for air (sounds familiar). On exhalation, the airway might be partially opened by the pressure that the lungs exert trying to expel the CO2, but that's not the usual issue with apnea sufferers. The concept appears backwards to me. I want a clear airway both directions, and CPAP type devices provide this. It bothers me that it is apparently approved by the FDA.

(emphasis mine)

Thank you for saving me the time, as this was exactly my point.

The way it works is to create pressure in the airway, whether during inhalation or exhalation it accomplishes the same thing, to keep the airway pressurized thereby not allowing it to collapse. Think of it this way, it doesn't matter how you pressurize the straw or from which direction, just so long as it remains pressurized. I am not saying they work I am just saying that is what they are purported to do

"Purported", indeed. Put your finger over the far end of a straw and try to suck the air through it. What happens? A flat straw, with no air movement, due to negative pressure. The "Ps" in XPAP stand for "Positive Pressure". If this device has one capability, which is to restrict airflow in one, the other, or even both directions, your airway would collapse on inhale, just like the straw. Inhalation against something restricting it, whether your airway or a device, creates comparative negative pressure, and the airway collapses.

That is the exact polar opposite of what is needed. Provent can create EPAP positive pressure, but to what end? That would be as stupid as the US invading a different foreign country that had no part in the terror act that P*ssed them off in the first place. We know something that stupid could never happen.

To keep the airway from collapsing, you either need an airway not prone to collapse (not suffer from OSA), or positive air pressure. What a concept...somebody should try to invent something that does that.

The only difference in pressure this thing creates, is on exhalation. It can't possibly be of any value to the OSA patient, unless he is a major share-holder in this fly-by-night company.

You can capitalize and bold it all you like but you're missing the point. The way you are thinking about it is incorrect. The airway is pressurized by air pressure remaining in the airway to keep it from collapsing. You have OSA because the airway collapses, if the airway is pressurized, regardless of from how or where it will remain open allowing you to breathe.

In the process of breathing out you completely exhale, and there is no air or pressure left in your airway. Your airway collapses, the collapse occurs prior to the inhale, and you are unable to breathe in. That is what happens in an OSA event (not in a CA). In their situation when you are breathing out the airflow out is reduced creating pressure inside the airway so that your airway will not collapse. Once you begin breathing in you are creating more pressure in the inhale as air comes in. This keeps the airway pressurized and open.

Now I agree, it may indeed not work for everyone, you may have to have a moderate case where your airway was only partially obstructed, and not completely in order for it to work. You may also be breathing in more of your exhale in this manner. I do not know, and I do not know if it would work, all I am trying to pass along is that the concept is not flawed, it should work, and they should offer some free samples if it does to get customers who it could work for.

As an afterthought to give you a better visual representation to imagine think of it this way; Your lungs are a balloon, your airway is the part where you blow up the balloon. Blow up the balloon with a breath, release the airway, what happens? All the air exits the balloon and the airway collapses. Now take the same balloon, blow it up with a breath, and this time instead of fully letting go only allow 3/4 of the air out before blowing another breath in it. What happened? The airway remained pressurized, as all the air could not escape, and you were able to blow another breath in it. That is how they are claiming it works. I have no way to know if it is true or not, but the theory is sound.

Everyone is getting very emotional about the EPAP thing comparing it to CPAP and XPAP etc. While your doing that comparison just keep in mind that PAP simply stands for Positive Airway Pressure, as in a pressurized airway will not collapse. Don't get hung up on how it is pressurized to understand the concept here. Your thinking they are treating EPAP when in fact their description of the E portion is just to tell you they are using the exhale cycle to create PAP. Even though it may sound counterintuitive when you first look at it, it really isn't, as to whether or not it will work, that's a different story.

The thing is, why bother with a technology that might work when you've got a technology that does work. The same argument applies to dental appliances. These are treatments for people who would otherwise leave their CPAP machines in a closet.

I totally agree, for me though I was just thinking aloud that if it indeed worked it would be a nice thing to have for a power outage, or for a plane ride, or a short overnight trip. I was considering it could have a place, maybe not a permanent daily thing, but maybe as a just when needed type of thing or in case of emergency (or laziness). even if the therapy was only 80% as good I've had a few occasions where if I had that in my wallet it might have come in handy.

[TyroneShoes]

You can capitalize and bold it all you like but you're missing the point. The way you are thinking about it is incorrect. The airway is pressurized by air pressure remaining in the airway to keep it from collapsing...

...think of it this way; Your lungs are a balloon, your airway is the part where you blow up the balloon. Blow up the balloon with a breath, release the airway, what happens? All the air exits the balloon and the airway collapses. Now take the same balloon, blow it up with a breath, and this time instead of fully letting go only allow 3/4 of the air out before blowing another breath in it. What happened? The airway remained pressurized, as all the air could not escape, and you were able to blow another breath in it. That is how they are claiming it works. I have no way to know if it is true or not, but the theory is sound.

Everyone is getting very emotional about the EPAP thing comparing it to CPAP and XPAP etc. While your doing that comparison just keep in mind that PAP simply stands for Positive Airway Pressure, as in a pressurized airway will not collapse. Don't get hung up on how it is pressurized to understand the concept here. Your thinking they are treating EPAP when in fact their description of the E portion is just to tell you they are using the exhale cycle to create PAP. Even though it may sound counterintuitive when you first look at it, it really isn't, as to whether or not it will work, that's a different story.

I could not disagree more, which pains me greatly because of how much I respect this discussion and everyone participating. And I think the point that is being missed might be that the laws of physics can't be violated.

There is always pressure in your lungs, because there is always air pressure everywhere. The way breathing works is by (I can't believe I am actually explaining this) comparative pressure. Our diaphragm attempts to increase the cavity that your lungs are in when you inhale, making the pressure negative in comparison to the air pressure of the outside environment, and the principles of fluid dynamics attempt to equalize the pressure by drawing more air into that cavity, which fills your lungs. The opposite happens when you exhale. But inhalation and exhalation are always a result of the comparative pressure between what the pressure of the air is inside the cavity, and outside. If the pressure is greater and there is a path for equalization, air flows from the higher pressure area to the lower pressure area, regardless of inhale or exhale.

You have to get "hung up" on this enough to make that critical distinction, or it will not make sense. So yes, I am "hung up" on it to that degree, because that is the means to the end.

The problem with OSA is that there is a restriction to the fluid motion of the air during inhalation. Not exhalation. There is no need to help keep the airway open during exhalation, as exhalation is never the issue.

XPAP raises the comparative pressure (pressure is positive compared to the pressure inside your lungs combined with the positive pressure of inhalation) on inhale to force the airway open and keep it from collapsing; it actually "blows you up like blowing up a balloon" to do that, and blowing up a balloon is exactly the identical process of creating more positive pressure inside the balloon than the air pressure of the outside environment; the pressure from the environment during inflating a balloon or your lungs, is comparatively negative to that pressure of the air inflating the balloon, or your lungs, or the laws of physics won't allow that to happen. XPAP just tilts the balance by raising that inhalation pressure.

When you exhale, it is very common to have enough pressure to accomplish that (void the C02 by exhaling) naturally, even if you have OSA, which actually causes the pressure back into the system to be comparatively higher than the XPAP pressure, making the XPAP pressure comparatively negative.

I find the balloon analogy to be completely not valid due to the fact that it is based on air. Breathing is based on incoming air, and outgoing waste products (C02). Keeping air in the balloon to keep it pressurized to hold the exit path open is fine, but apply that to lungs, and what is keeping the airway open with a restrictor-based device such as Provent (not that it actually needs any help) is C02. You want to get rid of the C02, which is what exhalation is all about in the first place, not keep it inside your airway and lungs.

Something that restricts that from happening is not a good idea; its like breathing into a paper bag when you hyperventilate, which is done specifically to keep you from overbreathing oxygen (by increasing the percentage of C02). But unless you are in the middle of a panic attack, that is pretty worthless and probably not recommended.

And it is also invalid because the second you attempt to breathe in, the pressure is instantly comparatively lower inside your airway than outside your airway, and again, fluid dynamics causes the higher pressure outside your airway to press against it and collapse it. There is no baloon that stays inflated, even partly, once the outside pressure is comparatively higher than the inside pressure.

I am not emotional at all about this; I am completely calm. I am completely aware what PAP means, but maybe some don't quite understand what it means in relationship to the fluid dynamics involved. The "Positive" part refers to comparative pressure; positive compared to the unaided pressure normal attempts to breath in a SA patient during inhalation, and actually negative pressure compared to exhalation, which typically overcomes it (is pushed back by the higher pressure of exhalation).

During exhalation, a PAP device actually has comparatively negative pressure to both exhalation and the pressure relief valve in the mask. Exhalation has higher pressure than the XPAP system does during exhalation, or you would never be able to exhale. Period.

Provent has comparatively the same pressure during inhalation as unaided breathing, maybe even a little less. And it has positive comparative pressure during exhalation, at the point where no one wants or needs it.

I emboldened the comments for your benefit, not mine. Those emboldened comments? They were the actual point. I won't mention which of us missed that point, because I think very highly of all members here, and it really does not matter when someone misses a point. I would never try to use that as something to chide someone over, because we all miss points. Its just that this time I didn't, while others might have. That's all.

But quite honestly, this is Physics 101. You don't have to be a Rhodes Scholar to comprehend this, because it is simple. Although apparently, not quite simple enough.

[Sleepster]

Our diaphragm attempts to increase the cavity that your lungs are in when you inhale, making the pressure negative in comparison to the air pressure of the outside environment, and the principles of fluid dynamics attempt to equalize the pressure by drawing more air into that cavity, which fills your lungs.

The diaphragm moves making the pressure inside your lungs less than the pressure outside your lungs. It's the greater pressure on the outside that pushes the air into your lungs.

This may seem like it's semantics, but it does create confusion when people don't understand it. For example, when you drink through a straw you don't draw the fluid up into the straw. The atmosphere pushes the fluid up the straw.

[Galactus]

You can capitalize and bold it all you like but you're missing the point. The way you are thinking about it is incorrect. The airway is pressurized by air pressure remaining in the airway to keep it from collapsing...

...think of it this way; Your lungs are a balloon, your airway is the part where you blow up the balloon. Blow up the balloon with a breath, release the airway, what happens? All the air exits the balloon and the airway collapses. Now take the same balloon, blow it up with a breath, and this time instead of fully letting go only allow 3/4 of the air out before blowing another breath in it. What happened? The airway remained pressurized, as all the air could not escape, and you were able to blow another breath in it. That is how they are claiming it works. I have no way to know if it is true or not, but the theory is sound.

Everyone is getting very emotional about the EPAP thing comparing it to CPAP and XPAP etc. While your doing that comparison just keep in mind that PAP simply stands for Positive Airway Pressure, as in a pressurized airway will not collapse. Don't get hung up on how it is pressurized to understand the concept here. Your thinking they are treating EPAP when in fact their description of the E portion is just to tell you they are using the exhale cycle to create PAP. Even though it may sound counterintuitive when you first look at it, it really isn't, as to whether or not it will work, that's a different story.

I could not disagree more, which pains me greatly because of how much I respect this discussion and everyone participating. And I think the point that is being missed might be that the laws of physics can't be violated.

There is always pressure in your lungs, because there is always air pressure everywhere. The way breathing works is by (I can't believe I am actually explaining this) comparative pressure. Our diaphragm attempts to increase the cavity that your lungs are in when you inhale, making the pressure negative in comparison to the air pressure of the outside environment, and the principles of fluid dynamics attempt to equalize the pressure by drawing more air into that cavity, which fills your lungs. The opposite happens when you exhale. But inhalation and exhalation are always a result of the comparative pressure between what the pressure of the air is inside the cavity, and outside. If the pressure is greater and there is a path for equalization, air flows from the higher pressure area to the lower pressure area, regardless of inhale or exhale.

You have to get "hung up" on this enough to make that critical distinction, or it will not make sense. So yes, I am "hung up" on it to that degree, because that is the means to the end.

The problem with OSA is that there is a restriction to the fluid motion of the air during inhalation. Not exhalation. There is no need to help keep the airway open during exhalation, as exhalation is never the issue.

XPAP raises the comparative pressure (pressure is positive compared to the pressure inside your lungs combined with the positive pressure of inhalation) on inhale to force the airway open and keep it from collapsing; it actually "blows you up like blowing up a balloon" to do that, and blowing up a balloon is exactly the identical process of creating more positive pressure inside the balloon than the air pressure of the outside environment; the pressure from the environment during inflating a balloon or your lungs, is comparatively negative to that pressure of the air inflating the balloon, or your lungs, or the laws of physics won't allow that to happen. XPAP just tilts the balance by raising that inhalation pressure.

When you exhale, it is very common to have enough pressure to accomplish that (void the C02 by exhaling) naturally, even if you have OSA, which actually causes the pressure back into the system to be comparatively higher than the XPAP pressure, making the XPAP pressure comparatively negative.

I find the balloon analogy to be completely not valid due to the fact that it is based on air. Breathing is based on incoming air, and outgoing waste products (C02). Keeping air in the balloon to keep it pressurized to hold the exit path open is fine, but apply that to lungs, and what is keeping the airway open with a restrictor-based device such as Provent (not that it actually needs any help) is C02. You want to get rid of the C02, which is what exhalation is all about in the first place, not keep it inside your airway and lungs.

Something that restricts that from happening is not a good idea; its like breathing into a paper bag when you hyperventilate, which is done specifically to keep you from overbreathing oxygen (by increasing the percentage of C02). But unless you are in the middle of a panic attack, that is pretty worthless and probably not recommended.

And it is also invalid because the second you attempt to breathe in, the pressure is instantly comparatively lower inside your airway than outside your airway, and again, fluid dynamics causes the higher pressure outside your airway to press against it and collapse it. There is no baloon that stays inflated, even partly, once the outside pressure is comparatively higher than the inside pressure.

I am not emotional at all about this; I am completely calm. I am completely aware what PAP means, but maybe some don't quite understand what it means in relationship to the fluid dynamics involved. The "Positive" part refers to comparative pressure; positive compared to the unaided pressure normal attempts to breath in a SA patient during inhalation, and actually negative pressure compared to exhalation, which typically overcomes it (is pushed back by the higher pressure of exhalation).

During exhalation, a PAP device actually has comparatively negative pressure to both exhalation and the pressure relief valve in the mask. Exhalation has higher pressure than the XPAP system does during exhalation, or you would never be able to exhale. Period.

Provent has comparatively the same pressure during inhalation as unaided breathing, maybe even a little less. And it has positive comparative pressure during exhalation, at the point where no one wants or needs it.

I emboldened the comments for your benefit, not mine. Those emboldened comments? They were the actual point. I won't mention which of us missed that point, because I think very highly of all members here, and it really does not matter when someone misses a point. I would never try to use that as something to chide someone over, because we all miss points. Its just that this time I didn't, while others might have. That's all.

But quite honestly, this is Physics 101. You don't have to be a Rhodes Scholar to comprehend this, because it is simple. Although apparently, not quite simple enough.

Sorry but I'm not missing the point and neither is Provent, you are. I respect you and everything you said, but you have it wrong. You are thinking in terms of positive and negative pressure, and all the rest, in regards to how we breathe, and what you are saying is true. However, the Positive in PAP is not the difference in breathing. It is the difference in the soft tissue collapsing. The positivity referred to is pressure in the airway to keep it open. Whether achieved by forcing air in from the mouth or nose, or by keeping it there by not allowing the full exhale the result is the same, an open airway. It really is that simple, you can belabor the point all you want but the objective is an airway that doesn't collapse, and this will achieve that. I could possibly have the "science" or the "dynamic" wrong, but the working of it is correct.

The balloon example I gave is indeed the perfect example, and is not refuted by anything that you said. Put a Provent over the tip of the balloon and the result will be an open airway created by the pressure inside created by the limiting of exhalation with the valve they use.

Maybe the only way you'll get a scientific explanation in the manner that you want is to email them directly. They were very nice and responded very quickly so take a moment and message them, maybe they can explain it "correctly".